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In Therapy, What is a Conflict of Interest?

A large church may allow for no conflict of interest if both the therapist and patient are members of the congregation, but only if it does not make the patient uncomfortable.
A therapist that works for a company may have a conflict of interest if the company is placing the therapist in a position where they want confidential information.
Having a sexual relationship with a client is a huge conflict of interest.
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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 05 April 2014
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There are a number of examples of what constitutes a conflict of interest in therapy. Just as in medicine, treating certain patients may not be in the best interest of the patient or the therapist. A therapist, for instance, would have a direct conflict in trying to counsel his or her own family members, just as a doctor would be unlikely to treat the illnesses of his or her own immediate family (beyond offering some basic care as needed). The premise of most therapy is that a therapist is to bring objectivity to sessions, and he or she cannot bring the same level of distance to those people who he or she knows very well.

These examples are called non-sexual dual relationships, and they are not illegal, though they may not always be advised. Additional non-sexual dual relationships, where a conflict of interest might occur include the following:

  • A therapist and client have a friendship outside of therapy, where the therapist and client have a business relationship.
  • The client and therapist live together in very small communities or belong to the same communal organizations.
  • The therapist works not only as a therapist for a person, but also may evaluate them in some way.
  • This last is the case in institutions and in prisons, when therapists may also make judgments about the client’s future, and such a relationship could also exist in organizations that employ a counselor for their employees to visit.

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Not all outside relationships with a therapist will pose a significant conflict of interest in therapy. For instance, if someone attends a large church that her therapist also happens to attend, this may be relatively harmless, though it can potentially affect the patient's privacy, or make her feel slightly uncomfortable if she meets her therapist in a social setting. The therapist is still bound by confidentiality, and cannot disclose that the person is his client, which may make for a few awkward moments. If a patient does share this type of dual relationship with a therapist, discussing in therapy how meetings in the “outside world” should be handled makes good sense.

On the other hand, not all clients want to see their therapist in the outside world, and really prefer anonymity and privacy when attending therapy. They may feel more conflicted about discussing their problems with someone they know or are likely to meet regularly. When dual relationships exist, it’s important to find out if they have the potential to create a discomfort in therapy, for either the therapist or client, and to decide if the client would be best served with another therapist.

Another way that conflict of interest in therapy may occur is when a therapist treats more than one client of the same family. It is very important, especially in couples or family counseling, to clearly define the degree of confidentiality each person being counseled will have. Many times, therapists who work with more than one family member will very directly state that anything said by clients is not confidential to related clients. Of course, this may affect the degree of honesty people in family or couples therapy will exhibit. If it seems clear that one person is struggling with issues or needs greater confidentiality, the therapist may recommend that person seek counseling with a private therapist too.

Similarly, therapists may feel it is a conflict to treat more than one client of the same family in private settings. Since each client would have total confidentiality, but might be speculating about their family members, it may be hard to preserve this privacy. This is especially the case when the therapist has information about each related client from other family members. It is often in the best interest of the clients if they each have their own therapist.

Professional therapy should never include sexual relations between therapist and client. This is undoubtedly a conflict of interest in therapy. Adding a sexual component to the relationship can prove tremendously damaging to a client, since that person is incredibly vulnerable in the therapeutic setting.

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Discuss this Article

anon347091
Post 5

What about a therapist who drops a client after four sessions, and the client isn't a close knit community member of a family member or anything stated in this article and is stating conflict of interest?

anon218196
Post 4

@anon157181: I do not think you should ever date a previous client. I think I can see your perspective though: You and the previous client have a strong and meaningful connection, and who knows what the future may hold, so why not at least give it a chance?

In a successful counseling relationship, there is often a strong connection made. Many times, a client comes in to the relationship vulnerable. He or she looks to the therapist to be a stable relationship to rely on, during which he or she can receive encouragement and feel supported.

Personally, I think it is highly important for the client to experience having a healthy relationship. Maybe he or she has never had one, ever! And if the therapist and client are of the opposite genders, it is all the more important to have a healthy relationship that is solely platonic, because the client needs to know that non-sexual relationships are possible and can be healthy. Either way, you are the example of this relationship, which will help them in countless future relationships.

Feelings and emotions are very strong during therapy sessions, and the client can easily attribute strong and non-platonic feelings for their therapist in being so cared about and listened to (clinicians can as well, because they feel so respected, appreciated and helpful). As his or her therapist in the past, it was important back then for you to maintain the positive relationship and supportive role as the therapist and therapist alone.

I think it is important for the client to continue to have the memory and experience of a supportive therapist that was purely a support to them. To start dating the previous client would rob him or her of this (potentially one-in-a-lifetime) positive relationship experience that existed for the sole purpose of helping the client. The idea of dating the previous client may seem like you could continue to help the client and be that positive relationship, but would in fact change and corrupt the entire previous relationship to a different concept completely.

A foundation built on the relationship of a client and therapist dynamic does not bode well for a long and fulfilling relationship. One person's role was to only need help, while the other person's role was to only give help. Even though the dynamic changed with time, any resulting dating relationship cannot be healthy or beneficial for either party. I hope this helps and that you do not consider going through with it.

anon157181
Post 3

What about if your client no longer is a client in your institution and initiates contact beyond that? Such as going for a coffee? Also, what if your former client is flirting with you and you flirt back?

latte31
Post 2

Icecream17 - I know that many mystery shopping companies will also offer a conflict of interest disclosure statement for the shopper on every shop. This states that if the shopper has any relationship or even knows someone that works at the location being shopped, they will not be allowed to conduct the mystery shop.

Withholding your identity is everything in mystery shopping. As a matter of fact if you are spotted as a mystery shopper by anyone in the company, you will not be paid because it will invalidate the study and the mystery shopping company has to send another shopper.

icecream17
Post 1

I think that a therapist should never treat a friend in therapy because by the very nature of the relationship the therapist cannot be objective. I also think that a therapist can lose his license over that.

Conflict of interest policies are designed to protect the clients from malpractice. Most institutions have a zero no conflict of interest policy in order to maintain the necessary levels of professionalism in the industry.

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