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The therapeutic relationship is central to counselors' work with clients. The therapeutic relationship is the association, rapport, and connection between a counselor and client. The establishment of the therapeutic relationship begins with the joining process, wherein the counselor and client get to know each other and clarify the need and purpose for counseling. The therapeutic relationship includes such things as unconditional regard for the client, placing the needs of the client first, engaging the client in a positive and collaborative manner, understanding the client and his or her context as it pertains to the presenting problem, mutually agreeing upon treatment goals and interventions, and empowering the client. In essence, the therapeutic relationship is the interaction, connection, and process between counselor and client in efforts to bring about the desired results in therapy.

Understanding the roles that a counselor plays and that the counselor may simultaneously engage in two or more of those roles is central to understanding the concept of dual or multiple relationships (the terms are used interchangeably). Counseling professionals function in a variety of professional roles, corresponding with their education, training, and experience. These include the roles of therapist, supervisor, researcher, employer, consultant, professional association officer, or expert witness. Simultaneously, therapists are functioning in other roles related to the personal, social, and business aspects of their lives (e.g., family member, friend, religious organization member, social acquaintance, sexual partner, business partner). A multiple relationship is defined as a situation in which the therapist functions in roles associated with a professional relationship with a client and also assumes another definitive and intended role that is not inconsequential or the result of a chance encounter. The multiple relationships may be concurrent or consecutive.

The concept of boundaries is critical to the discussion and understanding of multiple relationships. A professional boundary is conceptualized as a frame or limit that demarcates what is included or excluded from the therapeutic relationship. This includes the structure and content of therapy, as well as the professional responsibilities and behaviors that appropriately help clients. Critical areas relevant to boundary issues include time, place, space, money, gifts, services, clothing, language, self-disclosure, and physical contact. Meeting clients outside of the standard location for sessions or exchanging gifts with clients are examples of potential boundary violations.

Related to the construct of boundaries is the power a person has to influence another person or events. Power has the potential to be both helpful and harmful to those involved. This is particularly the case when there is unequal power between the parties involved and when one person has the ability to impose his or her will over others. Factors that contribute to power differences include such things as role, sex, education, and socioeconomic status. Therapists are considered to have greater power than clients in the therapeutic relationship. Therapists' professional power is derived from four sources: societal ascription, expert knowledge, client expectations, and personal power. For example, in society, therapists occupy a position of authority and respect based on the work that they do and the potential influence that they have on people. When people (e.g., clients) come to them, the expectation is that therapists are experts within the field and that they have the knowledge and ability to help clients with the problems or challenges they face. Through the licensing process, society grants professionals the right to use their knowledge and power to benefit others.

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