A female counselor works with a male client for about one year in a suburban area. They agreed to meet weekly for the first four months of psychotherapy, and then they agreed to meet twice per month. They developed a good therapeutic alliance. During the course of their work, he discussed significant facts about his troubled past, numerous details about failed past relationships, and sexual fantasies. The main therapeutic issues are depression and loneliness.

During the current session, the client related to having made a new female friend. As social isolation, loneliness, and depression are regular themes in treatment, the counselor frames this as positive progress.

As the conversation continues, the counselor is surprised to learn that the client's new friend is the ex-wife of the counselor's husband. The client reveals that he became aware of that information after several dates and recently felt comfortable revealing this to the counselor. He also indicated that the relationship is taking on a more serious tone.

The ex-wife moved back to the area about six months ago. The counselor knows that the ex-wife had been struggling with isolation and loneliness as well. The counselor, her husband, and his ex-wife are on good terms. They see her regularly for informal family events and do holidays together with their adult children and grandchildren.

After the session is over, the counselor has time to reflect on her concerns. The counselor feels stuck and overwhelmed by her present situation. She calls you for an ethics consult.

1. What are the ethical issues involved?

2. What would you suggest that she does?

3. With whom does the counselor discuss the multiple roles?

4. With only the client?

5. With the client and the ex-wife?

6. With her husband, the client, and the ex-wife?

7. Can the counselor continue the treatment relationship with the client?

8. Even if they terminate therapy, how does the counselor cope with family gatherings since she knows significant details about her client's life?

The Ethical Dilemma I would use in this case would be The Feminist Model for Ethical Decision-Making (Hill, Glaser & Harden, 1995) Step 1. Recognizing a Problem Step 2. Defining the Problem Step 3. Developing a solution Step 4. Choosing a Solution Step 5. Reviewing the Process. Step 6. Implementing and Evaluating the Decision Step 7. Continuing Reflection