Is there any ethical/therapeutical guidelines preventing a psychologist to claim to be a friend of the patient?

The relevant points are:

  • I am aware that there are rules against treating friends, and I have even found references to disciplinary actions when the relationship started after the treatment.

  • But here there is no relationship other than the professional one. Patient and psychologist did not knew before treatment, do not meet outside of practice hours, and do not develop any social activity that could be interpreted as friendship. It is just the therapist claiming to be a friend.

  • OTOH, there is no ill-intent. No "I am your friend, so tell me your credit card number" schema or anything like that.

Could this kind of action be considered as going against ethical/therapeutical principles?

If a country is needed, it would be in Spain, although I am asking just to inform myself so I would be ok with an "universal" answer if that is possible.

  • $\begingroup$ If actually being a friend isn't allowed, then the friendship would have to be a lie. There aren't many circumstances where a patient's health would improve when they learn that this friendship was a deceptive sham. $\endgroup$ Dec 27 '21 at 15:43

When someone says they are your friend, there can be different contexts to the word. For example, Giletta et al (2012) talks of some of these contexts within adolescents.

In the therapy room, Carl Rogers who founded Person-Centred Therapy (PCT) always maintained the importance of Unconditional Positive Regard (UPR) and it is (in its basic form) basic acceptance and support of a person regardless of what the person says or does.

PCT therapists and Integrative Therapists will incorporate UPR into their therapy, whereas Psychodynamic Therapists will be more strict on the client-therapist relationship.

You said,

there is no relationship other than the professional one

Within therapy, there can be a friendship dynamic in play, and that is fine as it is a therapeutic friendship.

There is the fine line within the therapeutic boundaries of the relationship which needs to be maintained at all times. If that line is crossed, the friendship is more than a client-therapist relationship and therefore ethics state that therapy should be redirected to another therapist to address the potential issues with transference and counter-transference mentioned in my other answer on the subject.

I have even found references to disciplinary actions when the relationship started after the treatment

It is where the boundaries are not maintained and breaches of these boundaries are not addressed when therapists are disciplined and often removed from Professional Standards Registers in the UK.


(🔓 = open access journal)

Giletta, M., Scholte, R. H., Prinstein, M. J., Engels, R. C., Rabaglietti, E., & Burk, W. J. (2012). Friendship context matters: examining the domain specificity of alcohol and depression socialization among adolescents. Journal of abnormal child psychology, 40(7), 1027–1043. https://doi.org/10.1007/s10802-012-9625-8 🔓

  • $\begingroup$ Thank you for your detailed answer. But I wonder if multitude of meanings of "friend" shouldn't count against the psychologist claiming to be a friend; after all there is no telling on how the patient would interpret that. I mean, if the psyhcologist wants to tell "I care about you" he can just say "I care about you", if he says "I am your friend" then the patient might understand it as "You can count on me coming to your birthday party.", leading to crossing those boundaries (at least from the patient POV). $\endgroup$
    – Mysterion
    Dec 29 '21 at 11:29
  • $\begingroup$ @Mysterion - A therapist who chooses to say something like this should have a very good idea how their client will interpret such things and if there is any doubt, they should make it very clear what they mean. If they don't and the wrong impression is made, that can also open them up to a disciplinary hearing. $\endgroup$ Dec 29 '21 at 11:34
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    $\begingroup$ The point about Unconditional Positive Regard is very interesting and proper, I will inform myself about it, thank you. I will wait a little more to see if I get any other opinions before marking the answer as correct, and so far I still cannot upvote, but I am on it! $\endgroup$
    – Mysterion
    Dec 29 '21 at 11:39
  • $\begingroup$ Please bear in mind that opinions are off-topic on StackExchange and answers are to be backed by reputable websites and literature. $\endgroup$ Dec 29 '21 at 11:43

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