(WITHDRAWN) Why Can't We be Friends? Friendships between Helping Professionals and Members of Mental Health or Other Human Service Organizations

Background: What would happen if practitioners (i.e., service providers or staff) and members (i.e., consumers) of mental health or other organizations started to socialize and become friends by going out for drinks together, for example, or going to baseball games or out to dinner? In short, could service providers develop friendships with people under their care? The answer is yes potentially, or at least yes maybe, for such friendships have developed for decades in clubhouse-modeled community mental health programs. Perhaps these friendships are only possible in clubhouses, for clubhouses differ in important ways from other community mental healthcare (e.g., near-total equalization of power between staff and program members). However clubhouses are not so unique (e.g., primary focus on recovery, employment, housing, and social relations) that friendships elsewhere are completely unrealistic.

Surprisingly, friendships between clubhouse staff and members have yet to be studied empirically.

Methods: We interviewed six clubhouse staff that form such friendships and held three focus groups with twenty clubhouse members in order to better understand from both perspectives (staff and members) what we herein refer to as a “friendship policy.” What is the nature of such friendships? What are challenges and benefits of a friendship policy?

Results: We found that staff-member friendships were both similar and different to friendships elsewhere. Examples of similarities include: (1) bonding based on shared interests; (2) choosing at times to never, sometimes, or always accept invitations; (3) deciding what personal information to share with people and what to keep private; and (4) having some friendships come and go while others persist over time, and having some close relationships while others simply involve shared activity. Examples of differences include: (1) staff awareness of power differential; (2) careful staff avoidance of sharing information with members that may be therapeutically harmful; and (3) prohibitions against both romantic relations and staff disclosure of information shared by members in a staff-member friendship.

There are benefits to staff-member friendships. The giveaway of staff free time (both optional and enjoyable) communicates to members that they are valued and fun to be with, and staff can persuade certain members (some shyer than others) to socialize in order to combat social isolation while promoting social participation and skills. In addition, friendships create multiple teaching opportunities when staff and members can fruitfully process the natural ups and downs and waxing and waning of many or most social relationships, and friendships build rapport and promote well-rounded assessment in unique times and settings (e.g., in bars or sporting events on evenings or weekends). However there are challenges. For example, staff on rare occasions must work afterhours when members are in urgent need of assistance while out and about. In addition, relationships can always sour, and consequences can vary (e.g., a rare agency dropout; potential influence of letdown on mental health). Furthermore, some members report feeling disappointed when invitations fail to include them, although this can be processed fruitfully.

Implications: We offer suggestions for mental health or other agencies that may consider implementing a friendship policy.