How best to help?

[IrmaJean]

Ever since my experience during therapy, I have made a point of trying to offer support to others who develop feelings for their therapist. Unfortunately, from time to time, I talk with someone whose therapist is behaving in what seems to me to be an unprofessional manner. This is not a place that I am personally familiar with and I am not always sure how best to help. I just recently spoke with someone who is confused and vulnerable right now. Her therapist has done things such as ask her to meet and socialize with him outside of sessions. I am very concerned for her. I have noticed that coming down too hard on the therapist involved often seems to frighten the person away, leaving me unable to help. I tried gently pointing out the red flags to her. Anyone have any suggestions for the best approach to help her? I hope that no one finds this post triggering in any way.

[David O]

Good morning Irmajean,

This is such a touchy and sensitive area, and it's one that's drilled into I think all mental and medical health professionals (and attorneys). Survey after survey of psychologists and psychiatrists suggests that 8-10% of clinicians have sexual contact with their clients/patients. The rules are clear and this type of boundary violation is drilled in our trainings, in newsletters, supervisions, etc., and is written not only into our rules of professional conduct, but also in statute-- they are legislated state by state in nearly all 50 states.

Sexual contact is not just sex, it now includes touching of breasts, oral sex and any other form of erotic contact. Any clinician whose behavior crosses this line, stands to have their license suspended or revoked, a fine and of course, if prosecuted, they may face much stiffer penalties in that if sued, their malpractice insurance will not pay out since it was deliberate behavior (much like fraud).

Irmajean, I don't think there is a gentle way of approaching this... my thoughts are that clients should know this or be told immediately (irrespective of the shock in their response) of the outcomes following these encounters-- very, very few are positive and most result in an exacerbation of their condition plus added concerns of depression, relapse and even suicide.

Clinicians who do this prey on their clients, especially those who may be confused and unsure, or those whose vulnerability (a newly divorced person, one has lost a loved one and is severely depressed and not thinking clearly, someone whose illness clouds their judgment, etc.) makes them an easy target.

With respect to damages, in Walker vs. Parzen, a $4.6 million award was granted by the San Diego superior court after the patient testified of being psychologically damaged following her being seduced by her therapist. There have been many suits of this magnitude over the years and the standard of proof is very low.

Bottom line is that any form of social contact outside of the therapy session, which is initiated by either party, creates the slippery slope that leads to great personal damage to the client (much like being molested by a parent) and puts the clinician on the path to being suspended from practice. The rules are so explicit that we are not permitted to see someone even after therapy has ended, unless 2 years have passed; however, even that is no protection and clinicians have been prosecuted for his even 10-15 years after therapy ended.

In a word--- it's a significant violation, one that is so serious as to warrant legislation that one can't "beat around the bush" on this one. It sounds as if the person you're talking with is with a clinician who may be preying on her vulnerability and confusion and you may be the only person that can shoot straight with her. This is not the time to equivocate, mince words or hem and haw, regardless of their reaction! And you must remain ever so compassionate after you've told them this as the shock can be highly distressing.

Good luck and I hope this helps,

David

[IrmaJean]

Thanks so much, David. She is recently divorced and I suspect young and vulnerable, so I need to do this. The reason I have hesitated with being forceful in setting her straight is because twice in the past when I have done this, I never heard from the person again. But the only thing which I can control in this situation is giving her the truth as I see it. The rest is out of my hands. It's always discouraging encountering situations such as this in a place that is meant for healing. I will talk with her then. Thank you.

[Bluerose]

Honesty really is the best policy. Sometimes it hurts like hell, especially for vulnerable people like ourselves, but it really is for the best. It might hurt. It might not be what we want to hear but it certainly saves a lot of time and energy in the long run. Even if it takes us a while to realise that. So don’t expect a thank you from that person any time soon.