In therapy, what is a conflict of interest?

A large church may not allow conflict of interest if the therapist and patient are members of the congregation, but only if doing so does not make the patient uncomfortable.

There are several examples of what constitutes a conflict of interest in therapy. As in medicine, treating certain patients may not be in the best interest of the patient or therapist. A therapist, for example, would be in direct conflict when trying to counsel their own family members, just as a doctor would be unlikely to treat their immediate family’s illnesses (apart from providing some basic care as needed). The premise of most therapies is that the therapist must bring objectivity to sessions and cannot bring the same level of distance to people they know very well.

These examples are called non-sexual dual relationships and are not illegal, although not always advised. Additional non-sexual dual relationships where a conflict of interest may occur include the following:

The therapist and client have a friendship outside of therapy, where the therapist and client have a business relationship. The client and therapist live together in very small communities or belong to the same community organizations. The therapist does not only act as a therapist for a person, but can also evaluate him in some way. The latter is the case in institutions and prisons, where therapists can also make judgments about the client’s future, and such a relationship could also exist in organizations that employ a counselor for their staff to visit.

A therapist working for a company may have a conflict of interest if the company is putting the therapist in a position where he wants confidential information.

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Not all external relationships with a therapist represent a significant conflict of interest in therapy. For example, if someone attends a large church that their therapist also attends, this may be relatively harmless, although it may affect the patient’s privacy or make them feel a little uncomfortable if they meet their therapist in a social setting. The therapist is still subject to confidentiality and cannot reveal that the person is their client, which can cause some awkward moments. If a patient shares this kind of dual relationship with a therapist, it makes sense to discuss in therapy how meetings in the “outside world” should be conducted.

Having a sexual relationship with a client is a major conflict of interest.

On the other hand, not all clients want to see their therapist in the outside world and really prefer anonymity and privacy when attending therapy. They may feel more confused about discussing their problems with someone they know or are likely to meet regularly. When dual relationships exist, it is important to find out whether they have the potential to create discomfort in therapy for both therapist and client, and to decide whether the client would be better served with another therapist.

A therapist treating a couple may have a conflict of interest with respect to each partner’s confidentiality.

Another way that conflict of interest in therapy can occur is when a therapist treats more than one client from the same family. It is very important, especially in couples or family counseling, to clearly define the degree of confidentiality that each person being counseled will have. Often, therapists who work with more than one family member will state very directly that anything said by clients is not confidential to related clients. Of course, this can affect the degree of honesty that people in family or couples therapy will show. If it seems clear that a person is struggling with issues or needs greater confidentiality, the therapist may recommend that that person seek advice from a private therapist as well.

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A conflict of interest can benefit one partner, but not both.

Likewise, therapists may feel that it is conflicting to treat more than one client from the same family in private settings. As each client would have complete confidentiality but could be speculating about their family members, it can be difficult to preserve that privacy. This is especially the case when the therapist has information about each related client from other family members. Often, it is in the clients’ best interests to have their own therapist.

Professional therapy should never include sexual relations between therapist and client. This is undoubtedly a conflict of interest in therapy. Adding a sexual component to the relationship can be extremely harmful to the client, as that person is incredibly vulnerable in the therapeutic setting.

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