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Principle 7: Dual Relationships - some considerations

October 28, 2009
by Dr. Anne
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A credentialed counselor under NAADAC (A) learns from a femaleclient (C) that she is living with a male NCACII counselor (B) working in another office of the same agency. A is a friend of B and has attended parties at the his home; a comparison of addresses confirmed that they are the same. After gathering the information, A reported the information to her supervisor who then met with the client. The supervisor also compared addresses and asked C to describe the person with whom she lives. All the information gathered indicated that a dual relationship is present. However, the supervisor who does not want to complete the required paper work decided that the information from A and C is hearsay and therefore there is no need to report a breach of the NAADAC Code of Ethics or file a grievance with the state. The NAADAC Code of Ethics specifically states that counselors shall not engage in sexual behavior with current or former clients. Where does living in the same place fit into this principle? Since a female client and male counselor are living at the same address, do we automatically assume that a sexual relationship is present? What is the responsibility of the supervisor who does not want to make the report? What is the responsibility of counselor A in this situation? In the treatment setting, how do we teach new counselors to uphold ethical and legal standards when the supervisors ignore these standards?


In the case of a rural area, where accessible reatment was not otherwise available, the disclosure to the agency should be made by both the counselor and the client pre-admission. The agency could then work with the counselor, the client and other staff to keep their relationship separate from his work duties and her treatment and to seal the chart. Since the counselor works at a different location, that makes it easier for all. Things become ven more awkward should the client need to disclose sensitive info about the counselor. Pressure fals to the counselor to put the client's needs first and remain in integrity.

Further boundaries would need to be established should the need for family or couple counseling become evident. While it is awkward and challenging for all for someone to participate in a treatment experience where he or she works, it can ethically be done as long as it is handled out in the open and boundaries are clearly observed by all.

Mavis Humes Baird, CAC, CASAC, CMAT-S, CSAT-S, ICADC

Read Mavis's chapter in MENDING A SHATTERED HEART, now available from Gentle Path Press and Amazon!
Read Mavis's section on sex addiction in The Complete Idiot's Guide to Bipolar Disorder, now available on Amazon!
View Mavis' interviews with Dr Jon LaPook on Sex Addiction and Online Pornography and read their blogs on the disease concept at!

Principle 7 states "I understand that I must seek to nurture and support the development of a relationship of equals rather than to take unfair advantage of individuals who are vulnerable and exploitable."
It goes on to ban sexual behavior with current or former clients and state that "Because a relationship begins with a power differential, I shall not exploit relationships with current or former clients for personal gain, including social or business relationships."
I have several comments:
First, while there is a possibility that the relationship is not sexual, and the relationship may have started without a power differential, the present situation requires full disclosure by counselor B, and the disclosure should have been made at or before admission. If there was nothing to hide, why not disclose it.
Secondly, while technically, C is not a client or former client of B, the fact that he is now living with a client of his agency immediately changes the power differential in the relationship. It will certainly change the view of the counselor and the client in the eyes of the agency's other clients (and probably staff) as soon as the relationship becomes known, and it will become known.
Third, I have difficulty believing that the nature of the relationship wasn't explored more thoroughly at the time client C disclosed her living arrangements, given the thoroughness that A showed in investigating addresses etc.
Finally, the supervisor's attitude is unfortunately far too common. But the supervisor has an ethical, and managerial responsibility to deal with the situation, either alone or with B's supervisor. This may have been thoroughly discussed at the other office, or B may be keeping it secret in that office as well. If the latter is true, then B needs to be reminded of his responsibilities to the agency and to other clients as well. And B's actions need to be reported for an ethical review.
Dave Felt

The problem seems to be that A and B work at the same agency, correct? In other words, it would have been solved if the Client was receiving treatment at another facility (where B didn't work). Because otherwise, say B and C are marriedsurely that doesn't mean that C can never ethically receive treatment anywhere? So if C transfers to a new agency, the issue will be resolved (provided that B doesn't counsel her). Of course, in rural environments (or because of funding problems), it may not always be possible for someone to transfer facilities. I'm not sure what to do then ...

Dr. Anne

Anne S. Hatcher, EdD, CAC III, NCAC II, is Co-Director of the Center for Addiction Studies at...

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