If you have been in therapy, then you may have experienced the special kind of intimacy that occurs when you open up your most painful thoughts and memories to another person. You probably felt your therapist’s genuine concern and empathy for you, and you likely felt safe within the sanctuary of your therapist’s office.
Since these feelings may also occur with friendship, it’s tempting to think of your therapist as your friend, and even to seek out a friendship outside the therapy session, or after therapy is completed. However, it’s important to understand that an ethical therapist can never be your friend … no, not even on Facebook.
The guidelines of each one of the professional organizations for therapists (American Psychological Association, National Association for Social Workers, and others) all specifically prohibit relationships that involve a “dual role.” A dual role, for example, is when someone acts both as therapist and friend. For similar reasons, your therapist can’t offer you a job, or hire you to fix her computer. The American Association for Marriage and Family Therapy states in their Code of Ethics:
Marriage and family therapists are aware of their influential positions with respect to clients, and they avoid exploiting the trust and dependency of such persons. Therapists, therefore, make every effort to avoid conditions and multiple relationships with clients that could impair professional judgment or increase the risk of exploitation. Such relationships include, but are not limited to, business or close personal relationships with a client or the client’s immediate family.
So “dual roles” can impair professional judgment – your therapist may not be able to think about you as clearly and objectively if she is counting on your friendship. If you are fixing her car, and the car still won’t run after you’ve worked on it, how will you feel? how will she feel toward you? And “dual roles” can increase the risk of exploitation. If your therapist asks you to watch her children for her, will you feel free to tell her “no”, or would you feel obligated to grant her every request because she has done so much for you as a therapist?
Even Facebook “friending” your therapist can be risky.
Imagine, for example, that your therapist does “friend” you on Facebook. You will then have access to a good deal of personal information about your therapist. Sometimes this may involve direct violation of the HIPAA guidelines for confidentiality – because you may wonder about other people in her Friend list …are they her clients too? are they wondering about you? Or, on your therapist’s Facebook page, perhaps you will discover that he or she has political views or religious views that you strongly disagree with. How will you feel about your therapist then? will you continue to be able to confide in her trustingly? What if you see that she has posted sad news about the loss of a loved one? will it still be possible for you to go to therapy and confide your troubles, without worrying about your therapist’s own grief? And what if you discover that your therapist is divorcing her husband. Will you still feel the same about her ability to help you with your own marriage?
Therapy is not friendship. A therapist can be truly “there” for you, and can be an objective helper, in part because she will never need you to be “there” for her. A friendship is a two-way relationship where both people give and both receive. Friendship is very valuable and we all need friends to lean on; but it’s not the same as therapy. A friend will have an opinion about your life, will have a stake in some of your decisions, will need to count on you when she is down. A therapist is able to be available for you and dozens of other clients at the same time, but she cannot welcome her clients into her personal life.
Your therapist likely does have genuine caring and concern for you, and perhaps if you had met some other way, he or she could have become your friend. But once the therapy “contract” is established, that possibility no longer exists. In fact, most mental health professionals agree that even once psychotherapy has ended, the therapeutic relationship still exists and friendship or romantic relationships are still unethical. Most of us want our friends to be people we can see as an equal. Even once therapy has ended, the therapist is someone whom you have turned to for help and guidance, someone you have confided in and who has not confided in you. The relationship is not “equal” in that sense. Therefore the therapeutic boundary, for most professionals, must remain in place indefinitely.