AAMFT

Romantic relationships with former clients or their family members would be prohibited… forever.

In the current working draft of the Code of Ethics for the American Association for Marriage and Family Therapy (AAMFT), there are a number of proposed changes worth discussing. Perhaps the most significant proposed change is in the rules about family therapists engaging in romantic relationships with former clients or their family members. The existing rule reads as follows — I know it’s long, but stick with me. Except for the title of the subprinciple, all emphasis mine:

1.5 Sexual Intimacy with Former Clients and Others. Sexual intimacy with former clients, their spouses or partners, or individuals who are known to be close relatives, guardians or significant others of clients is likely to be harmful and is therefore prohibited for two years following the termination of therapy or last professional contact. After the two years following the last professional contact or termination, in an effort to avoid exploiting the trust and dependency of clients, marriage and family therapists should not engage in sexual intimacy with former clients, or their spouses or partners. If therapists engage in sexual intimacy with former clients, or their spouses or partners, more than two years after termination or last professional contact, the burden shifts to the therapist to demonstrate that there has been no exploitation or injury to the former client, or their spouse or partner.

The proposed new rule is much simpler and more stark:

1.5 Sexual Intimacy with Former Clients and Others. Sexual intimacy with former clients or with known members of the client’s family system is prohibited.

Gone would be the current “two-year rule.” Under the current rule, a therapist could get into a sexual relationship with a client’s family member without fear of repercussions if two years have passed since the end of therapy. However, a therapist who engages in a sexual relationship with the former client or their partner is always at some level of risk; it is, after all, very hard to prove the negative, especially in mental health. If someone says they have suffered emotionally, as the result of a romantic relationship with their former therapist, it is a high bar for the therapist to prove otherwise. As such, the current code effectively discourages relationships with former clients or their partners forever. The proposed new rule would shift that discouragement into a clear prohibition, and extend its reach to include all known members of the client’s family system, not just their partners.

There is a potential problem with the application of a blanket rule like this. Consider the family therapist working in a rural area, who may run parenting groups or other workshops for their county — a not-uncommon situation, especially when the therapist may be the only licensed mental health provider in the county (or one of very few). That therapist would never be able to date anyone who had come to a single parenting class, a single therapy session, or a single workshop, even if decades had passed since then. And even if you’re on board with that part (I waffle; it’s easy for me to judge from a place like Los Angeles, but I wonder whether my view would be different living someplace else), bear in mind that the therapist also would never be able to date anyone who had a family member who had ever come to a single parenting class, a single therapy session, or a single workshop, no matter how many years ago.

By working in a rural area, a therapist would be systematically dismantling their dating pool.

This proposed AAMFT rule seems to me to be unduly punitive to those therapists working in rural areas (the same argument could be made, albeit a bit less strongly, for those working in insular communities in urban areas), especially those who do so for a long time. It is right and appropriate to demand that therapists not get romantically involved with former clients or their family members when the therapeutic relationship was recent enough to bring a certain “ick factor,” or any risk of harm or exploitation, into the dating relationship; extending the post-therapy prohibition on such relationships from the current two years to five or even ten would be fine with me, and it seems reasonable to include family members in addition to the client and their partner in that prohibition. But to tell a therapist she can’t date someone if she discovers that person’s aunt and uncle had come to her for two sessions of marriage counseling 20 years ago? That, to me, is going too far.

And it isn’t just me. When the American Counseling Association (which represents counselors of various forms, including LPCs and LPCCs) adopted their new Code of Ethics for this year, they kept their five-year prohibition on romantic relationships with former clients rather than moving to one that would last forever. The ACA language, I think, gets it right, by putting a high demand on counselors to consider (and, importantly, document that they considered) the risk of harm or exploitation before engaging in any such relationship, but stopping short of outlawing them for all time:

A.5.c. Sexual and/or Romantic Relationships With Former Clients
Sexual and/or romantic counselor-client interactions or relationships with former clients, their romantic partners, or their family members are prohibited for a period of 5 years following the last professional contact. This prohibition applies to both in-person and electronic interactions or relationships. Counselors, before engaging in sexual and/or romantic interactions or relationships with former clients, their romantic partners, or their family members, demonstrate forethought and document (in written form) whether the interaction or relationship can be viewed as exploitive in any way and/or whether there is still potential to harm the former client; in cases of potential exploitation and/or harm, the counselor avoids entering into such an interaction or relationship.

As a general rule, I really like the 2014 ACA Code, particularly for how well it handles issues related to technology. AAMFT could learn from the example. And while I have concerns about this particular piece, there is certainly much to like in the draft AAMFT code as well; as I said, more on that to come. The public comment period for the current AAMFT draft Code of Ethics goes through August 1.

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In the interest of full disclosure, I was part of a task force that developed recommendations for the 2012 update to the AAMFT Code. I had no involvement with the current working draft.

What do you think of the AAMFT draft? Your comments here are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.