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Graduate Student Journal of Psychology                                                                             Copyright 2007 by the Department of Counseling & Clinical Psychology  
2007, Vol. 9                                                                                                                          Teachers College, Columbia University                          ISSN 1088-4661 
 
 
 

Proposed Standard for Multiple Relationships in the  
APA Ethical Principles of Psychologists and the Code of Conduct 

 
Veronica Lee Lestina 

Capella University 
 

Cynthia M. Walljasper 
Family Medicine of Mt. Pleasant, PC 

This article provides a proposal for new language and a revised standard for multiple relationships 
to be considered for the APA Ethics Code. The current multiple relationships language in the APA 
(2002) Ethical Principles of Psychologists and the Code of Conduct was updated in part due to rural 
American psychologists being involved in a variety of relationships with clients out of necessity. 
This article explores the differences between the previous APA (1992) Ethics Code and the current 
APA (2002) Ethics Code, addressing the strengths and weaknesses of the current code and the need 
for an updated version. The proposed language builds upon the 2002 Ethics Code’s strengths re-
garding the definition of multiple relationships and the idea that not all multiple relationships are 
ethical violations. It then provides a minimum standard for a strategy of assessing multiple relation-
ships and informing the client of the dynamics of a multiple relationship. 
 

 
As providers practicing in a rural generalist setting, the 

authors propose a review of the current standard regarding 
multiple relationships for psychologists as it is written in 
APA (2002) Ethical Principles of Psychologists and the 
Code of Conduct, Standard 3.05. In reviewing this standard, 
one can determine areas for growth in the language and 
specificity to assist all psychologists in clarifying multiple 
relationships, including the rural American psychologist. 
This article provides a review of the APA (2002) and APA 
(1992) Standards on multiple relationships as well as a pro-
posal for updating this standard. These proposed updated 
standards aims to help betterfulfill the needs of the profes-
sion today in terms of safeguarding and enforcing against 
potentially harmful multiple relationships.  

 
Current and Past Multiple Relationship Standards 

 
The current APA (2002) Ethical Principles of Psy-

chologists and Code of Conduct for multiple relationships is 
as follows: 

 
3.05 Multiple Relationships. 

(a) A multiple relationship occurs when a psychologist is in 
a professional role with a person and (1) at the same time is 
in another role with the same person, (2) at the same time is 
in a relationship with a person closely associated with or 
related to the person with whom the psychologist has the 
professional relationship, or (3) promises to enter into an-
other relationship in the future with the person or a person 
closely associated with or related to the person.  
 
Correspondence concerning this article should be addressed to 
Veronica Lestina, Family Medicine of Mt. Pleasant, PC, 501 
South White Street, Suite 1, Mt. Pleasant, Iowa 52641; e-mail: 
veronickins@mchsi.com. 

 

A psychologist refrains from entering into a multiple 
relationship if the multiple relationship could reasonably be 
expected to impair the psychologist’s objectivity, compe-
tence, or effectiveness in performing his or her functions as 
a psychologist, or otherwise risks exploitation or harm to 
the person with whom the professional relationship exists. 

Multiple relationships that would not reasonably be 
expected to cause impairment or risk exploitation or harm 
are not unethical. 

(b) If a psychologist finds that, due to unforeseen fac-
tors, a potentially harmful multiple relationship has arisen, 
the psychologist takes reasonable steps to resolve it with 
due regard for the best interests of the affected person and 
maximal compliance with the Ethics Code. 

(c) When psychologists are required by law, institu-
tional policy, or extraordinary circumstances to serve in 
more than one role in judicial or administrative proceed-
ings, at the outset they clarify role expectations and the 
extent of confidentiality and thereafter as changes occur. 
(See also Standards 3.04, Avoiding Harm, and 3.07, Third-
Party Requests for Services.) (APA, 2002, p.6). 

 
The previous APA (1992) Ethical Principles of Psy-

chologists and Code of Conduct Standard as it pertains to 
multiple relationships was as follows: 

 
1.17 Multiple Relationships.   
(a) In many communities and situations, it may not be 

feasible or reasonable for psychologists to avoid social or 
other nonprofessional contacts with persons such as pa-
tients, clients, students, supervisees, or research partici-
pants. Psychologists must always be sensitive to the poten-
tial harmful effects of other contacts on their work and on 
those persons with whom they deal. A psychologist refrains 
from entering into or promising another personal, scien-

25 



LESTINA AND WALLJASPER 
 

26 

tific, professional, financial, or other relationship with such 
persons if it appears likely that such a relationship rea-
sonably might impair the psychologist's objectivity or oth-
erwise interfere with the psychologist's effectively perform-
ing his or her functions as a psychologist, or might harm or 
exploit the other party.  

(b) Likewise, whenever feasible, a psychologist refrains 
from taking on professional or scientific obligations when 
pre-existing relationships would create a risk of such harm.  

(c) If a psychologist finds that, due to unforeseen fac-
tors, a potentially harmful multiple relationship has arisen, 
the psychologist attempts to resolve it with due regard for 
the best interests of the affected person and maximal com-
pliance with the Ethics Code. (APA, 1992, p. 1601) 
 

Changes in the Multiple Relationships Standard  
from 1992 to 2002 

 
The differences between the multiple relationships 

standards in the 1992 and 2002 Ethical Codes are outlined 
in Table 1. The 2002 code change allowed for a more ex-
plicit definition of a multiple relationship for psychologists, 
and it stated that not all multiple relationships are unethical 
(Smith, 2003b). Multiple relationships are viewed as some-
thing that the psychologist should refrain from, if possible, 
especially if it is reasonably “expected to impair the psy-
chologists’ professional performance or could exploit or 
harm the other individual” (Smith, 2003b, p. 65). 

The changes in the APA (2002) Ethics Code were im-
plemented due to a variety of problems in the interpretation 
and enforcement of the previous 1992 code. In a national 
survey, multiple relationships were found to be the second 
most frequent type of unethical conduct in which psycholo-
gists had difficulty maintaining clear, reasonable, and 
therapeutic boundaries with their clients (Pope & Vetter, 
1992). This survey underscored the need to more clearly 
define multiple relationships and delineate when they are 
therapeutically relevant/acceptable and when they are harm-
ful. 

Based on the survey’s findings, Pope and Vetter (1992) 
suggested that the standard must be specific enough for all 
psychologists yet take into account the special circum-
stances of those professionals who practice in small towns, 
rural communities, and other remote locales. These authors 
requested that a revised code provide direction in terms of 
multiple relationships that were premeditated and purpose-
ful versus accidental or incidental encounters. These sug-
gestions were taken into consideration for the changes in 
the current version of the APA (2002) Ethics Code. 

The earlier APA (1992) Ethics Code was directed to-
ward risk prevention. This is evidenced by the preamble 
stating the “psychologists’ primary goal is to provide for 
the welfare and protection of the individuals and groups 
with whom they work” (Sonne, 1994, p. 339). Bersoff 
(2003) indicates that the updated APA (2002) Ethics Code 
took an even greater risk reduction stance by defining a 

multiple relationship and indicating that not all dual rela-
tionships are potentially unethical. This was intended to 
further protect the welfare of the client and the professional, 
with the gained clarity of the language in the new code. 

 
Table 1 
Comparison of the Multiple Relationships Standards 
in 2002 and 1992 APA Ethics Codes 
 
2002 APA Ethics Code 1992 APA Ethics Code 
• Explicit definition of multiple 

relationships 
• No explicit definition of 

multiple relationships 
• Not all multiple relationships 

are unethical 
• Not all multiple rela-

tionships can be 
avoided 

• Enhanced risk prevention 
stance 

• Risk prevention stance 

• If a potentially harmful multi-
ple relationship arises, psy-
chologist will resolve in com-
pliance with Ethics Code 

• Same as 2002 Ethics 
Code 

• Refrain from engaging in mul-
tiple relationships if expected 
to impair psychologists’ objec-
tivity or performance, or harm 
the other individual in the rela-
tionship 

• Same as 2002 Ethics 
Code 

• If required by laws, policy, or 
circumstances to serve in more 
than one role, then clarify role 
expectations and confidential-
ity limits at outset and over 
time as needed 

• Not included in 1992 
Ethics Code 

 
Problems within the earlier APA (1992) Ethics Code 

called for more definitive language regarding multiple rela-
tionships, given that many psychologists were found “to be 
dealing with a variety of nonromantic, nonsexual relation-
ships with former clients” (Anderson & Kitchener, 1996, p. 
65). A problem with the 1992 edition of the code is that a 
clear definition of a multiple relationship was not provided, 
nor did the code comment on how one should determine 
that definition or decide when a multiple relationship might 
be unethical. With a large number of psychologists in blurry 
territory and no clear definition of unethical multiple rela-
tionships, the profession was at a high level of potential risk 
as a whole. Therefore, the updated APA (2002) Ethics Code 
aimed to provide more insight and clarification into this 
matter. 

 
Continued Concerns that Might Suggest Further 

Change to the 2002 Ethics Code 
 
A number of potential complications necessitate re-

examination of the current APA (2002) Ethics Code. 
Namely, the application of the 2002 Standard of multiple 
relationships in the profession may be inconsistently inter-
preted across licensing boards. With the current language, 



MULTIPLE RELATIONSHIPS AND ETHICS 
 

27 

each state may provide its own interpretation on a case-by-
case basis. This type of interpretation and utilization allows 
for a significant amount of subjectivity and possible dis-
crimination, which could be viewed as inconsistent, capri-
cious, and arbitrary.  

The civil courts could also use the current multiple re-
lationships standard in an inconsistent manner for malprac-
tice cases. Some boards continue to operate from the 1992 
Standard for multiple relationships, stating that the 2002 
change is at odds with the 1992 Standard (Bersoff, 2003; 
Schank, Slater, Banerjee-Stevens, & Skovholt, 2003). 
These applications and interpretations present risk man-
agement concerns for the profession of psychology. Not 
only could this lead to poor and inconsistent handling of 
clinical matters, but the state licensing boards could set 
themselves up for lawsuits. There continues to be variable 
interpretation of the 2002 Standard. The authors propose 
that the language and specificity be revised to encourage 
more consistent interpretation across all state boards; con-
tinue to provide for the best client welfare possible; ensure 
clear, sound, and just standards for psychologists; and re-
flect the ethical theory of the profession of psychology.  

   
Pros and Cons of the 2002 Standard for  

Multiple Relationships 
 

Pros 
 

The APA (2002) Ethics Code has come farther in clari-
fying multiple relationships than any other code of ethical 
conduct for psychology. It also has developed the profes-
sional standard that not all multiple relationships are un-
ethical. This is a positive development given that there have 
been disagreements about whether certain types of multiple 
relationships are ethical. The clarification helps protect both 
the psychologist and the client (Fisher, 2003; APA, 2002; 
APA, 1992). The improved definition of a multiple rela-
tionship provided a more realistic understanding of what 
may or may not be an ethical violation. In the 1992 Ethics 
Code, there was no explicit definition of a multiple relation-
ship; therefore, the licensure bodies had the freedom to con-
sider each case uniquely and thus did not provide consistent 
determinations on ethical violations. This, to some extent, 
left the psychologists involved in alleged unethical multiple 
relationships at the mercy of the subjective interpretations 
of the boards.  

The current APA (2002) Ethics Code is the first to in-
directly support rural and small town psychologists by stat-
ing that not all multiple relationships are unethical. In a 
rural area (not limited to a small town), a psychologist may 
be called to be a “teacher, administrator, researcher, thera-
pist, mediator, entrepreneur, crisis counselor, and referral 
source all in the course of a day, sometimes changing roles 
by the hour” (O’Conner, 2001). Due to this potential chang-
ing of hats, the psychologist, under the current code, has 
room to navigate and explore multiple relationships as long 

as they do not negatively impact client welfare. This more 
accurately reflects and supports the reality of daily life in 
rural America.  

Schank and Skovholt (1997) interviewed 16 psycholo-
gists in rural areas and small communities regarding ethical 
dilemmas the psychologists have dealt with in their prac-
tices. The authors found that all 16 psychologists identified 
significant concerns involving professional boundaries. The 
concerns included major themes of “overlapping business 
relationships, the effects of overlapping relationships on 
members of the psychologist’s own family, and the dilem-
mas of working with more than 1 family member as clients 
or with others who have friendships with individual clients” 
(Schank & Skovholt, 1997, p. 44). Although all 16 psy-
chologists understood the 1992 Ethics Code, each one 
struggled with how to best apply the multiple relationship 
standard since it did not allow for the possibility of an ethi-
cal multiple relationship. These findings support that rural 
psychologists in America have a significant interest in ex-
amining multiple relationship concerns. 

Rural psychologists are asked to compartmentalize and 
deal with blurred boundaries of multiple relationships in 
day-to-day life (Schank & Skovholt, 1997). Rural psy-
chologists must be aware at all times whether or not to ac-
cept social invitations for themselves and their family 
members, as this may introduce even more difficulties with 
handling multiple relationships in rural practice. Attendance 
at church, running errands, and shopping at the local gro-
cery store become thoughtful encounters rather than the 
simple daily task that most professionals have the luxury of 
performing automatically. The effects of multiple relation-
ship concerns for rural psychologists and clients are begin-
ning to be explored in more depth; however, the effects this 
may or may not have on the rural psychologists’ families 
has yet to be explored (Schank & Skovholt, 1997). Com-
munity acceptance and trust is of great value for the rural 
psychologist, so she or he must be aware that each decision 
she or he makes may impact oneself, one’s family, potential 
clients, and/or community (Schank & Skovholt, 1997).  

To elaborate, the following are true-to-life examples of 
the overlap that occurs daily for the rural psychologist.  
• Imagine that during a session your client expresses frus-

tration about the boy her daughter has begun dating. You 
realize that the new boyfriend is your client.  

• Every time you go out for dinner with your family, you 
are likely to see at least one or two of your clients, either 
as other diners or as restaurant employees. You find 
yourself wondering if there are any guidelines about how 
much to tip the waiter if he is your therapy client.  

• You need someone to fix your garage door, and there is 
really only one business in town that does this kind of 
work. The business owner’s spouse happens to be a pre-
vious therapy client. 

• After developing a relationship with a client, he tells you 
he is suing his ex-girlfriend for custody of their child. 



LESTINA AND WALLJASPER 
 

28 

You learn the ex-girlfriend is a previous client of yours. 
Your records could be subpoenaed by both parents. 

• Your spouse wants to buy a vehicle and has worked out 
an initial deal with a salesperson who you previously 
evaluated for ADHD. 

• Your child wants to play at a friend’s house, and you 
have done therapy with that friend’s brother.  

Which of these multiple relationships could be harmful? 
How does the psychologist know? 
 

The current code allows for the recognition of this real-
ity for rural and small town psychologists. It does not state 
that all multiple relationships for rural psychologists are 
acceptable. It simply implies that all potential and ongoing 
multiple relationships need to be examined. If there is no 
foreseen harm to the client, the multiple relationship is 
likely not to be considered unethical. This does not mean 
that the decision to have a multiple relationship should be 
taken lightly nor should it be assumed to be a simple deci-
sion process, as the above examples indicate.  

In sum, the current code provides more leeway for the 
psychologist to determine if and when a multiple relation-
ship is potentially unethical. Assuming the psychologist 
goes through the determination process with integrity, the 
APA (2002) Ethics Code is helpful in giving the psycholo-
gist this room to operate effectively. 
 
Cons 
 

As with any code, there are usually areas that can be 
further developed within the framework of the current stan-
dard. The profession is not stagnant. There continue to be 
changes, interpretations, ideals, and other variables that 
allow for the profession of psychology to evolve. These 
changes have led to revisions of the APA Ethics Code a 
number of times.  

In examining the current APA (2002) Ethics Code as it 
pertains to multiple relationships, one can find a number of 
potential pitfalls or areas of confusion. The added statement 
that not all multiple relationships are unethical is a positive 
development, yet it has its own set of drawbacks. Schank 
and Skovholt (1997) remind the reader that, “psychologists 
must maintain a balance of flexibility in overlapping rela-
tionships” (p. 48), yet the psychologist must also have clear 
expectations and boundaries in each relationship. This is a 
tricky area for the psychologist to navigate.  

The updated APA (2002) Ethics Code does not provide 
a clear step-by-step process of how the professional should 
determine whether or not the potential multiple relationship 
might be unethical. Therefore, a psychologist can easily and 
unintentionally be led into poorly defined or overlapping 
relationships. It does not take much for an ethical multiple 
relationship to fall into an unethical one. Holub and Lee 
(1990) note that “blurring of boundaries may become prob-
lematic for the therapist who becomes a compassionate 
friend to a client or acts as professional for a friend” (p. 
107). In most cases of multiple relationships that become 

unethical, “the relationships began insidiously” (Hamilton 
& Spruill, p. 318).  

Another potential pitfall for the current ethics code is 
that regardless of the clear definition of a multiple relation-
ship, there may still be difficulty in carrying out the stan-
dard. For instance, Smith, McGuire, Abbott, and Blau 
(1991) note that there is “often a discrepancy between what 
clinicians know to be the ethically preferred course of ac-
tion in dealing with professional-ethical dilemmas, and their 
stated willingness to implement this ideal” (p. 238). The 
idea that the professional can be aware of the problematic 
and potentially unethical situation and not be able to steer 
clear of this dangerous situation is frightening, especially 
considering that the psychologist has the responsibility to 
determine whether or not the multiple relationship could 
negatively impact the client’s welfare.  

The professional is responsible for judging conduct in 
relationships outside of therapy and how such conduct 
could potentially result in harm to the client (Schank et al., 
2003). If the psychologist who is responsible for examining 
the multiple relationship for potential harm to the client has 
impaired objectivity, then there is definitely a problem ac-
cording to the current APA (2002) Ethics Code (Schank et 
al., 2003). Due to the complex and often ambiguous nature 
of multiple relationships, Schank and colleagues (2003) 
caution the professional to stay away from developing mul-
tiple relationships at all.  

Ultimately, the psychologist is responsible for making 
the judgment regarding the multiple relationship and puts 
him/herself on the line if something goes awry. Since the 
APA (2002) Ethics Code does not describe in detail how to 
examine potential multiple relationships for harm, the psy-
chologist has no basic template from which to operate a 
checks and balances system. The APA (2002) Ethics Code 
is assuming that the psychologist will have the integrity and 
capacity to make this determination professionally. Given 
that we have the code for a reason (i.e., there have been 
problems with some psychologists’ integrity), outlining the 
process of evaluating multiple relationships more specifi-
cally may help to keep the professional accountable as well 
as provide some protection for the psychologist who does 
go through a specific evaluation process. There are three 
main areas that the psychologist must seriously consider 
when examining a potential multiple relationship, according 
to Smith (2003a): issues of power, length of treatment, and 
termination.  

First, the psychologist needs to gain a clear awareness 
of how much power he or she has in the relationship 
(Smith, 2003a), as this will help determine the likelihood 
for harm. In making an informed decision, the psychologist 
must also be aware of the vulnerability the client may ex-
perience (Schank et al., 2003). “This power continues even 
after the therapy relationship ends” (Schank et al., 2003, p. 
183). Typically, a client allows the psychologist to be in an 
elevated hierarchical position. The client looks to the thera-
pist for advice, approval, and even worth, at times. Fur-
thermore, the client discloses very difficult personal mate-



MULTIPLE RELATIONSHIPS AND ETHICS 
 

29 

rial, widening the power differential between client and 
psychologist. The psychologist who does not handle oneself 
professionally and properly can harm the client psychologi-
cally.  

The impaired judgment of a professional may allow for 
a lingering problem that could potentially have lasting ef-
fects upon the client or other individual involved in the 
multiple relationship; this highlights the importance of be-
ing as specific as possible in the language that covers mul-
tiple relationships. It is not easy to accurately predict the 
potential risks and benefits of a multiple relationship even if 
the professional has unimpaired judgment (Schank, Slater, 
Benerjee-Stevens, & Skovholt, 2003).  

Second, what will be the duration of the contact or rela-
tionship? The longer the duration; the more concern. As 
mentioned by Smith (2003a), it is important to examine the 
length of a professional relationship before making a deci-
sion on a dual role. This could seemingly apply to both 
short-term and long-term relationships, in either a positive 
or negative manner. A psychologist could have worked 
with an individual for a long time, developed substantial 
trust and rapport, and have significant risk of harm if a mul-
tiple relationship developed. On the other hand, some indi-
viduals may only work with a psychologist for a brief time 
and not be appropriate for a multiple relationship.  

If possible, multiple relationships should be avoided, as 
a general rule. If it is not possible, then the professional 
must implement a strategy to determine whether or not to 
engage in the multiple relationship. Simply having a time 
frame of how long a client/therapist relationship has been 
established is not sufficient because each case is unique. All 
situations must be weighed as carefully and objectively as 
possible, with peer consultation periodically. Additionally, 
the professional is urged to consider other consultations, 
such as with a supervisor, attorney, state psychological as-
sociation, ethics panel, or state ethics board. 

Third, in the case of a therapeutic relationship, has it 
been terminated? If so, how long ago and what was the out-
come (i.e., positive or negative)? Termination is the last 
area that Smith (2003a) emphasizes as a key factor in 
evaluating multiple relationships. A client treated for mild 
depression 25 years ago, for example, is different from a 
client with Borderline Personality Disorder who finished 
treatment (for now) three weeks ago. Some clients who 
have terminated three or four years prior would not be ap-
propriate for a multiple relationship, whereas others would 
be appropriate. The APA (2002) Ethics Code indicates that 
a sexual relationship (i.e., an intimate and physical relation-
ship) should not occur prior to two years following termina-
tion. This is simply a minimum. Some professionals believe 
that a sexual relationship should not occur with a previous, 
current, or future client—this is the easiest and perhaps best 
answer to the question of whether a sexual relationship be-
tween psychologist and client is ever ethical. Once again, 
the power and hierarchical differences could be severely 
damaging to the client even if a few years have passed. The 
disclosure was one-sided, and it is difficult to transform that 

into a two-way relationship. It does not appear that a sexual 
relationship could be an equal two-way relationship be-
tween a psychologist and a previous, current, or future cli-
ent.  

Smith (2003a) reported that these three areas must be 
examined carefully to make an informed decision about the 
foreseeable risk of a multiple relationship. The more in-
formed the psychologist is, the more likely he or she will be 
able to make an objective judgment about the multiple rela-
tionship. Therefore, although there are many positive as-
pects of the current APA (2002) Ethics Code in regard to 
multiple relationships, continued concerns need to be ad-
dressed to better protect psychologists and the people with 
whom they work. 

 
New Language Proposed for the  
Multiple Relationships Standard 

 
Most of the APA (2002) Ethics Code Standard 3.05 

that covers multiple relationships is important to keep in the 
new proposed standard offered here. Several clarifications 
and additions are recommended. The proposed revision is 
as follows:  

 
Multiple Relationships Proposed Standard. 
(a) A multiple relationship occurs when a psychologist 

is in a professional role with a person and (1) at the same 
time is in another role with the same person, (2) at the same 
time is in a relationship with a person closely associated 
with or related to the person with whom the psychologist 
has the professional relationship, or (3) promises to enter 
into another relationship in the future with the person or a 
person closely associated with or related to the person. 

A psychologist refrains from entering into a multiple 
relationship if the multiple relationship could reasonably be 
expected to impair the psychologist’s objectivity, compe-
tence, or effectiveness in performing his or her functions as 
a psychologist, or otherwise risks exploitation or harm to 
the person with whom the professional relationship exists. 

Multiple relationships that would not reasonably be 
expected to cause impairment or risk exploitation or harm 
are not unethical. 

(b) If a psychologist finds that there is a possibility of a 
multiple relationship prior to the multiple relationship oc-
curring, then the psychologist is obligated to go through a 
number of steps in order to assess objectively if the rela-
tionship could potentially impair his or her functions as a 
psychologist or otherwise risk harm or exploitation to the 
client or person with whom the professional relationship 
exists. The assessment process should begin by a self-
assessment of the nature of the multiple relationship. The 
psychologist should outline the type of relationship and the 
actual or projected expectations, length, and roles (includ-
ing power differences) for both the professional relation-
ship and the other relationship. At this point, if the psy-
chologist believes the multiple relationship is not ethical, 



LESTINA AND WALLJASPER 
 

30 

then s/he does not allow the multiple relationship to de-
velop. 

However, if the psychologist believes that the multiple 
relationship is still potentially ethical, then the psychologist 
should consult with another psychological or legal profes-
sional with documentation of this consultation, at a mini-
mum. The other professional should assist in an objective 
assessment and provide the psychologist with a documented 
opinion. The original psychologist ultimately makes the 
decision and would be held responsible for continuing or 
not continuing in the development of the multiple relation-
ship. 

(c) If a psychologist finds that, due to unforeseen fac-
tors, a potentially harmful multiple relationship has arisen, 
the psychologist takes reasonable steps to resolve it with 
due regard for the best interests of the affected person and 
maximal compliance with the Ethics Code. 

(d) An assessment process should also be done if the 
psychologist has found him/herself in the position of (c) as 
listed directly above. This should begin with the same self-
assessment as listed in (b) above. The psychologist should 
outline the professional relationship, expectations, length, 
and roles and outline the type of multiple relationship, ex-
pectations, length to date, projected length, and current and 
future roles. The psychologist makes an initial assessment. 
If the psychologist deems that the multiple relationship 
should cease, then the psychologist should move forward 
with this making certain that the professional relationship 
is intact and did not suffer. If the professional relationship 
suffered, then the psychologist should provide appropriate 
referrals for the individual.  

If the psychologist deems that the current multiple rela-
tionship is not causing undue harm or exploitation to the 
individual with whom s/he is in the professional relation-
ship, then the psychologist should receive written docu-
mented consultation for additional objective assessment by 
another psychologist or legal professional. The psycholo-
gist makes his/her decision and is responsible for his/her 
actions. 

(e) When psychologists are required by law, institu-
tional policy, or extraordinary circumstances to serve in 
more than one role in judicial or administrative proceed-
ings, at the outset they clarify role expectations and the 
extent of confidentiality and thereafter as changes occur. 

(f) If a multiple relationship is occurring within a pro-
fessional relationship, then the psychologist is obligated to 
discuss the dynamic of the multiple relationship with the 
individual who is also in the professional relationship with 
the psychologist. The psychologist must inform the individ-
ual that s/he has the right to inform the psychologist if an 
unforeseen harmful or exploitative event occurs. The psy-
chologist must also inform the individual that s/he is agree-
ing to the multiple relationship under the assumption that 
there are no foreseen exploitative or harmful events that 
will come of the dual venture. The psychologist must also 
include in an informed consent the expectations and roles 
of himself/herself as well as the expectations and roles of 

the individual. This informed consent discussion of multiple 
roles should be documented within the client’s record. If, 
however, the situation or characteristics of the client lead 
the psychologist to believe that open discussions and in-
formed consent of the multiple relationship would be harm-
ful to the client’s welfare, then the psychologist should re-
frain from this discussion with the client and document the 
rationale.  
 

The above language in the proposed revised standard 
for multiple relationships in the APA Ethics Code better 
addresses the evolvement of the profession and current con-
cerns in this area (see Table 2). Part A maintained the same 
definition of a multiple relationship. This definition is spe-
cific enough to include all possible multiple relationships, 
including those that are ethical violations and those that are 
not. Making this definition any more specific or limiting it 
to only relationships that are ethical violations would not be 
taking into account the often necessary and viable multiple 
relationships that present in some situations, such as rural 
practice.  

Part B of the proposed standard would be new to the 
Ethics Code. It specifies the process of assessment for the 
psychologist if a potential multiple relationship arises. The 
steps for risk-management provide a clear understanding of 
a minimum standard. This proposed section also makes it 
clear that consultation with another professional is needed 
in addition to one’s own assessment. An objective opinion 
should be sought, documented, and utilized in the decision 
of whether to engage in or continue a multiple relationship. 
This section will hopefully lead professionals to seek more 
input and hence reduce the risk of an ethical violation. This 
assessment process will provide a clear indication of a po-
tential ethical violation if the consultant’s documented ob-
jective opinion was not in congruence with the decision the 
professional made about the relationship. If the consultant 
and psychologist cannot agree, a third opinion could be 
sought and documented. At that point, an ethics panel or 
licensing board may be the most appropriate consultation.  

One potential concern is what to do if the consulting 
psychologist or other professional is impaired, biased, or 
under-trained in the area of multiple relationships. For in-
stance, an urban ethics board reviewer without experience 
in rural practice may not be the best consultant in some 
situations. In this case, the urban psychologist may have 
very different expectations regarding roles given his/her 
different cultural perspective. Thus, the consultant needs to 
be chosen carefully. Overall, the assessment procedure 
should provide a clearer evaluation of potential impairment 
or risk of harm. 

Part B in the APA (2002) Ethics Code was not altered 
and as presented in Part C of the proposed standard.  

Part D is similar to the assessment process in Part B of 
the proposed standard; however, Part D is applied to situa-
tions in which the psychologist finds him/herself in a multi- 
ple relationship without prior time to examine the potential 
harm of this relationship. Because the multiple relationship 



MULTIPLE RELATIONSHIPS AND ETHICS 
 

31 

Table 2 
Comparison of the Proposed Multiple Relationships Stan-
dard and Current 2002 APA Multiple Relationships Stan-
dard 
 

Proposed Multiple Relationships 
Standard 

2002 APA Ethics Code 
Standard 

• Explicit definition of multiple 
relationships 

• Same as proposed 

• Not all multiple relationships are 
unethical 

• Same as proposed 

• Enhanced risk prevention stance • Risk prevention 
• If a potentially harmful multiple 

relationship arises, psychologist 
will resolve in compliance with 
Ethics Code 

• Same as proposed 

• Refrain from engaging in multiple 
relationships if expected to impair 
psychologists’ objectivity or per-
formance or harm the other indi-
vidual in the relationship 

• Same as proposed 

• If required by laws, policy, or 
circumstances to serve in more 
than one role, then clarify role ex-
pectations and confidentiality lim-
its at outset and over time as 
needed 

• Same as proposed 

• Explicit assessment process to 
determine whether multiple rela-
tionship is potentially harmful 

• Not addressed 
 

• Explicit resolution process for 
ending multiple relationship 

• Not addressed 

• Explicit description of need for 
consultation 

• Not addressed 

• Explicit description of need for 
discussion and informed consent 
of multiple relationship with other 
individual 

• Not addressed 

 
has occurred or is ongoing, the psychologist needs to do an 
assessment to determine if there are any unforeseen factors 
that could be harmful to the client as well as determine if 
the multiple relationship should continue or terminate. Part 
E consists of the same language that was utilized in the 
APA (2002) Ethics Code in Part C.  

Finally, Part F is a new addition that addresses the need 
to inform and discuss the ethical issues of the multiple rela-
tionship with the individual with whom the psychologist 
has the professional relationship. This informed consent and 
discussion will better safeguard the welfare of the client or 
other individual in the multiple relationship. The client can 
be made aware of the expectations and roles for him-
self/herself as well as the professional in each of the rela-
tionships. This allows for the client to be a part of the dis-
cussion in terms of potential consequences of the multiple 
relationship. It also provides a clear understanding from the 
beginning so that neither party is making assumptions about 
what the dual relationship means at present or in the future. 
Risk management and protection for the client as well as 

the professional is an important piece of this new addition. 
Having this informed consent discussion documented in the 
client’s file allows for more consistent interpretation and 
evaluation of potential ethical violations due to multiple 
relationships. This proposed standard allows for exceptions 
in which it may be harmful to the client to discuss and ob-
tain informed consent regarding the multiple relationship. 
Examples of this type of situation include a client who is 
psychotic, who is not competent to provide informed con-
sent, or who is so low functioning that he or she may not 
understand the relevant issues. However, it is the authors’ 
belief that at least a simplistic acknowledgment of the mul-
tiple role is possible for most clients. 

The changes proposed to the APA Ethics Code offer a 
number of positive benefits. The first is that the process of 
assessment for potential and current multiple relationships 
is better defined and established. A standard allows for 
more consistent interpretation and evaluation of potential 
ethical violations with multiple relationships. Better protec-
tion is offered to the client and the professional with a stan-
dardized minimum of assessing a potential problem or risk. 
The professional is required to document as well as consult 
with others in order to comply with ethical guidelines and 
standards. This allows for a better system of documentation 
and objectivity.  

The second area that is new in this revised language is 
the directive to engage the client in an informed consent 
discussion regarding the multiple relationship. This final 
section allows for the continued enhancement of client wel-
fare as well as providing a better map for the psychologist 
for a clear, clinically sound, and minimum standard.  

 
Conclusion 

 
The purpose of this article was to address the need to 

update the current standard for psychologists regarding po-
tential multiple relationships. Although the current APA 
(2002) Ethics Code provides a clearer definition and more 
leeway for the psychologist to make an objective decision 
regarding the ethical possibilities of a multiple relationship, 
there continues to be the potential for complications, par-
ticularly for rural and small-community psychologists.  

The proposed standard upholds the strengths of the 
APA (2002) Ethics Code in terms of the definition of a 
multiple relationship and the possibility that not all multiple 
relationships are ethical violations. Building on those 
strengths, the proposed revisions to this standard provide a 
minimum guideline for evaluating potential and current 
multiple relationships to encourage more consistent inter-
pretations. The new language also provides guidance to the 
psychologist that the client needs to be fully informed of the 
dynamics of a multiple relationship. 

The new language proposed is designed to meet the 
needs of the current profession as it has evolved to require a 
more specific multiple relationship standard. It is hoped that 
a more specific strategy for assessing multiple relationships 



LESTINA AND WALLJASPER 
 

32 

and the call to inform and discuss this issue with clients will 
provide a better platform to decrease the incidents of ethical 
violations with multiple relationships for psychologists.  
 

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