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Nov 28, 2022

It’s the Lack of Thought That Counts: Ethical Decision Making in Dual Relationships

Curt and Katie chat about dual relationships. We talk about the types of dual relationships, how often therapists get in trouble for these types of relationships, how to manage dual relationships, and the ethical decision making process to go through to decide whether to engage in a dual relationship. This is a law and ethics continuing education podcourse.

Transcripts for this episode will be available at!

In this podcast episode we talk about ethical decision making to navigate dual relationships

We take a deeper dive into the complex relationships that we can have with our clients, our supervisors and our supervisees.

What are dual relationships?

  • Therapists know a lot about a very specific dual relationship: having sex with your clients, which is not acceptable
  • There are many different types of potential dual relationships (we talk about the definitions of each type)
  • The different hats we may wear with clients and colleagues

How do you manage a dual relationship?

  • Open conversations
  • Outside neutral party facilitating the transition in the relationship
  • The assessment of benefit or harm, whether there is coercion
  • Exploring how culture interacts with these types of relationships

How often are therapists getting in trouble for dual relationships?

  • About 1/3 of complaints are due to sexual relationships with clients
  • Other types of complaints include conflict of interest, non-sexual, or not described
  • Concerns in rural areas are actually less dual relationships than incompetence
  • Most complaints happen after the relationships have ended

Why do therapists engage in harmful dual relationships?

“Oftentimes [in predatory dual relationships] there is a conspiratorial element of it – if the client knows (hey, we're stepping across the line) or there is a very manipulative element if the therapist is framing it as this is good for you. And so, once there's a rupture or an end to the relationship and you start talking about, oh, my therapist did this and people are like "what?!?!", I think it's that element of [realizing] I've been wronged by my therapist, and let me go and tell the world that they did this thing.” – Katie Vernoy, LMFT

  • Boundary slips
  • Manipulation, intellectualization
  • Not a thoughtful process
  • Not an examination of bias
  • Therapists going through an intuitive process versus a formal decision-making process

What is a strong formal process for ethical decision making?

“One of the calls to action, as far as any other ethics professors: really reinforcing the importance of an ethical decision-making model, because that is what the licensing boards and the ethics committees want you to do. If you go through a good model, and even if you end up with slightly the wrong answer, if you've put good thought into it, it at least formalizes the process and gives people an insight into how you're thinking about things.” – Curt Widhalm, LMFT

  • Pope and Vasquez have a 17 Step Process for ethical decision making
  • Deeply examining the question, the impact, and exploring any bias
  • Identifying and understanding relevant laws and ethics
  • Consultation, documentation, and evaluation
  • We walk through a specific dual relationship question: what happens if your client refers a friend and colleague to you? How do you decide whether to take the client or not?


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Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide

Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!

 Once you’ve listened to this episode, to get CE credit you just need to go to, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed - you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out

You can find this full course (including handouts and resources) here:

Continuing Education Approvals:

When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information

CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit.

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Pope: Steps in Ethical Decision Making

California Association of Marriage and Family Therapists (CAMFT) Code of Ethics


References mentioned in this continuing education podcast:

Boland-Prom, K. Johnson, J. & Gunaganti, G. S. (2015) Sanctioning Patterns of Social Work Licensing Boards, 2000–2009, Journal of Human Behavior in the Social Environment, 25:2, 126-136, DOI: 10.1080/10911359.2014.947464

Brownlee, K., LeBlanc, H., Halverson, G., Piché, T., & Brazeau, J. (2019). Exploring self-reflection in dual relationship decision-making. Journal of Social Work, 19(5), 629–641.

Pearson, B., & Piazza, N. (1997). Classification of dual relationships in the helping professions. Counselor Education and Supervision, 37(2), 89-99.

Pope, K. S., Vasquez, M. J. T., Chavez-Dueñas, N. Y., & Adames, H. Y. (2021). Ethics in Psychotherapy and Counseling: A Practical Guide (6th ed.). Wiley.

Wilkinson, Tyler, Dannielle Smith, and Ramona Wimberly. "Trends in ethical complaints leading to professional counseling licensing boards disciplinary actions." Journal of Counseling & Development 97.1 (2019): 98-104.

*The full reference list can be found in the course on our learning platform.


Relevant Episodes of MTSG Podcast:

Dual Relationships: Pros and Cons

Negotiating Sliding Scale

Therapists Are Not Robots: How we can show humanity in the room

Therapy as a Political Act: An interview with Dr. Travis Heath

What You Should Know About Walk and Talk and Other Non-Traditional Counseling Settings Part 1 and Part 2

Therapy with an Audience: An interview with Doug Friedman, LCSW

Small Town Sex Therapist: An interview with Jeanette Tolson, LCSW, CASAC

Whole Person Therapist Episodes

Therapy for Executives and Emerging Leaders

Who we are:

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at:

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at:

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Voice Over by DW McCann

Music by Crystal Grooms Mangano