Abstract

The Delphi methodology was used to explore the underlying ethics of nonsexual dual relationship. The goal was to clarify the definitions of appropriate and inappropriate dual relationships, to generate a list that experts in the field endorse as harms and benefits from nonsexual dual relationships, and to generate a list that experts in the field endorse as causes of harms and benefits from nonsexual dual relationships. These three goals are in response to three obstacles to consensus in the debate on the ethics of nonsexual dual relationships. Clarifying the definition of dual relationship, the harms and benefits of dual relationships, and the causes of these harms and benefits will shift the debate towards discussing the underlying ethical issues of nonsexual dual relationships and developing guidelines to assist therapists faced with negotiating dual relationships. This study makes use of Role Theory as a framework for developing guidelines for therapists. Three open-ended questions were posed in Delphi I to invited panelists. Delphi II consisted of follow-up phone or email contact requesting clarification of Delphi I responses. Delphi III asked 29 panelists to rank items generated from Delphi I and II on a seven-point Likert scale. The researcher compiled a final profile of items from the responses to Delphi III based on median scores and interquartile ranges. The panel agreed on far more definitions of inappropriate dual relationships than appropriate dual relationships. There were no items of agreement for benefits or causes of benefits from dual relationships. The term dual relationship carries a negative connotation affecting how panelists responded to the study. The underlying ethics of dual relationships are related to how therapists understand the role of the therapist and the nature of the therapeutic relationship. Directions for future research as well as implications for training therapists and writing the code of ethics are discussed.