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Nonsexual Multiple Relationships: A Practical Decision-Making Model For Clinicians

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About the Course:

The term nonsexual multiple relationships has created great confusion in our profession-and great controversy. You may have heard in workshops or read in books or journals that hugging a client, giving a gift to a client, or meeting a client outside of the office constitutes a multiple relationship and is prohibited by our ethics code or by the standard of care sustained by professional licensing boards. Not accurate.

You may also have heard or read that telling a client something personal about yourself or unexpectedly encountering a client at a social event are examples of unprofessional multiple relationships. Again, not accurate.

The inaccuracies, or errors, in our thinking about nonsexual multiple relationships, mire us in confusion and controversy. The errors cripple our movement towards a comprehensive and practical model of ethical decision-making regarding multiple relationships with clients.

This course is intended to provide some concrete guidelines for such ethical decision making in a clinical setting.

This course is based on the reading-based online article, Nonsexual Multiple Relationships: A Practical Decision-Making Model For Clinicians created by Janet Sonne, Ph.D.

Publication Date:


Course Material Author

Janet Sonne, Ph.D.
Janet Sonne, Ph.D. is a licensed psychologist in independent clinical and forensic practice in Redlands, California. She received her BA in psychology from Stanford University and her Ph.D. in clinical psychology from UCLA. She recently retired from her position as professor of Psychology at Loma Linda University where she served as Director of Clinical training for Ph.D. graduate students in psychology. She is former chair and member of the California Psychological Association Ethics Committee. She also served twice as a member of the American Psychological Association Ethics Committee. She is an expert consultant to the California Board of Psychology, Board of Behavioral Science Examiners, and Board of Nursing, as well as to attorneys and religious organizations, regarding professional standard of care and competency issues, and perpetration and sequelae of childhood sexual abuse. She is the author of several publications on the topic of therapist-patient relationships, including the book co-authored with Drs. Ken Pope and Jean Holroyd entitled Sexual Feelings in Psychotherapy: Explorations for Therapists and Therapists in Training. In 2007, her article "Nonsexual Multiple Relationships: A Practical Decision-Making Model For Clinicians" received the American Psychological Association Division 42 Award for Best CE article in The Independent Practitioner. Dr. Sonne's interest in the intricacies of the ethical practice of psychotherapy began at Stanford in her first psychology course. Dr. Phil Zimbardo taught the course and ignited her fascination with how people make decisions to behave in altruistic vs. self-serving ways towards others. While at UCLA, she participated with Dr. Pope and Dr. Jackie Bouhoutsos in the Post Therapy Support Group project, an innovative group therapy program for individuals who experienced sexual intimacies with their therapists. Observing first hand the complex underlying dynamics and powerfully negative effects of such experiences fanned Dr. Sonne's dedication to research and intervention with the patients as well as with the therapist perpetrators. Her experiences on the California Psychological Association and the American Psychological Association Ethics Committees, and various professional licensing boards enhanced her appreciation of the importance of training mental health professionals to conceptualize ethical practice as a process of decision-making rather than a set of rules. As she and Drs. Pope and Holroyd discussed in their book, Sexual Feelings in Psychotherapy, a significant component of that process is the therapist's own reactions to the patient, even though some of those feelings are likely to be experienced as taboo for acknowledgement and exploration. This second edition is designed to expand discussion of the therapist's taboo reactions to patients beyond sexual feelings.

Janet Sonne, Ph.D. authored the material only, and was not involved in creating this CE course. They are identified here for your own evaluation of the relevancy of the material this course is based on.

Course Creator

Recommended For:

This basic-to-intermediate course material is designed for Licensed Professional Counselors, Social Workers, Psychologists, Chemical Dependency Counselors, Marriage and Family Therapists, Nurses, and other allied healthcare professionals who are likely to gain professionally from increased knowledge in the areas of ethics and boundary issues.

Course Objectives:

After taking this course, you should be able to:

  1. Clarify the definition of nonsexual multiple relationships in a therapeutic relationship.
  2. Utilize a new decision-making model that is designed to serve as a practical checklist of elements for therapists to consider as they engage in the complex process of recognizing and then deciding whether or not to enter nonsexual relationships with their clients.


Disclosure of Relevant Financial Relationships

Disclosure of Relevant Financial Relationships

CE Learning Systems, LLC is an independent provider of continuing medical education. CE Learning Systems, LLC has no proprietary or financial interest in medical or healthcare products over which the FDA (USA) or EMA (EU) has regulatory authority.

In accordance with our disclosure policies, CE Learning Systems, LLC is committed to ensuring balance, independence, objectivity, and scientific rigor for all accredited continuing education. These policies include assigning relevance to, and mitigating, all perceived or real conflicts of interest between any individual with control over the content and any ineligible company (commercial interest).

Any individual with control over accredited content, including planner, faculty, and reviewer, is required to globally disclose:

  1. Individual relationship(s) or lack thereof, and its nature, with any/all ineligible company, and
  2. any investigational, off-label, or non-FDA approved content or discussion

CE Learning Systems, LLC has reviewed these disclosures, assigned relevance based on the relationship and scope of content, and identified those with the potential to compromise the goals and educational integrity of the education. Relevant relationships, or lack thereof, are shared with the learner.

Education has been independently peer-reviewed to validate content, mitigate identified conflicts of interest, and ensure:

  1. All recommendations involving clinical medicine is based on evidence that is accepted within the medical profession as adequate justification for their indications and contraindications in the care of patients.
  2. All scientific research referred to, reported, or used in accredited continuing education in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection, and analysis.
  3. Content is appropriate, fair and balanced, unbiased, referenced, and non-promotional.

The planners have reported the following: There are no relevant disclosures.

Course Material Author

The authors have disclosed any disclosures within the material.

Course Creator: Tyler Gibson
There are no relevant disclosures.
Commercial support

There is no commercial support for this distance-learning course.

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Course Number 101771
1 CE credit hour
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  • Reading-Based Online
Exam Fee $5.97
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