Commitment to self or commitment to client?

12/10/2010

You are a social worker who works in a family service agency. You have been working with a family (father, mother, two kids) for over a year. Much of your work has been to empower the mother and have recommended she consider attending Al-Anon to learn more about dealing with her husband's drinking behavior. You have also been attending a local Al-Anon group for quite a while and have established a support network through that group for yourself. Lo and behold when you attend the weekly group who walks in but your client! Yes, you suggested Al-Anon to her, but you never expected her to show up in YOUR group! You feel uncomfortable sharing like you usually do. What do you do?

6 Comments

lzoll

12/10/2010 03:56:07 am

Wait for them to make the first move. Let them approach you. They might not want others to know that they know you. Talk about it in the next session.

OR..Just tell them you are there for the coffee!!!!!!

Nova Star

12/30/2010 09:03:03 am

I think I would have anticipated this beforehand, and would have asked which group she was likely to attend. If she said it was my group, I would have let her know that I sometimes attended that group as well, and worked out with her how we would respond to one another if we appeared in the same one.

Jonathan Singer link

1/7/2011 02:26:20 am

Avoiding dual-relationships is part of social work's code of ethics. If you and your client attend the same Al-Anon meeting you will most likely develop a dual relationship, which is a violation of our code of ethics.

In the moment you would respect confidentiality and let her make contact if she so choses.

Next I would staff with your supervisor or in peer-supervision to make sure you are clear on your professional responsibilities. Talk about it with your therapist if you've been triggered. Once you're clear then you can address your client:

In the long-run I think the question is not, "how can you attend the same meeting," but rather, "what is the best way to work out attending the same meeting but on different days, or different meetings without your client feeling like she is being 'forced' to leave the meeting you recommended that she attend?" I agree with Nova Star that talking about groups beforehand would have been a good idea - particularly if you live in a rural area with a limited number of Al-Anon groups. Since you didn't do that I would suggest contacting her prior to your next session to talk about this. I wouldn't wait until the next session because then you're dealing with your issue on her dime. Since this is your issue you need to deal with it on your dime. I would take the lead in the conversation. Talk about how your discomfort is associated with your personal needs and your professional obligations (specify the code of ethics dual-relationship issues), but not her personally. Then I'd do the standard therapy thing by letting her know that just as you had your experience, you are sure she had her own experience and you'd like to hear about it. Then process her experience, including how she decided on that group.

After she's heard you and visa versa, then I'd be honest with her about your personal needs (e.g. I need that group, or it is convenient but I've been to others that would work just as well - coffee is lousy everywhere), and her needs (e.g. it was my first time so I'm happy going elsewhere.). At the end of the conversation you need to come up with either different groups or alternating visits.

In her next session acknowledge the good work she did and how she helped you grow as a therapist by reminding you to be clear about boundaries in and outside of sessions. Be clear that your needs have been met and that you want to make sure this session focuses on her goals for treatment.

TERRY DREW KARANEN link

1/31/2011 10:13:58 am

Jonathan Singer was one of my mentors (without his knowledge!) during my MSW studies at Temple and I have the utmost respect for him. Having said that, I must disagree with what I consider to be his rather cut-n-dry, black-n-white explanation.

The NASW Code is NOT a rule book, it is a guideline. It's all well and good to say the therapist should go to another meeting, but what if this is not in Center City Philly, but out in the Central PA rurals, where the next meeting might be 125 miles away?

Dual relationships should be avoided, but they can and do exist outside of the perfect world of codes and classes. When that happens we must each decide how to maintain our professional ethics while dealing with the realities of the situation. Nova Star makes a good point (particularly if this WAS a rural situation): Think ahead! If we are counseling clients in areas in which we are personally affected, then it behooves us to take a step back and realize in advance what not only might happen, but very well could happen. The ethical dilemma presented would be a hard lesson learned, but hopefully not one that the practitioner would repeat!

Jonathan Singer link

1/31/2011 11:46:55 pm

Terry - I'm honored that I was doing something worthy of your respect during your time at Temple. As I read your response, I don't think you and I are in disagreement. We agree that dual relationships should be avoided when possible. We also agree that in some settings (e.g. rural, small religious communities, etc), dual relationships are inevitable. Thinking ahead and learning from ones mistakes is the hallmark of a master clinician. I agree with all of that.

My response was mostly a detailed explanation of what ethical issues would need to be addressed as you dealt the consequences of not planning ahead. It fleshed out the question of "how can I clean up this mess without violating the code of ethics?" 1) staff with your supervisor; 2) do not charge clients for sessions if you are not addressing their clinical concerns; 3) establish protocol in which your client's confidentiality is maintained. Above all, I think this situation could provide a great opportunity for strengthening the therapeutic relationship and making progress towards your client's goals.

Terry Karanen link

2/1/2011 04:36:59 am

Jonathan, Just to clarify, you are STILL doing something worthy of my respect! There's no way ANY graduate course can cover everything the student wants to know and having your podcasts to review helps fill in many of the blanks for me. Not blanks caused by Temple, mind you...just "my" blanks! LOL!
Thanks for all you do!

Commitment to self or commitment to client?

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