Therapy Tidbits – March/April 2019

The latest volume in our Therapy Tidbits series is here:

Therapy Tidbits – March/April 2019 is a 1-hour online continuing education (CE) course comprised of select articles from the March/April 2019 issue of The National Psychologist.

Therapy Tidbits – March/April 2019 is a 1-hour online continuing education (CE) course comprised of select articles from the March/April 2019 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep psychologists informed about practice issues. The articles included in this course are:

  • Major Push Seeks to Expand RxP Jurisdictions – Discusses the efforts of the RxP movement, including challenges along the path to prescription authority for psychologists.
  • Controversy Swirls around APA Guidelines on Men, Boys – Explains the purpose of the APA guidelines, and the criticism they have undergone.
  • PSYPACT Almost Ready to Take Effect – Introduces what PSYPACT is and explains what needs to happen for it to commence.
  • Retirees are Untapped Market for Psychologists – Explains how psychologists can help those planning for retirement, and those who are in process of it.
  • Integrated Care is Future for Psychology – Acknowledges the changing healthcare platform and provides suggestions for future psychologists to excel in integrated care.
  • Rule-Making, State Boards Reshaping Psychology – Questions the TSBEP decision to grant unsupervised practice to masters-level Licensed Psychological Associates (LPAs).
  • Pain Management Demands Attention to Mental Health – Discusses how psychologists can be integral in ending the war on prescription drug abuse.
  • Choosing Interpreter Requires Considerations – Provides points to consider when choosing an interpreter for use in clinical practice.
  • Practicalities in Animal Assisted Therapy – Provides practical, experience-based advise on including animals in your practice with patients.

Course #11-26 | 2019 | 19 pages | 10 posttest questions

  • CE Credit: 1 Hour
  • Target Audience: Psychologists
  • Learning Level: Introductory
  • Course Type: Online

CE INFORMATION

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for this program and its content. Professional Development Resources is also approved by the Florida Board of Psychology and the Office of School Psychology and is CE Broker compliant (#50-1635).

COURSE DIRECTIONS

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You’ll have 3 years from purchase date to complete for credit.  Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Georgia State Board of Occupational Therapy; the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135); the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Earn CE Wherever YOU Love to Be!

Ethics and Law CE for Florida Psychologists

New Online CE Course @pdresources.org

Ethics and Law in Florida PsychologyEthics and Law in Florida Psychology is a 3-hour online continuing education (CE) course that meets the ethics and law requirement for license renewal of Florida psychologists.

The purpose of this course is to ensure that Florida-licensed psychologists are fully aware of the ethical and legal privileges and constraints under which they are licensed to practice in the State of Florida. It provides the opportunity for a comprehensive reading of the APA Code of Ethics and the three sets of statutes and rules governing the practice of psychology in Florida. Completing this course will fulfill the requirement that licensed psychologists in Florida complete each biennial renewal period three hours of continuing education on professional ethics and Florida statutes and rules affecting the practice of psychology.

Case examples are included in this course for the purpose of illustrating the types of practices errors that occur in real life and their real consequences for clients. They are actual cases found in the official public records of the Florida Department of Health Division of Medical Quality Assurance. Licensing board complaints are a matter of public record. Nevertheless, the case reports outlined are included only for the purpose of illustrating the kinds of errors that occur in the practice of psychology and therefore contain no specifics like names, dates, or case numbers.

Course #31-05 | 2018 | 55 pages | 20 posttest questions

Courses also required for renewal of Florida psychologists:

Florida-licensed psychologists are required to complete a total of 40 hours of continuing education during each 2-year renewal cycle. All 40 hours may be obtained through online courses provided by APA-approved sponsors. The current license renewal cycle will end on May 31, 2018.

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document).

Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Contact Hour or CEU?

By Gina Ulery @pdresources

Contact Hour or CEU?

Contact Hour or CEU?The definitions of contact hour and continuing education unit, or CEU – and the difference between the two – are often misunderstood.

Some professions (such as Occupational Therapy and Speech-Language Pathology) prefer the term CEU. Most mental health professions (Psychology, Social Work, Marriage & Family Therapy, etc.), however, use CE contact hour or credit hour.

Although the terms seem interchangeable, they have different meanings. One CE contact hour is equal to 50-60 minutes of a learning activity, depending on jurisdictional requirements. One CEU is equal to 10 contact hours – meaning that one contact hour is equal to .1 (1/10 or one tenth) of a CEU.

So if your particular licensing board requires that you complete 3 CEUs per renewal cycle, that can be interpreted as 30 contact hours required.

It would be much simpler if all accrediting bodies and licensing boards could agree upon one standard term, but what fun would that be? 🙂

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. Our purpose is to provide high quality online continuing education (CE) courses on topics relevant to members of the healthcare professions we serve. We strive to keep our carbon footprint small by being completely paperless, allowing telecommuting, recycling, using energy-efficient lights and powering off electronics when not in use. We provide online CE courses to allow our colleagues to earn credits from the comfort of their own home or office so we can all be as green as possible (no paper, no shipping or handling, no travel expenses, etc.). Sustainability isn’t part of our work – it’s a guiding influence for all of our work.

We are approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within one week of completion).

Earn CE Wherever YOU Love to Be.

 

 

The Fun and Folly of Manifesting Joy

By Bernard De Koven

Manifesting JoySo, how do you know when someone is being or feeling playful? Hmmm?

When J. Nina Lieberman was doing the research that led to her dissertation on Playfulness: Its Relationship to Imagination and Creativity, she arrived at a concept she called “Manifest joy.” Joy made manifest. Made visible. Audible. Undeniably present.

I read and re-read her book, and as remarkable as much of her findings proved to be, nothing, for me, was more remarkable than those two words: manifest joy. Except, perhaps, for two more, which I mention later in this article.

They are solid insights. They are observable, researchable, and they touch something deeper than all that. They substantiate something profoundly spiritual. Something in life that validates living itself. They are poetic, is what they are. In a research paper.

We see joy manifest in those we love. I think, in many ways, it is why we love them.

The majority of joy-manifesters seem to be children and other furry beings. For adults, it takes a village.
It is somewhat more difficult for us to find these moments of manifest joy in our adult world. We find it some times in sports, but rarely, and only by the winners. More often, perhaps, among the spectators. But again, only by some, and only when their side has scored. We see it much more often in informal sports, pick-up games, block parties, picnics, outdoor concerts, and the like. But even then, in retrospect, at least, there’s something extraordinary about these events, something wonderfully, and unfortunately unusual.

Bubbling Effervescence

The term “manifest joy” got me dreaming – rethinking my many encounters with communities of players in terms of what I actually experience about their behavior that has kept me going all these many years.

There was another term that also got me dreaming. She used it to help us understand manifest joy specifically in connection to playfulness.

She writes:

Perhaps a good way to start is to concretize the individual at the various age levels. We have the kindergartner who skips, hops, and jumps, who is likely to smile more readily, so glint-in-the-eye behavior, move easily among his or her peers, and be more imaginative in labeling his or her play products. The playful high school student seems to be two different types: One is physically alert, enthusiastic, and intellectually curious; the other is physically mobile, spontaneously joyful, humorous, group-oriented, and friendly…

If we were faced with stating the results in a nutshell, we would be justified in saying that what has been labeled “bubbling effervescence” in the adolescent is the carryover from the kindergartener’s all-pervasive playfulness.

“Bubbling effervescence.” Yes, yes, joy manifest, playfulness incarnate.

Source: https://www.psychologytoday.com/blog/having-fun/201605/manifest-joy

Five Simple Things Psychologists Wish Their Patients Would Do

From The Huffington Post

5 Things Psychologists Wish Their Patients Would DoTherapists want the best possible outcomes for their patients, and surprisingly there are about 5 simple common things they would like to see happen.

Everyday Health asked five psychologists to share their lists of things they would like to see their patients do.

They were all pretty consistent, making frequent references to mindfulness, self-compassion, self-awareness, healthy lifestyle adjustments, and work on positive relationships. Here’s their advice:

 

1. Practice mindfulness

Mindfulness is not an exotic technique: It’s simply about being present in the moment without judgment, says Dr. Rego, director of psychology training at Montefiore Medical Center and associate professor of clinical psychiatry and behavioral sciences at Albert Einstein College of Medicine in New York City.

“Our minds are built to jump around, back and forth, especially in today’s multitasking world,” he says, but “there’s a great deal of research supporting the mental and physical benefits of learning to be more mindful.”

Dr. Greenberg, a clinical psychologist in Mill Valley, California, who blogs forPsychology Today and is the author of the upcoming book The Stress-Resistant Brain, says that mindful self-awareness is “building an observer perspective on yourself and your life,” and that it’s one of the most important early steps a person can make toward change.

One way to practice mindfulness is by focusing on awareness of your breathing, says Dr. Symington, a clinical psychologist in private practice in Pasadena, California. “You close your eyes and follow your breath for a specified period of time,” he says, which helps lower stress levels and improves your skill at detecting internal sensations, like feelings of tension.

 

2. Be kind to yourself

Greenberg calls this sidelining your inner critic. “Seeing yourself with loving eyes doesn’t always come naturally,” she says, and talking back to your inner critic takes practice. “Change happens when you drop perfectionism and give yourself permission to be a human being who makes mistakes,” she explains.

Dr. Malkin, a psychologist and psychology instructor at Harvard Medical School, and author of Rethinking Narcissism, echoes Greenberg’s recommendation. “Many of my clients berate themselves for each and every mistake,” he says. But research shows that this kind of self-punishment is the worst way to change behavior. “We’d all do much better celebrating our moments of success than laying into ourselves for our ‘failures,’” he says.

“Question [your] thoughts,” advises Rego. “All too often, we buy into our thoughts without challenging them.” You need to be willing to consider that your initial reactions to things may be wrong, especially when those reactions are extremely negative, says Rego.

 

3. Practice Self-Observation and Evaluation

While you need to counter self-punishment, you also need to be willing to examine yourself realistically. “Be willing to be uncomfortable,” advises Greenberg. “Therapy works by helping clients access their thoughts and feelings about difficult or painful experiences.” The more you avoid going to these painful places, she says, the slower things will go.

And try not to be too impatient with yourself as you navigate that process. “No matter how hard we work to change, old habits occasionally creep back in,” says Malkin.

You shouldn’t see the return of something you thought you’d resolved as a failure, but as an opportunity to ask questions of yourself, says Malkin. For example, you might ask yourself, “What made it harder this time for me to skip the drink, or use a gentler tone with my partner, or exercise when I felt panic coming on?” he says. “There’s always an answer — and finding it often leads to tremendous growth.”

Understanding what triggers a return of behaviors is important, says Symington, adding that self-knowledge can help you plan for these vulnerable moments in your life. “Identify the pattern and then make a plan for the challenging space you know is coming.” Your plan might include having healthy distractions available for when you may need them, or preparing ahead of time to encourage a friend or hug a loved one.

When it comes to children in therapy, Dr. Kauffman, a child psychologist in Menlo Park, California, says that parents may need to be observers for their child. “It’s incredibly beneficial to have an update and a heads-up from parents before a session,” she says, because children often forget to share “fairly significant events.”

 

4. Do What You Can to Stay Physically Healthy

Sleep well — period. “This is the lowest-hanging fruit in mental health,” Malkin says.

And keep a food diary, suggests Symington: “Just the act of recording meals often improves our diet.” Most people are surprised, he adds, about how much their diet affects their mood and behavior.

Exercise has many proven benefits: It boosts mood, reduces anxious energy, and promotes good health overall, says Symington. “Put it on the schedule and make it non-negotiable,” he advises.

“Increasing activity levels … has been shown to directly improve [symptoms of]anxiety and depression,” agrees Rego.

 

5. Make and Strengthen Healthy Relationships

“We live in a network of relationships that either hold us back or push us forward,” notes Malkin, “and people don’t always like our efforts to change.”

Greenberg agrees that as you find self-improvement in therapy and learn to be assertive and set boundaries, “People in your life may push back or be angry at you.” She says that you need to be ready for these changes, and you may have to move away from unhealthy relationships to allow room for healthier ones.

“Change is hard,” agrees Symington, who advises sharing the struggle with a friend or spouse, and advising others you’re close to of your goals.

Building and strengthening social networks is also critical, notes Rego. “Strong, healthy social networks serve as an excellent buffer for life’s stresses and can help decrease the impact of psychological disorders,” he says.

For parents whose child is in therapy, however, the advice is a little different. Children must choose their own comfort level with sharing, which is something most parents understand, says Kauffman.

“Some parents can’t help but probe and question about the content of therapy sessions,” she adds. “It’s important for parents to understand the value and power of the safe and confidential therapeutic space for a child.” If something comes up that parents do need to know about, she works with the child to explore ways of communicating the information to the parents. Read More…

5 Things Psychologists Wish Their Patients Would Do was originally published on Everyday Health.

Arizona Psychologist Continuing Education Requirements

By Gina Ulery

Arizona Psychologist Continuing Education Requirements

Arizona-licensed psychologists are required to earn 60 hours of continuing education (CE) credits every 2 years for license renewal on April 30th of odd-numbered years. Of the 60 hours, 4 hours must be in ethics and 4 hours must be on domestic violence or child abuse. A minimum of 40 hours must be earned in Category 1 credit with APA-approval. All 60 hours may be earned through online/home study courses offered through APA-approved sponsors and that provide a certificate of completion.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists and maintains responsibility for all programs and content. Arizona psychologists may earn all 60 hours for renewal through online courses available at www.pdresources.org.


Arizona Board of Psychologist Examiners
View the Board Website
or Email the Board
Phone: 602-542-8162
CE Required: 60 hours every 2 years (minimum 40 from Cat 1)
Home Study Allowed: No limit (considered Cat 1 – must have certificate)
License Expiration: 4/30, odd years
National Accreditation Accepted: APA
Notes: 4 hrs professional ethics & 4 hrs domestic violence OR child abuse required each renewal (must be from Cat 1)
Date of Info: 2/6/2015

Caregiver Help: Sex and Dementia

By Elaine K. Sanchez; Alex A. Sanchez, EdD

Caregiver Help: Sex and DementiaCaregiver Help: Sex and Dementia is a 1-hour online video continuing education (CE/CEU) course that explores how Alzheimer’s and other dementia-related diseases impact the brain in ways that can cause some surprising, challenging and inappropriate behaviors. Some people with dementia may develop a heightened interest in sex – even to the point of aggression; experience a waning or complete loss of interest in sex; become addicted to pornography; lose the ability to understand what kind of behavior is acceptable; have a different perception of place and time and a different interpretation of reality from their caregivers; get agitated and upset when their caregivers don’t communicate with them effectively; and behave in ways that are confusing and upsetting to family members and professional healthcare workers. Even so, the patient deserves to be treated with respect and every effort should be made to maintain their dignity. Course #10-86 | 2015 | 55 minutes | 7 posttest questions

This online video streaming course provides instant access to the course video, course handout and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account) and mark your answers on while viewing the video. Then submit online when ready to receive credit.


CE Information:

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

About the Speakers:

Elaine K. Sanchez is an author, speaker and co-founder of CaregiverHelp.com. She co-teaches “Gero 407- Caregiving” at Western Oregon University with her husband Alex, and she writes the daily blog, “Caregiver Help Word of the Day.” She is the author of four books, including Letters from Madelyn, Chronicles of a Caregiver and contributes articles regularly to CaringTimes, Griswold Home Care’s blog.

Alex A. Sanchez, EdD, is the co-founder of CaregiverHelp.com, a video-based caregiver support program, and currently co-teaches “Gero 407- Caregiving” with Elaine at Western Oregon University. He earned his Master’s in Counseling and his Doctorate in Educational Psychology at New Mexico State University. He retired from Oregon State University in 2012, after teaching a doctoral program in Community College Leadership for 15 years. Previously he served as President of Central New Mexico Community College in Albuquerque, NM, President of Rio Hondo College in Whittier, CA, Vice President for Community and International Programs at the University of New Mexico, Academic Dean at New Mexico Military Institute, and Founding Director of Dona Ana Community College in Las Cruces, NM.

APA’s Telepsychology 50-State Review & Guidelines

By the American Psychological Association

Telepsychology Review & GuidelinesThe trend toward telepsychology — the use of communication technologies in the provision of psychological services — has the potential to reduce hospitalizations, increase access to mental health care and save lives. But there are also limitations and restrictions on the use of telepsychology. Statutes and regulations governing the provision of telepsychology services vary greatly from state to state.

Over the past few years, a growing number of states have passed or updated laws or rules governing telepsychology practice. The increasing volume of laws pertain to both delivery of and payment for telepsychology services.

In light of these developments, the APA Practice Directorate’s Office of Legal & Regulatory Affairs has updated the Telepsychology 50-state review (previously called the Telehealth 50-state review) to guide psychologists in navigating the regulations and provisions in their state.

Telepsychology 50 state review (PDF, 1.01MB)

At its late July 2013 meeting, the APA Council of Representatives approved new Guidelines for the Practice of Telepsychology. A Joint Task Force on the Development of Telepsychology Guidelines for Psychologists, comprised of members representing APA, the Association of State and Provincial Psychology Boards and the American Psychological Association Insurance Trust (APAIT), was formed in 2011 to create guidelines for the practice of telepsychology.

The new telepsychology guidelines (PDF, 113KB) are available on the APA Practice Organization’s Practice Central website.

If you have any questions, please contact the APA Office of Legal & Regulatory affairs or call (202) 336-5886.

Virginia Psychologists Continuing Education Requirements and License Renewals

virginia psychologists continuing education and license renewalsVirginia-licensed psychologists have an annual license renewal with a June 30th deadline. Fourteen (14) continuing education hours are required for license renewal. Eight (8) hours are allowed from home study, and six hours must be live, if APA approved. 1.5 hours of ethics, standards of practice or laws governing the profession of psychology are required.

Continuing education allows for the top possible standards for the psychology profession. All psychologists are required to complete continuing education hours as a licensing condition.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content.

Requirements for Continuing Education

Psychologists licensed in the state of Virginia have a yearly license renewal with a deadline of June 30th. Fourteen hours of continuing education are required to renew a license. Of the 14 hours, 8 hours are allowed from home study, and 6 hours must be live. APA approval is required. 1.5 hours of ethics, standards of practice or laws governing the profession of psychology are needed to renew.

Information obtained from the Virginia Board of Psychology on April 16, 2014.

Continuing Education Courses for Psychologists: https://www.pdresources.org/courselisting/newarrival/1

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Multiple Relationships Not Always Bad

By Ofer Zur, PhD

Entering into dual relationships with psychotherapy patients has been a topic of significant controversy in professional psychology. Although these types of extratherapeutic alliances have generally been considered to be unethical conduct, some authors recently have supported their development as both ethical and, in some cases, even therapeutic.

I was surprised to read the statement of my esteemed colleague, Ed Zuckerman, PhD, in the last issue of The National Psychologist (Nov/Dec, 2011), whereas part of an article on “The Fiduciary Heart of Ethics“ he stated, “We have an ethical obligation to avoid multiple relationships.”

This statement is in contrast to the APA’s code of ethics, (Section 3.05), which clearly states that: “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence or effectiveness in performing his or her functions as a psychologist or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”

Multiple relationships not always badMultiple relationships not reasonably expected to cause impairment or risk exploitation or harm are not unethical.

Zuckerman’s statement and discussion of multiple relationships are not only incorrect, unsupported and outdated, but also are in clear contrast to the standard of care of psychotherapy and counseling. For example, multiple relationships are mandated in military settings where psychologists often have primary loyalty to the Department of Defense and only a secondary loyalty to the person they are treating in the consulting room. Multiple relationships are inherent in some correctional settings, such as prisons, where psychologists have a responsibility to the security of the institution, as well as to the mental health of actual patients.

Zuckerman, who to the best of my knowledge, lives in Pennsylvania, should be aware that multiple relationships are unavoidable in small communities and rural areas, which are quite prevalent in his state. In fact, they are a normal and healthy part of such interconnected communities. Familiarity and multiple relationships between all members of small communities, including health care providers, is how such communities survive and thrive.

Not all multiple relationships are created equal. There are different types of multiple relationships:

  • A social multiple relationship is one in which a therapist and client are also friends, acquaintances or have some other type of social relationship within their community.
  • A professional multiple relationship is where a psychotherapist/counselor and client, are also professional colleagues in colleges or training institutions, presenters in professional conferences, co-authors of a book, or other situations that create professional multiple relationships.
  • Institutional multiple relationships take place in the military, prisons, some police departments and mental hospitals where multiple relationships are an inherent part of the institutional settings.
  • Forensic multiple relationships involve clinicians who serve as treating therapists, evaluators and witnesses in trials or hearings.
  • Supervisory relationships inherently involve multiple relationships and multiple loyalties. A supervisor has a professional relationship and duty to the supervisee and to the client, as well as to the profession.
  • A sexual multiple relationship is where a therapist and client are also involved in a sexual relationship.


Sexual multiple relationships with current clients are always unethical. A business multiple relationship is generally ill-advised. These are relationships, in which a therapist and client are business partners or have an employer-employee relationship.

Multiple relationships can be ethical or unethical, legal or illegal, and can be avoidable, unavoidable or mandated. They can also be planned and anticipated or unexpected. Then they can be concurrent or sequential and can also very with different levels of involvement, from low/minimal to intense.

In summary:

  • Non-sexual multiple relationships are not necessarily unethical or illegal.
  • Multiple relationships can’t be avoided in many settings and are mandated in others.
  • Multiple relationships are a healthy part of small and rural communities.
  • Sexual multiple relationships with current clients are always unethical.


Non-sexual multiple relationships do not necessarily lead to exploitation, sex or harm. The opposite can be true. Multiple relationships can reduce isolation and prevent exploitation rather than lead to it. Almost all professional association codes of ethics do not mandate a blanket avoidance of multiple relationships.

Source: Ethics & Risk Management: Expert Tips VI