When Patients Are Normal People: Strategies for Managing Dual Relationships

A significant number of generalist physicians, particularly those in rural areas, often find themselves participating in the care of patients for whom the therapeutic relationship overlaps with another relationship (e.g. social or professional). Although psychiatrists and psychologists are typically advised to avoid such “dual relationships,” no such prohibition exists for generalists. Little, if any, guidance exists to aid in the management of such dual relationships for the generalist who provides treatment for psychiatric conditions for his or her patients. The author, a generalist with experience in the treatment of mood disorders, describes potential challenges faced by the generalist who chooses to provide care for “dual relationship” patients and outlines strategies for successfully meeting these challenges.