Integrity Respect Values Ethics
by Allan Barsky, JD, MSW, PhD
As social workers, we know that we should generally avoid dual (or multiple) relationships, particularly when there are risks of exploitation or harm to clients (NASW Code of Ethics, Standards 1.06(a) and (c)). We should also avoid dual relationships with students, supervisees, and others who may be in vulnerable situations that are due to power differentials and personal circumstances. Avoiding dual relationships supports social work values such as honesty, integrity, and fidelity (dedication to serve people in need). In addition, we should be aware that if we engage in dual relationships, then we are responsible for taking steps to minimize any conflicts of interests (Standard 1.06(d)). Because our relationships with clients are based on trust, we may bear responsibility for any harm that befalls our clients as a result of our dual relationships and conflicts of interest.
Although avoiding dual relationships is often the most prudent course of action, the NASW Code does not place an outright ban on dual relationships. It recognizes that some dual relationships may be unavoidable, unintentional, or even desirable. In a small town or a community, for instance, it may be unreasonable to expect that workers would never see clients outside their professional capacities; workers may develop relationships with clients through interactions in their neighborhoods, schools, houses of worship, cultural organizations, online social networking, or other community activities. If you are the sole social worker in a small, remote town, then refusing to serve particular clients because of prior relationships could mean that those clients would be denied access to social work services.
As social work pioneer Jane Addams noted, there are many benefits of living in the same communities as the people we serve. When we live and work in the same communities as the people we serve, we can get to know their needs, interests, wishes, and hopes in a more direct and insightful manner. The question, then, is not simply how to avoid dual relationships, but also, how we should manage potential conflicts of interest when we anticipate engaging in dual relationships. In this article, let’s consider the different types of dual relationships and then explore how to manage risks in anticipation of entering future dual relationships.
Types of Dual Relationships
Dual relationships may be “concurrent” or “sequential.” In concurrent dual relationships, we have two or more relationships with our clients at the same time. If you were to act as a real estate agent for one of your current social work clients, for instance, you would be engaging in a concurrent dual relationship. If you conducted a psychosocial assessment with a friend, you would be engaging in a concurrent dual relationship. Sequential dual relationships are relationships that occur one after the other. If you had a sexual relationship with a former client, for instance, you would be engaging in a sequential dual relationship. In social work, we often abide by the motto, “Once a client, always a client.” Accordingly, the NASW Code prohibits sexual relationships with both current and former clients (Standard 1.09). The rationale for prohibiting sexual relationships with former clients is that clients may continue to be vulnerable even after they terminate their professional social work relationships.
The NASW Code does not have such stringent prohibitions against other types of relationships with former clients. For instance, there is no absolute ban on engaging in business transactions with former clients. Still, we should be careful about potential conflicts of interest with both current and former clients. Assume that you hire a former client to babysit your children. Even if you treat the client kindly and fairly as a babysitter, others may perceive that you are taking advantage of the former client. If troubles arise during babysitting, the former client may also claim that you exploited your role as a social worker.
Dual relationships may be “intentional” or “unintentional.” In an intentional dual relationship, we know that we are entering into two or more relationships with the same person. In an unintentional dual relationship, we have not planned to enter into the second relationship with the client; the dual relationship arises as a result of unforeseen or accidental circumstances. Assume, for instance, that you are facilitating a group for people with anxiety and, unbeknown to you, one of your group members starts to date your adult child. At this point, you need to decide how to manage the potential conflicts of interest that arise given this dual relationship. Even though the dual relationship is unintentional, you and the client may decide to terminate your social work services. As with other forms of dual relationships, you do not want potential biases from nonprofessional relationships to interfere with your professional role as a social worker. The client may be better served by a professional who does not have a dual relationship.
“Anticipatory” dual relationships arise when we currently have one type of relationship and we foresee the possibility of engaging in a second relationship that could raise conflict-of-interest issues. Let’s consider four examples of anticipatory dual relationships:
- A social worker, Albert, is thinking about asking a client (who is a licensed attorney) for legal advice.
- Prof. Batiste currently teaches a social work student in a class and is thinking about hiring that student as a research assistant.
- An addiction treatment program plans to hire a former client (Claire) as a case aide for the program.
- A gender-queer social work student (Deon) helps their field agency develop a funding proposal for a program for gender-queer clients that could hire Deon upon their graduation.
In each of these situations, we could avoid potential conflicts of interest by not engaging in the second relationship. In Situation 1, for instance, Albert could simply hire another person to provide legal advice. This option could be the safest one for the social worker and the client. Why enter into a dual relationship when the worker has different options for legal advice? In the other situations, however, there may be ethically justifiable reasons to enter into the second relationship. In Situation 2, Prof. Batiste can benefit from the student’s assistance, and the student can benefit from both the research experience and the salary for being a research assistant. Within university contexts, professors are encouraged to hire students, given these mutual benefits. Universities also benefit, as research assistantships can be used to attract and retain students in their programs. If the risks of exploitation or harm to students are minimal, then arguably, hiring students leads to positive consequences for everyone involved. The question arises, however, about how to identify and manage potential risks from entering into the anticipated second relationship.
Identifying and Managing Potential Risks
When assessing the ethicality of entering an anticipated second relationship, we need to consider the possible benefits and risks. This assessment should include both probable and less likely benefits and risks. By identifying all benefits and risks, we are in a better position to make informed decisions, including how to minimize risks. In Situation 2, for instance, one risk is that other students may suspect that the professor is favoring the student hired as a research assistant. To manage this risk, the professor could wait until the course is over and then decide which student to hire.
Situation 3 arguably entails greater risks than Situation 2, given that a client in an addiction treatment program may be psychologically vulnerable. Even though the program is not planning to hire Claire until she completes the program, she may continue to be at risk of relapse and may need further services. Prudent practice suggests that the program should not hire Claire until she has a significant period of abstinence upon return to the community. The hiring staff might also assess Claire’s situation to ensure that she is ready and able to act as a case aide. If she has challenges maintaining appropriate boundaries, for instance, then she might be prone to oversharing or overidentifying with future clients. In addition to assessing Claire’s ability to serve as a case aide, the program can also reduce risks by providing her with proper training and supervision. She needs to understand, for instance, how her role as a case aide is different from her prior role as a client. If she has relationships with other clients at the program, then she will need to know how to navigate future interactions with them in her work capacity. Claire may bring many strengths to her role as a case aide. Still, she may benefit from support in transitioning to her new role.
In Case 4, the situation does not raise risks to clients per se. A potential conflict of interest arises, however, because Deon is developing a funding proposal that may lead the agency to hiring Deon. Some people might view Deon’s involvement in the proposal as self-serving. Consider whether the funding proposal is for the good of gender-queer clients or whether it is primarily a vehicle for Deon to get a job. Deon and the agency may have good motivations; still, they may need to deal with perceptions about conflicting interests. One of the primary methods of dealing with the potential conflict is transparency. Deon and the agency should be open and honest about the possibility that they may use the new funding to hire Deon. They are not trying to hide anything. In the funding proposal, they could identify Deon as the social worker to be hired for this new position, highlighting their relevant skills and knowledge. Alternatively, the funding proposal could provide for a competitive and open hiring process. With this alternative, the program would need to ensure that the hiring process truly is open and fair. Further, Deon might want to create some social distance between themself and the people conducting the hiring process. Ideally, the hiring committee is seen as a body that makes hiring decisions based on the merits rather than based on prior relationships or friendships.
Conclusion
When anticipating the possibility of entering into a dual relationship, we need to consider a number of factors, including the potential conflicts of interest and risks to the people we are serving. In addition, we should consider what the NASW Code of Ethics, regulations, laws, and agency policies say regarding the types of dual relationships that we are considering. We have a responsibility to minimize the risks of dual relationships, even when entering dual relationships that are unavoidable. Strategies for managing risks include:
- seeking consultation or supervision about how to handle the risks,
- documenting the ethical justifications for engaging in a dual relationship,
- offering clients different options for services,
- ensuring that the client is aware of the potential conflict of interest and provides informed consent to services, and
- monitoring services for any risks of harm to the patient or others and acting in a timely manner to address such risks.
Entering dual relationships with clients may pose a number of risks to clients, including the risks of emotional, financial, and social harm. As social workers, we need to be vigilant about our integrity and professional responsibilities to clients and others in vulnerable situations. Doing what is right for a potential client may mean referring that client to another professional for assistance. By anticipating potential dual relationships and conflicts of interest, we can plan how to navigate the ethical issues rather than simply reacting to problems after they arise.
Allan Barsky, PhD, JD, MSW, is Professor of Social Work at Florida Atlantic University and author of Social Work Values and Ethics (Oxford University Press).
The views expressed in this article do not necessarily represent the views of any of the organizations to which the author is affiliated, or the views of The New Social Worker magazine or White Hat Communications.
*Dr. Barsky thanks Dr. Heather Thompson, Director of the Sandler School of Social Work, for suggesting the idea of “anticipatory dual relationships” for this article.