A Thin Line
Patient/Therapist Sexual Contact

According to a report published in August of 1996 by the public health watch dog group, Public Citizen Health Research Group, the number of all doctors disciplined for sexual misconduct doubled from 1990 to 1994. Of the total disciplinary actions taken against doctors, 5.1% were for sexual abuse of patients or other sexual misconduct. The American Psychiatric Association, a professional organization for psychiatrists which enforces its own code of ethics suspends or expels an average of 12 members per year for various forms of patient exploitation, most of them sexual. The Association of State and Provincial Psychology Boards estimates 100 Psychologists lose their licenses annually for sexual misconduct. In addition, The American Psychological Association, a professional organization for Psychologists, estimates 10 members are expelled annually for sexual misconduct.

Psychiatrists
Are You Being Exploited?

The American Psychiatric Association's committee on Ethics offers these suggestions to help you tell if your therapist may be stepping over the ethical line. You should be wary if your therapist:

* Begins to disclose personal problems or begins to discuss his or her personal life, including sexual experience, in detail;

* Offers not to charge for sessions or greatly reduces the fee, even when payment is not a hardship;

* Offers to socialize with you outside the office or outside office hours;

* Begins to touch you in seemingly "comforting" ways, such as hugging, putting an arm around you during therapy, holding your hand or caressing you;

* Begins to regularly extend therapy sessions significantly beyond the normal session-by ten to fifteen minutes or more;

* Suggests a relationship beyond that of therapist and patient-offering you the opportunity to participate in business deals, for instance, or soliciting stock market advice.

* File a written ethical complaint with the District branch of the American Psychiatric Association in your area, or with APA directly. The APA has no statute of limitations on such complaints;

* File a written complaint with the appropriate professional licensing board in your state (depending on your state, psychiatrists, psychologists and psychiatric social workers may have different licensing bodies). Most states have statutes of limitation on such complaints, so it is best to file a complaint as near to the time of the alleged abuse as possible.

* Begin a civil or, depending on where you live, criminal action. States having either civil or criminal laws against therapist/patient sexual contact include California, Colorado, Florida, Georgia, Illinois, Iowa, Maine, Minnesota, New Mexico, North Dakota, South Dakota and Wisconsin.

Psychologists

The ethical code of the American Psychological Association as well as most professional organizations specifically prohibits sexual contact between therapists and their clients. Bringing sex into therapy is believed to destroy trust and objectivity. While clients often feel love and even sexual attraction toward their therapists, it is considered a "bad idea" to end therapy in order to start a personal relationship. Sexual contact includes a wide range of behaviors besides intercourse, and these behaviors aim to arouse sexual feelings. They range from suggestive verbal remarks, to erotic hugging and kissing, to manual or oral genital contact. If anything makes you uncomfortable in therapy, talk to your therapist about it . An ethical therapist will want to discuss your feelings and try to understand them. It is possible that you may be misunderstanding your therapist's intentions. However, if you are still uncomfortable after the discussion and the therapist persists in his or her actions, you should consider taking additional steps such as talking to another therapist or changing your therapist.

If you think the therapist's behavior is inappropriate:

* Report the therapist's actions to a supervisor or agency director if the therapist is employed in an agency, to a state licensing board if the therapist is licensed and you think his or her behavior is unprofessional or illegal, to a state professional association or to a national professional association.

* If you think the therapist's behavior has harmed you or is illegal, it may be appropriate to file a civil lawsuit or a criminal complaint against the therapist.

Boston Association to Stop Treatment Abuse 528 Franklin St. Cambridge, MA 02139 (617) 661-4667

California Consumers for Responsible Therapy P.O. Box 2711 Fullerton, CA 92633 (714) 870-8864

Center for the Prevention of Sexual and Domestic Violence 1914 N 34th St., Suite 105 Seattle, WA 98103 (206) 634-1903

In Motion- People Abused in Counseling and Therapy 323 S. Pearl St. Denver, CO 80209 (303) 979-8073

Therapy Exploitation Link Line P.O. Box 115 Waban, MA 02168 (617) 964-8355

Professional Organizations

American Association for Marriage and Family Therapy 1133 15th Street, NW, Suite 300 Washington, DC 20005-2710 (202) 452-0109

American Psychiatric Association 1400 K Street, N.W. Washington, D.C. 20005 (202) 682-6000

American Psychological Association 750 First Street, NE Washington, DC 20002-4242 (202) 336-5700

Reference Materials

Books:

Sex in the Forbidden Zone. Peter Ritter, M.D., Ballantine Books Edition, 1991

Psychotherapists sexual involvement with clients: Intervention and Prevention. Gary Schoener., Walk in Counselor Center Breach of Trust., John Gonsiorek., Sage 1994

You Must be Dreaming. Kitty Waterson., Barbra Noel., Doubleday, 1992

Sexual Abuse by Professionals: A legal guide. Steven Bisbing, Linda Jorgenson, Pamela Sutherland, Michie Company, 1996

Videotapes:

"Ethical Concerns about Sexual Involvement Between Psychiatrists and Patients: Videotaped Vignettes for Discussion." Prepared by the American Psychiatric Association Subcommittee on Education of Psychiatrists on Ethical Issues, for sale through American Psychiatric Press, Inc., 1400 K St., NW, Washington, DC 20005, 800-368-5777

According to the National Institute of Mental Health, more than 30 million Americans need help dealing with situations that seem out of their control. Choosing to work with mental health professionals such as psychiatrists, psychologists or marriage and family therapists is considered one approach to resolving such problems. Psychiatrists and psychologists are trained professionals who specialize in psychotherapy and other forms of treatment to prevent, diagnose and treat human behavior. Psychiatrists are medical doctors who graduate from accredited medical schools and are licensed by their state licensing board. Psychologists are not medical doctors, but have varying degrees of education depending on state licensing and accreditation requirements.

The Association of State and Provincial Psychology Boards is the alliance of state, territorial and provincial agencies, however regulatory authority exists at the state level. Psychiatrists are licensed (medical) at the state level and state licensing boards handle any regulatory issues regarding a physician's medical license. Psychiatrists who are board certified by the American Board of Medical Specialties (ABMS) in Psychiatry and Neurology do so on a voluntary basis and have additional training and certification requirements considered by the American Medical Association to be a "Good Housekeeping Seal of Approval." For information about a physician's certification status call 800- 776-CERT.

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