Ethics, Boundaries, and Dual-Relationship Analysis
The framework
Ethics items are structured judgment items, not recall items. Know the core duties - informed consent, competence, confidentiality, avoiding harm, non-exploitation, accurate advertising, and responsible termination - then apply them to the facts. Questions rarely ask whether a duty exists; they ask which duty controls and what you do first.
Multiple and dual relationships
Not every dual relationship is prohibited. Distinguish a boundary crossing (attending a client's graduation, accepting a modest gift, brief self-disclosure) from a boundary violation (using the client to meet your own needs). The test is whether the secondary relationship risks impairing clinical judgment, exploiting the power differential, or harming the client - and whether you documented the reasoning and consulted.
Sexual misconduct
Sexual or romantic involvement with a current client is always prohibited and is grounds for discipline. It is never excused by client initiation or "consent." Relationships with former clients are analyzed for exploitation of the prior therapeutic relationship and the persisting power differential.
Other tested conduct
Bartering, loans to clients, treating friends or family members, social media contact, and searching for client information online all resolve through the same analysis. Custody evaluations, expert testimony, and fee disputes raise competence and role-conflict questions; performing a custody evaluation for a current therapy client is a classic role conflict.
Rule of thumb
Before any secondary relationship, run three checks: (1) Am I using a power differential? (2) Whose need is being met? (3) Could I defend this to the Committee with documentation and consultation? If any answer is uncomfortable, don't do it.