Running head: TEACHING CASE

Dual Relationships and Ethical Boundaries

Karin Troy
The University of North Carolina at Pembroke

Running head: TEACHING CASE

Dual Relationships and Ethical Boundaries

Facts
Sandra is a hospice social worker in a rural county by the name of Charming. Charming
is a middle class city flushed with old brick houses, buildings and historical monuments. Torri,
Sandras client, was born and raised in Charming and deliberately says that Charming is her only
home. Torri has been divorced for 2 years and she raises her 3-year old daughter Jessica alone.
Torri parents passed away in a car accident when she was 12 and Jessicas father fled somewhere
out of state after the divorce. Plus, the hopes of finding the parents of Jessicas father is slight to
none because Torri never met them. However, after Jessica was born Torri suddenly began to
experience several health problems. She began experiencing shortness of breath, chest pain, and
extreme fatigue and nausea. When Torri finally visited the doctor, she became aware that she
was suffering from stage 3 breast cancer and was expected to live 3 more years at the most. The
diagnosis of cancer is strenuous for everyone, knowing the fact that the days of his/her life are
numbered.
Throughout the entire 3 years of Sandras consultation with Torri, she has became very
close with Torri. Sandra felt as if she were obligated to help Torri with whatever she may have
needed. Sandra was the only person Torri could actually call her friend. Torri would call Sandra
crying about how she was ready for everything to be over, she would call when she was having
good days, and she even called when she just wanted someone to converse with. Yet, as Torri
became close to her three year mark, she began thinking about plans for Jessica. She became
very nervous, anxious, and depressed about leaving her baby girl behind but she knew she had to
find Jessica a great caregiver because she not able anymore. Before Sandra could explore the
options for adoption or kinship placement, Torri insisted that Sandra adopt Jessica. Sandra and

Running head: TEACHING CASE

Torri were like best friends so Torri was aware of Sandras desire to adopt a child. Sandra was in
a committed relationship since she was 13 and she figured it was time for a new addition to the
family. However, Sandra was never able to adopt successfully due to inconvenient circumstances
each time the adoption became close to an end. On the other hand, Sandra is also aware of the
ethical principles she had already broken by speaking with Torri daily, and this would not be a
good idea. Although, Sandra really wants to take Jessica in as her own, she knows the risk of
doing so. Sandra treated Jessica as her own, she babysat some weekends and would buy things
such as diapers wipes and baby milk when Sandra was unable to do so.
The ethical dilemma involves a conflict between Sandras responsibility to Torri as a
friend and Sandras responsibility to Torri as a client. Typically, the most important aspect to
consider is the possibility of Sandra losing her licensure if she takes Jessica in. Sandras duty to
her employer should come first because she is expected to follow the rules and regulations of the
employer (Rothman, 2013). Dual relationships that include the development of a friendship that
may lead to communication outside of the work setting is strictly prohibited (Dewane, 2010).
Sandra and Torri has already established a friendship since the first day of services. Therefore,
Sandras commitment to following the Code of Ethics is already diminished. Secondly, Sandras
obligation to her friend must be evaluated as well. Torris condition is very terminal, and Sandra
may feel that giving Sandra the assurance of Jessicas future being in good hands could give
Torri the peace of mind that she needs. In the same way, this request could be Torris last wish
before her battle with cancer ends. Lastly, Jessica is very young so she may not remember
exactly what may have happened to her mother, but Sandra can always make sure that she
remembers her mother, which the family that adopts her may not. In other words, Sandra must
think about how Jessica will deal with this loss. Sandra is the only family that Jessica and Torri

Running head: TEACHING CASE

have, she has no one else to comfort her. With that being said, it is very difficult to determine if
any of these principles are any less important than the other because it depends on which aspect
of the dilemma Sandra is most committed. The dilemma can be defined by the responsibility to a
friend v. the responsibility to the employer.
Ethical Principles
The ethical principles relevant to this dilemma are: the social worker main priority is
helping clients with their social problem, attempting to value the dignity and worth of the client
through self-determination, becoming a valuable asset in the helping process by prioritizing
human relationships, and putting forth an effort to behave in a trustworthy manner (National
Association of Social Workers, 2008). Basically, the most important principle would have to be
making certain that the social workers true intentions are for helping the client resolve the social
problem. In this dilemma, the most important factor would be helping the client become clear
about the circumstances of which Sandra could not adopt Jessica but she can make sure that the
family that adopts Jessica is perfect. The difficulty of choosing the social workers main priority
as helping the client opposed to valuing human relationships helped me realize that no matter
what the relationship may have been Sandra has a job and she must follow the guidelines
expected by her employer.
Possible Outcomes
The worst case scenario for this dilemma would be Sandra refusing to grant Torris wish.
As a result, Torri could report Sandras dual relationship, which would then lead to Sandra losing
her job. Sandra could encourage Torri that adoption is the better option because it gives them
both what they want. Jessica will be taken care of sufficiently, and Sandra can still have her job

Running head: TEACHING CASE

and be a part of Jessicas future. Then again, Sandra could do as Torri ask and still lose her job.
On the other hand, Sandra could begin looking for adoption families and allow Torri to choose
the best fit for Jessica under the circumstances that Sandra keeps contact with Jessica at least
once a week. But if the adoption family does not treat Jessica accordingly, Sandra will definitely
feel the guilt. Although, Sandra has already violated regulations, it is possible that she could do
her job efficiently and satisfy Torris last wishes without putting her job in jeopardy.
Safeguards and Provisions
The most important safeguard in this dilemma should be preventing Sandra from losing
her job but at the same time giving Torri peace of mind that Jessica will be protected. But this
may mean that Sandra must continue to provide for Jessica leading to dependency. These
provisions can be detrimental to the safeguard of Sandras job. This dual relationship has shaped
her life in such a way that she either option made would require continuity of neglect and
insubordination towards Sandras employer. The safeguards and provisions put in place for this
dilemma puts Sandra in a corner of choosing what feels right and what is ethically right
according to rules and regulations.
Early Warning
Typically, whatever choice Sandra makes it is possible that she may be aware when the
problem has risen. If her manager finds out about Sandra adopting her former clients child, it is
expected that she will be confronted about the situation before the next course of action is taken.
On the other hand, visiting Jessica after the adoption has taken place trouble may be unforeseen.
In this dilemma, if things go wrong the worst situation would be Sandra losing her job and

Running head: TEACHING CASE

Jessicas adoptive parents treat her badly and refuses to inform her about her biological mother
and what she did to make sure that she was safe.
Literature Review
Dual relationships in the social work profession is very common. Particularly, most
instances occur in the spur of the moment when a hospice client has become emotional and the
social holds the clients hand, lending the client twenty dollars for gas so that they can get home,
running grocery store errands with clients, adopting the clients child, and even giving a client a
ride home (Dewane, 2010). Each of these situations are considered unethical for social workers
simply because they do not follow the NASW Code of Ethics. As a social worker, maintaining
professional boundaries in order to avoid social and recreational activities with clients
(Pawlukewicz & Ondrus, 2013).
Practicing ethical decision making in Social Work can become very overwhelming if the
dilemma is not evaluated correctly and carefully. However, research states that many clients
choose a professional that shares the same attitude and values as themselves which lead to ethical
challenges on the professional (Gonyea, Wright, & EarlKulkosky, 2014). Similarly, the
friendship between Sandra and Torri may have been led by the familiarity of their attitudes,
interest, life goals, and struggles as well. According to a study of rural therapists, several
strategies are used to determine whether the dual relationship was necessary. Primarily,
professional judgment was used by weighing the pros and cons of the dual relationship (Gonyea
et al., 2014). Next the therapist examined the level of benefit and detriment from the clients
perspective. Basically stating that if the therapist believed the relationship would help the client
with their social problem then the relationship was considered acceptable. Also, the context and
nature of the relationship was taken into account as well. These therapist felt that it was

Running head: TEACHING CASE

imperative to look at the level of intimacy and type of relationship presented. Sometimes the
therapist may run into the client in a grocery store unexpectedly and a conversation may be
sparked (Gonyea et al., 2014). Lastly, these therapist noted that the limited access to supervision
can be examined as well. Apparently, the lack of supervision leads to the increased potential of
dual relationships according to the study (Gonyea et al., 2014).
While some critics argue that avoiding dual relationships should be mandatory, others
believe that doing so takes the core of connection out of social work practice (Dewane, 2010). In
cases such as this boundaries must be clearly stated for purposes that making the ethical choice
based on NASW may hurt the client more than making the choice more beneficial to the client.
In some cases, dual relationships may be beneficial, but the self-judgment of the professional
must be very accurate in order to take that risk for the sake of the client and not the social
worker.
Resolution
Sandras ethical dilemma is very difficult to pursue without a certain perspective in mind.
Basically, the social worker and Jessica enjoy each other and their love for each other is
unbreakable at this point. The 3 year has become attached to Jessica because her mother is not
able to give the attention and affection that she used to because of her condition. I would choose
to adopt Jessica, even though the decision would not be solely for the client I would know that I
helped ease the worry of my friends suffering. Torri has sat in her death bed for 3 years straight
and it would be incredibly terrible to allow a toddler who has watched their mother deteriorate be
shipped off with strangers. As social workers I understand that we have guidelines and ethics we
must live by but the guilt that any social worker would live with by choosing commitment to the
employer would be unbearable. Under no circumstances will I act as if I am above the Code of

Running head: TEACHING CASE

Ethics, but I do believe that a child who doesnt know any of her family deserves to be with
someone that she does know. Hospice care is a very hard path for me because my main focus
would be making sure that the needs and wants of that client are fulfilled. With this ethical
dilemma, one must empathize with the client because if the social worker were in those shoes
he/she would want someone to do the same for them. Specifically, the most important principle
that had a significant impact on my decision was the main priority of the social worker helping
the client with social problem. Torris social problem was evident to be that she trusted no one
else with the life of her child because she didnt have any family and she did what she felt was
right. Therefore, my decision to grant my clients wish was not only for Torri but for the child as
well.

Running head: TEACHING CASE

9
References

Dewane, J. (2010). Respecting boundaries-The dos and donts of dual relationships. Social
Work Today. 10(1), 18
Gonyea, J. J., Wright, D. W., & EarlKulkosky, T. (2014). Navigating dual relationships in rural
communities. Journal Of Marital And Family Therapy, 40(1), 125-136.
doi:10.1111/j.1752-0606.2012.00335.x
Pawlukewicz, J., & Ondrus, S. (2013). Ethical Dilemmas: The Use of Applied Scenarios in the
Helping Professions. Journal Of Social Work Values & Ethics, 10(1), 2-12.
Rothman, J.(2013) From the front lines: Student cases in social work ethics. Pearson.
Workers, N. A. (2008). NASW Code of Ethics (Guide to the Everyday Professional Conduct of
Social Workers). Washington, DC: NASW.