Psychotherapist-patient sexual contact after termination of treatment: an analysis and a proposal

Article Abstract:

There is general agreement among psychotherapists and psychotherapy organizations that sexual contact with patients in treatment is unethical. There is much less agreement over whether sexual contact with former patients is always unethical, and for those who think it is sometimes ethical, under what circumstances it might be considered so. The legal system and other entities outside the mental health professions are now addressing this problem, but within the mental health profession, little action has been taken. Seven states have enacted laws criminalizing sex with patients when the patient is in treatment. Three of these states have also criminalized sexual contact with former patients under certain circumstances, mainly when the psychotherapist terminates treatment primarily to be able to engage in sexual activity with the patient. There is concern that the laws criminalizing sexual activity with former patients may be unconstitutional. Four states have enacted civil statutes that allow patients to sue psychotherapists for misusing their positions to engage them in sexual activity. Some courts have found that sexual activity with former patients constitutes malpractice. Both state administrative boards and professional societies issue standards and codes of ethics for professionals they oversee or that are members of the society. The administrative boards can fine or suspend the licenses of those that defy the codes. With the diversity of actions being taken, the questions of why sexual contact between psychotherapists and former patients should be restricted and when circumstances would allow it are being overlooked. The main reasons given for banning sexual activity with present patients include impaired decision making, coercion, fraud, and exploitation of a fiduciary relationship. These are less problematical factors when considering former patients, but not completely so. Restricting sexual activity with former patients for at least one year following termination of treatment would help ensure patients are protected without infringing upon either the patient's or the therapist's right to associate with one another. The one-year period should also preclude social contact so that the therapist-patient relationship can be completely severed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Editorial

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Criminalization of psychotherapist-patient sex

Article Abstract:

The issue of sexual relations between psychotherapists and their patients or former patients has been increasingly debated in the literature over the past 15 years. It is estimated that between 7 and 15 percent of psychotherapists have such contact with their patients, and that more than 90 percent of the patients suffer some sort of harm as a consequence. Professional groups have begun educational programs for practitioners, and licenses have been revoked. But despite these efforts and the potential consequences, the behavior continues. The arguments for and against criminalization are discussed in this article. Masters and Johnson were the first to call for criminalization of psychotherapist-patient sexual relations, and in 1983 Wisconsin became the first state to do so. Six other states have followed, and others have legislation pending. But whether this issue is an appropriate one for social policy is debatable. Advocates of criminalization often argue that it would serve as a deterrent; others see it as retribution. It would also be effective against unlicensed therapists who are not governed by a professional organization. Opponents of legislation to criminalize psychotherapist-patient sexual contact say it would only obscure the issue and possibly deter victims or colleagues from reporting incidents. Criminalization might also void malpractice insurance under many policies, eliminating a valuable resource for victims. There are other, psychological reasons to avoid criminalization as well. It is important that those involved in evaluating legislation to criminalize sexual relations between psychotherapists and patients consider the pros and cons of such legislation and whether or not some other form of control would provide a better solution. (Consumer Summary produced by Reliance Medical Information, Inc.)

Interpretation and construction, Psychologists, Criminal act

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The prevention of psychotherapist sexual misconduct: avoiding the slippery slope

Article Abstract:

Sexual relations between therapist and patient can be prevented by avoiding 'slippery slope' behavior or by observing the bounds of permissible therapeutic behavior. Many factors contribute to the problem of therapist sexual exploitation and these are inherent in the nature of the psychotherapy relationship as well as in the individual behavior characteristics of patient and therapist. It is suggested that strict and careful boundary behaviors must be firmly followed by the therapist to avoid any untoward sexual contact with the patient.

Management

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