Exploring Dual Relationships and Boundary Crossings in Ethical Clinical Practice

CE Course Description

Dual relationships in behavioral health practice refer to any situations where multiple roles exist between a therapist and a client. Examples of dual relationships include when the client is also a student, friend, family member, employee, or business associate of the therapist. Boundary crossings and violations may occur in situations where dual relationships exist.  While boundary crossings may be unavoidable and harmless in certain situations, such as when the clinician and client both live in a small community and see each other away from the therapeutic setting, boundary violations are those that are harmful and exploitative.

Author: Kimberley Fortin, LCSW-R

CE Course Objectives

1. Demonstrate an understanding of the legal, ethical, and clinical issues involved with dual relationships.
2. Recognize the difference between boundary crossing and boundary violation.
3. Identify criteria for evaluating dual relationships and boundaries. 
4. Review case studies exploring dual relationships and boundary crossings.

CE Course Outline:

Section 1: Introduction (5 minutes)

1. Overview of course objectives and topics (5 minutes)

Section 2: Boundaries, Boundary Crossings & Boundary Violations (7 minutes)

1. Definitions and importance of boundaries in professional settings(7 minutes)

Section 3: Dual Relationships (7 minutes)

1. Understanding dual relationships and their implications(7 minutes)

Section 4: Boundaries and Technology (6 minutes)

1. Exploring boundary issues in digital communication (6 minutes)

Section 5: Professional Associations’ Stance on Dual Relationships (5 minutes)

1. Summary of guidelines from key professional organizations (5 minutes)

Section 6: Decision-Making Process for Dual Relationships (8 minutes)

1. Steps and considerations for ethical decision-making (8 minutes)

Section 7: Clear Boundaries to Avoid Unethical Behavior (6 minutes)

1. Strategies for maintaining professional boundaries (6 minutes)

Section 8: Unethical Dual Relationships & Sexual Misconduct (5 minutes)

1. Discussing potential consequences and examples (5 minutes)

Section 9: Addressing Attraction to Clients (5 minutes)

1. Managing personal feelings within a professional context (5 minutes)

Section 10: Reporting Violations (5 minutes)

1. Procedures for reporting unethical behavior (5 minutes)

Section 11: Additional Considerations (3 minutes)

1. Brief mention of other factors influencing boundary management (3 minutes)

Section 12: Case Studies (8 minutes)

1. Case Study 1 (3 minutes)
2. Case Analysis 1 (2 minutes)
3. Case Study 2 (3 minutes)
4. Case Analysis 2 (2 minutes)

Section 13: Conclusion (3 minutes)

1. Recap of key points and final thoughts (3 minutes)

Additional Resources

1. References (Not timed) 

Total Time: 60 minutes (1 hour)
Course Level: Introductory