Nicholas A. Cummings, PhD, ScD
The editors and chapter contributors to this volume, through a diverse series of approaches and considerations, have dispelled for all time the monolithic notion that dual relationships are always harmful and should be avoided. Dual relationships in therapy may be harmful or beneficial, to be avoided or unavoidable, inadvertent or inevitable; in short, they just are. In this sense dual relationships are like rain, which just is. Rain is usually beneficial, but it may be harmful (floods) or desperately needed (drought). No one would consider banishing rain; we do try to prohibit dual relationships.
For 9 years I sat on the APA Insurance Trust and also served as its chair. During this period several hundred malpractice cases, or threats of malpractice, were studied, and the conclusion was that approximately 90% could be attributed to dual relationships gone awry. Not satisfied with this simplistic explanation, I spent a lot of time studying the events and interviewing the perpetrators, and I found that in all but a few notable exceptions the therapist exercised poor judgment and disregarded what would be best for the client. Almost all had never read the APA Code of Ethics until they were sued. In my interviews with them it was apparent this was by far not the first instance of poor therapeutic judgment, although the event that brought them down was perhaps the poorest of their frequent poor judgments. The problem was not so much dual relationships, but the manner in which they conducted themselves in situations that would never have been a problem for most psychotherapists. But for a couple of notable exceptions,