When your clients are in a close relationship with each other

When your clients are in a close relationship with each other

As psychologists we are often asked to work with family members, friends or loved ones of our existing clients. Clients who have found therapy with you to be beneficial may want to recommend you to people close to them because they trust you and can vouch for the service you offer. Why is it generally not recommended to see members of the same family or clients who are in a close relationship – and where do you draw the line?

Seeing more than one family member or clients who are flatmates or close friends can create more challenges than benefits for clients. For instance, it can be very difficult for the treating psychologist to prevent the relationship with one client from influencing the psychologist’s relationship with the other. When clients are family members this is especially the case, as your knowledge of the family dynamics could impair your objectivity. When clients are close friends, their relationship may sour down the track and potentially become a focus of therapy.

Will they be able to trust you and feel comfortable talking with you about how they feel about their friend? What if what one client tells you something about their friend, partner or family member that influences how you think and feel about your other client? Another challenge is maintaining confidentiality; it is often too difficult to remember what each client has told you and you may inadvertently break confidentiality by unintentionally disclosing details to friends or family members. This leaves you open to complaints being made against you for breaking confidentiality and not maintaining appropriate professional boundaries. Increasingly, seeing multiple members of a family is viewed as a boundary violation and can incur disciplinary action from AHPRA. 

Even if the first client is no longer consulting the psychologist, the experience of having worked with them – and the resultant knowledge about that client and family processes – can interfere with the psychologist’s objectivity in providing a service to the other. If possible, providing individual treatment with more than one family member or clients in a close relationship should be avoided.

What should you do if you find out two of your clients are related or in a relationship?

In this case, considering the challenges raised above, if you do not feel able to manage the situation and deliver a service competently to both clients, you may need to consider terminating with one or both clients. However, you must do so without breaking confidentiality. You can inform your client that you can no longer see them for professional reasons, without disclosing the exact nature of the conflict of interest.

The APS Ethical Guidelines for managing professional boundaries and multiple relationships is a key resource that has been developed to assist members to address boundary issues and multiple relationships.