Development of the Nonsexual Multiple Relationship Scale (NSMRS)

Current research in the area of ethics and nonsexual multiple relationships that occur between clinicians and their patients lacks an established measure to assess the acceptability of these relationships. The aim of this study was to provide researchers with a psychometrically sound measure that can be used to assess perceived acceptability of a wide range of nonsexual multiple relationships. The construction of this measure involved three phases: (1) item generation through a review of the literature and feedback from consultants, (2) pilot testing, and (3) factor analysis. It was hypothesized that the measure would yield a four factor solution pertaining to the derived face valid categories: of social interactions, business interactions, therapy related interactions, and social networking/use of technology. Based on a review of the literature, a preliminary list of 125 items related to nonsexual multiple relationships were generated from the literature and formed the developmental version of the Nonsexual Multiple Relationship Scale (NSMRS-D). Four licensed clinical psychologists practicing in rural areas served as "experts" to review the items. Based on their recommendations, 14 items were deleted, 84 items were retained (22 of which were modified slightly) and 31 items were added. The 142 item modified NSMRS-D was pilot tested on a sample of six graduate students which resulted in minor modifications of the wording of items and the deletion of one item due to lack of clarity. The final 141 item NSMRS was then administered to 448 undergraduate and graduate students at a mid-sized Midwestern university. Of these, 397 participants produced usable surveys. A principle component analysis with Promax rotation with Kaiser Normalization suggested a six-factor solution accounting for 51.06 % of the variance. A total of 132 items were retained. Factor names include (1) Intentional Multiple Relationships (57 items), (2) Incidental Therapist-Client Contacts (29 items), (3) Former Therapeutic Interactions (22 items), (4) Therapy with Acquaintances (12 items), (5) Social Networking/Technology (8 items), and (6) Gift Exchange (4 items). Internal reliability for the total measure was .98 and alpha for the individual factors ranged from .867 (Factor 5) to .971 (Factor 1). Limitations of this study and implications for future research are discussed.