Indigenous Kinship Obligation Norms and Therapist Boundary-Setting Among Ghanaian Clinical Psychologists: A Factorial Vignette Experiment on Dual-Role Dilemmas and Confidentiality Erosion
Year: 2026
Type: article
Abstract: Ghanaian clinical psychologists practise within extended-family systems that impose enforceable obligations of material support, mediation and secrecy on kin. When a therapist and a client share a lineage, those obligations can collide with the dual-role prohibitions and confidentiality rules imported from Euro-American professional codes. Practising clinicians (N = 214) were randomised to vignettes crossing kinship distance (close kin, distant kin, non-kin), obligation salience (high, low) and confidentiality risk (high, low), and rated the likelihood of accepting a dual role and of disclosing client information to family. The analysis used a mixed-effects model with random intercepts for respondent. Acceptance of dual roles was higher under high obligation salience than under low salience (β = 0.71, SE = 0.09, p <.001), and the effect was strongest for close kin. Willingness to disclose was higher when obligation salience was high and confidentiality risk was low (β = 0.54, SE = 0.11, p <.001). The results suggest that boundary erosion is not a failure of individual ethical commitment but a predictable response to enforceable kinship claims. Training and supervision that treat kinship obligation as a structural feature of the clinical setting, rather than as a character flaw, are more likely to protect confidentiality than codes that simply prohibit dual roles.
Institution: University of Dar es Salaam
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7223240578