All guidelines do prohibit exploitation and harm of clients. Dual relationships may not be avoidable in rural communities, the military and among small communities, such as churches, gays, lesbians, the deaf, people with AIDS, Hispanic, African American and many other minorities. The prohibition of dual relationships may be unconstitutional as it may infringe on people's constitutional rights of freedom of association. Exploitative therapists will exploit with or without dual relationships. Avoiding all dual relationships keeps therapists in unrealistic and inappropriate power positions, increasing the likelihood of exploitation.
Isolation forces the therapist to rely on the client's report as the main source of knowledge.
Therapeutic effectiveness can be diminished by excluding collateral information and by exclusive reliance on a client's subjective stories. Not all therapeutic approaches disparage dual relationships. The most practiced and empirically based approaches, such as Behavioral, Humanistic, Cognitive, Family Systems, Group and Existential therapy at times see dual relationships as an important and integral part of the treatment plan. Most graduate and post-graduate education not only instills fear of licensing agencies and lawsuits, but also delivers inadequate instruction in personal integrity, individual ethics, and how to navigate the complex issues of boundaries, duality, and intimacy in therapy. Celebrating dual relationships may alter the power differential between therapists and clients in a manner, which can facilitate better health and healing.