Exploring the ethical issues of dual relationships and researching our own clients: a narrative case study approach

This study investigates the issues and ethics of dual relationships in therapy and in research. It is a narrative inquiry into the lived experience of being in a dual relationship told from the perspective of both client/participant and therapist/researcher: a dual perspective on a dual relationship. It is a narrative case study of a situation arising in the researcher's professional practice, carried out in collaboration with an ex-client participant, exploring, in depth, the overlapping relationship between the ex-client and therapist during the therapy and then within the further research relationship.
The underlying philosophical approach of the study and methodology is a social constructionist narrative inquiry that guided the design of the project, as well as the evolution of the methodology and methods used and the presentation of the findings. This posed challenges and re-thinking from traditional scientific methodologies and in the presentations of the stories. The collection of stories (data) involved a series of collaborative conversations between the therapist/researcher and ex-client/participant with the exchange and approval of the transcripts of these conversations with comments and reflections. The analysis (or 'findings') are represented as 'The Stories of the Overlapping Relationships', followed by discussions of more general relevance to therapists represented as 'Stories within Stories'.
The study offers valuable insights into these experiences: what implications there are for the quality and depth of the therapeutic relationship; whether and how they impact on therapeutic processes and on the final outcome of the work; and how both client and therapist make sense of their different roles. The implications of the overlapping relationships were complex and there were risks in terms of heightening the power imbalance between therapist and client and increasing client vulnerability. However, these risks were managed by ongoing, open and honest discussion, clear negotiated boundaries and strict confidentiality. There were some benefits of the overlapping relationships from a deeper understanding of the client's family and social context, in building trust and modelling healthy boundaries. The ex-client found it empowering to take part in the research and was a valuable participant.
The research has implications for several areas of practice such as managing therapeutic boundaries, friendship with ex-clients, researching our own clients, the importance of therapist/researcher reflexivity and relational ethics in practice.