Dueling Over Dual
John Fleer, PhD, JD
While writing this chapter, I am awaiting the decision from an administrative law judge who presided over a month-long hearing in which my client, a psychotherapist, was accused by her licensing board of unethical dual relationships. My client, whom I will call Dr. A, practices outpatient psychotherapy with adult clients who have been the victims of extreme trauma in childhood and/or adult life. Many of the clients carry diagnoses of post-traumatic stress disorder and/or dissociative disorders. Some meet DSM-TV (1994) AXIS II criteria for personality disorders as well.
A formal accusation was filed against Dr. A by her licensing board. The accusation was based upon the complaints of two former clients, X and Y. X was in psychotherapy with Dr. A for 4 years. X was, to say the least, a highly demanding and difficult client who was very specific regarding her needs in psychotherapy and the manner in which she wanted to be served. She received outpatient therapy twice a week and made frequent phone calls to Dr. A between office visits. During the 4 years of therapy, Dr. A, on several occasions, conducted sessions at X’s home. These were always at the request of X and in response to a crisis situation, or X’s inability to leave the home. Dr. A also went on occasional walks with X during the course of sessions, attended four social events (two birthday parties, a graduation party, and New Year’s party) at X’s invitation (and insistence) and exchanged gifts and cards over