Sexual Abuse Reading Centre
Sexual Abuse in Professional and Therapeutic Relationships
Sexual abuse in professional relationships. It grabs headlines, creates talk show fodder and leaves its victims mentally and emotionally shattered. And it happens more often than most people think. Most commonly reported between a patient and her (sometimes his) psychiatrist/psychologist/therapist. This misuse of power also occurs among lawyers, the clergy, doctors, dentists, police and law enforcement personal and teachers.
Problem Widespread
Just how widespread is the problem? "There is substantial incidence of sexual contact between physicians of all specialties, and their patients," says the Archives of Internal Medicine. The American and Canadian Psychiatric Association suspends or expels an average of 24 members per year for various forms of patient exploitation -- most of them sexual. A growing number of provinces in Canada and states in the USA have criminalized psychotherapist- patient sexual exploitation.
One self-reporting survey reported that "as high as 13.7 percent of male (therapists responding) and 3.1 percent of female respondents have engaged in some form of erotic contact with at least one patient." Like all victims of sexual abuse, the victim in this circumstance feels violated, betrayed, angry and ashamed. It makes no difference that the abuse may not have been a violent sexual assault. But when the abuser is a person in whom professional trust is placed, the betrayal is all the more bitter.
Unethical
Why is sexual contact between a professional and his or her client unethical? Legally, many professionals, including doctors, lawyers, professors, members of the clergy, law enforcement, police and therapists, are considered in a "fiduciary" relationship with their client - a relationship of trust, confidence or responsibility. A fiduciary relationship also denotes one party having less power than the other, with the more powerful party obligated to serve the best interests of the trusting party. Sexual contact compromises the judgment of the professional, and may harm the client, student or patient involved, which is why it is considered unethical. While therapist-patient sex has long been prohibited, other professions, including medicine and law, have adopted ethical rules forbidding such contact. In many cases, the courts have held the professional liable for the harm caused by the relationship.
Warning Signs of Danger
Are there any warning signs that a patient/therapist relationship may be in
dangerous territory? Yes. The Canadian and American Psychiatric Association's
Committee on Ethics offers these suggestions to alert you that your therapist
may be stepping over an ethical line.
A pat on the back, an arm on the shoulder or offer to extend an intense therapy session is not in and of itself a prelude to impropriety. But if a pattern develops that makes you uncomfortable, confront the therapist with the behavior, and ask him or her to stop. If exploitation has taken place, you should report it. While these guidelines were designed for patient/therapist relationships, they can be adapted to fit other professional relationships as well.
Unequal Relationship
Why is it so dangerous for professionals -- doctors/psychiatrists/ lawyers/clergy to have sexual contact with their patient/client/congregation member? Because the relationship is unequal, with the professional holding the power card, the psychological repercussions can run deep. It's been documented, for example, that patients are damaged by sexual contact with their therapist. One study of practicing therapists estimated that, in their observations, between 87 and 90 percent of patients who have sexual contact with their therapists are left emotionally scarred. This can surface in everything from suicide, depression, sexual dysfunction and anxiety disorders to feelings of worthlessness, humiliation and extreme guilt. Support groups, have formed throughout Canada and the United States to assist the victim to deal with the shattered lives as a result these encounters.
Legal Recourse
What are the laws pertaining to this issue? Is the law on my side? If you have been sexually victimized by a doctor, psychiatrist, therapist, lawyer, member of the clergy, or anyone else that is in a position of power, you have recourse. There are three courses of action you can pursue: file a written ethical complaint with the appropriate professional licensing board in your province or state, begin civil action alleging malpractice, or depending on the laws governing your state/province, file a criminal complaint with the local law enforcement agency/department.
Sex between professional and client is always a bad idea and is a criminal offense. It's important for victims of this type of unethical abuse to know that the law recognizes the harm it causes. And may allow for financial damages and criminal sanctions against the offending professional involved.
Don Winfield, BSW (Can.Equiv), Child Abuse Consultant, Copyright 1999 - All rights reserved
About the author:
Don Winfield is a Child Abuse Consultant who has over 18 years experience working with Victims and Survivors of Sexual Abuse and Sexual Assault - from the investigation/disclosure phase through to individual and group therapy.
Don also has been awarded the Solicitor General Of Ontario Crime Prevention Award and a Certificate of Merit from the Regional Board of Commissioners of Police (Ontario) for his dedicated and selfless effort in attempting to break the cycle of the crime of Child Sexual Abuse/Assault thus making our communities safer for all.
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