When people seek help from a therapist they do so because there is an area or areas in their lives in which they need guidance. By way of an interpersonal relationship, the client and the therapist can achieve goals to help improve the life of the client. An example of such a relationship is a client who goes to a psychotherapist for personal counseling because he or she is having difficulties in his or her marriage. Another example is an at-risk adult with a serious mental illness who attends counseling sessions with a trained professional to be diagnosed, learn about his or her disorder, and learn and practice coping skills and life skills that he or she may not be able to perform sufficiently within his or her societal structure.
In all cases, the therapist should be professional. All clients deserve to be treated in a professional manner, a client-centered manner, and with dignity and respect. Licensed professionals accept the obligation and responsibility to uphold a professional code of ethics. When a therapist violates the code of ethics, the therapist harms his or her clients and in most states, can and should be held lawfully and civilly accountable for his or her actions.
Ethics in Therapy
All clients going into therapy should be educated about ethical guidelines that are in place for therapists. For at-risk adults or for children, caretakers and family members should know the guidelines and do their best to be aware of what is going on during counseling sessions. Many mental health care workers have their clients’ best interests in mind, but there are some mental health care professionals that behave in ways that are far from professional.
Ethics in therapy defines how a professional will conduct him or herself in all interpersonal relationships with clients. According to the American Psychological Association (2011), the following elements are included in the general guiding principles concerning ethics:
1. Professionals should do no harm to clients.
2. Professionals are responsible for maintaining relationships of trust with clients and accept responsibility for their behavior. Professionals do not seek personal advantage.
3. Professionals do not condone unjust practices and strive to help all clients by ensuring their own biases, or beliefs do not affect the therapeutic relationship.
4. Professionals know their boundaries of competence and do not try to work outside of their abilities.
5. Professionals will respect the dignity of all clients.
Sexual Exploitation by a Therapist
One very serious breach of the ethics code for therapists that violates all the aforementioned guiding principles is sexual exploitation of a client. In the state of Wisconsin, “therapist” means a psychologist, physician, social worker, professional counselor, family and marriage counselor, clergy, or any person, licensed, certified, or not, who says he or she performs psychotherapy (Anonymous, n.d.). For obvious, common sense reasons any and all sexual contact and behavior is prohibited between therapist and client. When a therapist uses any client, whether the sexual behavior is consensual or not, for his or her own sexual gratification, harm to the client is imminent. Sexual exploitation by a therapist is horrible because the therapeutic relationship is supposed to be built on trust and clients in therapy are often exceptionally vulnerable. Clients should feel secure that a therapist will not abuse them, sexually or in any other way. In some states, the therapist is guilty of a felony offense when he or she makes sexual advances on any client or behaves in any sexual way with any client.
Therapists Who Victimize
Therapists who victimize clients often prey on those clients they know can be easily exploited. Therapists that do this are sexual predators and know they can use their position of power for their personal agenda. Studies have shown that “…adult survivors of childhood sexual and physical abuse are especially vulnerable to being sexually exploited by therapists” (Brodsky, 1989; Gabbard, 1989). These predators do not need to go out to seek their victims. Their victims come to them. In some states, therapists who sexually exploit a client can end up on the state sex offender registry, have their licenses revoked, face criminal charges and fines, and face civil lawsuit. “In 1983 Wisconsin became the first state to criminalize sexual exploitation by a psychotherapist” (Strasburger, Jorgenson, & Randles, 1991).
Effects of Sexual Exploitation on Victims
Once any kind of sexual behavior has taken place between the therapist and a client, the helping process is destroyed. During and after the abuse, the client may become increasingly depressed and confused. The victim might be afraid to report the therapist due to fear that no one will believe him or her. The victim may feel responsible and feel guilty. Some victims even want to protect the therapist because of the emotional bond that is often formed in therapy. Such professional misconduct may cause the victim to have difficulty trusting anyone, even family members or his or her significant other. Because of the lack of ability to trust, he or she may have difficulty seeking needed therapy in the future. The victim may become increasingly isolated, angry, and have problems concentrating. After victimization, there is an increased risk of suicide. The belief held by some helping professionals is that every time a therapist puts his or her hand on the client in any suggestive way or acts in any other sexually suggestive manner, a sexual assault has taken place.
Warning Signs and Inappropriate Behaviors
Professional Therapy Never Includes Sex (2004), outlines the following warning signs and inappropriate behaviors:
1. Giving the client seductive looks
2. Discussing the therapist’s relationships or sex life
3. Sitting too close to the client, holding or hugging the client, lying next to the client, kissing the client, touching the client, any sexual act with the client
4. Inviting the client to socialize (lunch, dinner, dating, or other social activities)
5. Offering to see the client after normal business hours
6. Confiding in the client about his or her personal life (work problems, family life, etc.)
7. Receiving or giving gifts
8. Supporting or suggesting a client’s isolation from social support systems thereby increasing the client’s dependency on the therapist
9. Telling the client he or she is special
There is no excuse for therapists who sexually exploiting a client. The therapist does not have the right to try to validate sexual exploitation by claiming he or she simply ‘made a mistake’. The client’s needs should always be the focus, not the therapist’s desires. No rationalization will excuse the sexually exploitative therapist from his or her behavior. Any sensual intimacy with a client is unethical. Therapists are always responsible for keeping sexual intimacy out of the therapy relationship. Victims and their families or caretakers need to know that when clients are victimized it is NEVER their fault!
Reporting a Therapist for Sexual Exploitation
Some victims decide to report the offending therapist. Victims may report the therapist because they want to make sure the therapist is not allowed to victimize anyone else. Victims may file a civil lawsuit. In addition, victims can report the therapist to the state licensing board and receive helpful information from a Bureau of Prevention, Treatment & Recovery department within the state department. A victim can file a complaint with local law enforcement for criminal action. A victim can check into available adult and/or child protective services for help. One may file a grievance with the agency where the therapist works. A division of quality assurance bureau may be in place to investigate the agency to find out if the clinic provides appropriate oversight of the staff members of the clinic.
If the therapist is not held accountable, especially in regard to the law, the shame falls on the system that lets a sexual predator slip through the cracks, allowing the miscreant to go on to victimize others. The bottom line is that a therapist who is guilty of sexual exploitation should not be allowed to hold a license anywhere.
One dark side of psychotherapy is the side where a sexual predator portrays him or herself as a therapist. People go into therapy for help, not to be harmed. Therapists accept the responsibility to behave ethically and lawfully in their professional practices. Sexual exploitation by a therapist is a very serious violation that decimates the therapeutic environment and has devastating effects on the victim.
American Psychological Association. (2011). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code/index.aspx
Anonymous. (2004). Professional therapy never includes sex. California Department of Consumer Affairs.
Anonymous. (n.d.) Wis. stat. ann. 940.22. Sexual exploitation by therapist. Retrieved from http://www.justdetention.org/pdf/legalresources/Wisconsin%20940.22.pdf
Brodsky, A. M. (1989). Sex between patient and therapist: Psychology’s data and response. In G. O. Gabbard (Ed.), Sexual exploitation in professional relationships (pp. 15-26). Washington DC: American Psychiatric Press.
Gabbard, G. O. (Ed.). (1989). Sexual exploitation in professional relationships. Washington, DC: American Psychiatric Press.
Strasburger, L. H., Jorgenson, L., & Randles, R. (1991). Criminalization of psychotherapist-patient sex. American Journal of Psychiatry, 148, 859-863.