Are there risks in enforcing ethical boundaries in the context of psychotherapy? This question arises when considering how and why ethical red tape becomes cemented into clinical practice, especially in regard to the client-psychologist relationship.
Dennis Wendt, associate professor in McGill’s Department of Educational & Counselling Psychology, and director of the Cultural and Indigenous Research in Counselling Psychology (CIRC) lab, tackled this dilemma in a recent study published in American Psychologist. The paper critically examined the traditional ethical stance on ‘multiple relationships’ (MRs) in psychotherapy, arguing that the prevailing, individualistic, risk-averse approach is often unfit for diverse communities.
In counselling settings, MRs arise when a professional therapeutic relationship coincides with a secondary relationship, such as a friendship, business relationship, or any other personal connection to the client. Such dual relationships raise reasonable concerns around client confidentiality, power imbalances, conflicts of interest, and similar ethical concerns. As a result, professional ethical codes ban them, and industry norms reinforce this prohibition. However, in an interview with The Tribune, Wendt shared deep-rooted reservations around these ethical frameworks that lack solid scientific backing.
“The idea that therapeutic relationships are better when they’re distant, I’ve long been suspicious of that,” Wendt noted.
The paper highlights compelling testimonies from racialized practitioners, exemplifying the real-world dangers of imposing the Western ethical frameworks uniformly. One of these testimonies came from Tanya McDougall, an Indigenous practitioner who was prohibited from assessing a young relative struggling during COVID closures. The paper showcases where ethical ‘protections’ can act as a barrier to accessing important mental health support, especially in remote and underserved areas where access is already limited.
Mawdah Albatnuni, a Muslim psychotherapist, echoed similar sentiments, explaining why clients benefit from placing their therapist within the social-religious map. Hard partitions feel inauthentic and stigmatizing of spiritual practice. MRs aren’t a slippery slope; rather, they are the on-ramp to care in communities where therapy is stigmatized and credibility is relational, not purely credentialed.
Lastly, Payton Bernett offered a 2SLGBTQIA+ perspective. As a trans clinician active in Montreal’s tight-knit 2SLGBTQIA+ recovery spaces, Bernett emphasized that visibility within the community is essential for signalling shared vulnerability and protection. With these testimonials, the authors contend that community-centred care and interconnected relationships are important for trust and support, showing how rigid prohibition of MRs may be more harmful than protective in some communities.
“Rigid rules can actually make us careless about the specific dynamics in front of us,” Wendt said. “It’s just lazy ethics.”
To begin this process of systematic reform, the paper proposes applying a communal selfhood lens to promote decolonial and liberation psychologies. This includes shifting the ethical frame from an individualistic, risk-averse ideology to one that prioritizes community welfare and aligns MR decisions with antiracist and anticolonial commitments. It also means moving from presumed ‘objectivity’ to critical hermeneutics—accepting that some closeness and community engagement can surface lived contexts of oppression and rebalance power.
“Who decides?” Wendt asked. “Too often, these are top-down rules from regulatory bodies that don’t reflect the communities being served.”
This question of who actually draws these boundaries remains. Navigating these ethical boundaries is nuanced and complex, and removing the one-size-fits-all approach invites difficult questions.
Wendt argues, “We need to bring community voices to the table and let them help shape those boundaries and practices.”
In practice, the paper supports a graded-risk approach: If an overlap is low-risk, non-coercive, and clearly helpful, name it, and document it with the client. Policies would move from blanket bans to a simple context-based checklist, taking into account power dynamics, client preferences, service scarcity, and a transparency plan.
Ultimately, Wendt and others ask whether the minimization of MRs in clinical contexts can, in and of itself, be ethically questionable. In minority groups, and even in the population at large, understanding the self as embedded in community instead of existing in silo may be the key to improving access, trust, and credibility. By stripping down the dogmatic thinking around client-practitioner relationships, we can take sure steps towards democratizing and destigmatizing care.
