Sexual Intimacy between Therapists and Patients

Sexual Intimacy between Therapists and Patients

Sexual Intimacy between Therapists and Patients

Sexual Intimacy between Therapists and Patients


"Pope and Bouhoutsos have written a no-nonsense and concise book which covers a great deal of what is known about sexual intimacy between therapists and their patients. . . . This book should be on the must read list for all psychologists." Psychotheraphy in Private Practice "A landmark volume in the psychotherapy literature. This tightly written book offers something valuable to therapists from the student level to the seasoned veteran. It reaches a new level of information comprehensiveness and theoretical integration." Patricia Keith-Spiegel, Former Three-Term Chair, APA Ethics Committee "A thoroughly unique, impressively comprehensive, and long-awaited contribution. A store-house of information." Jay Zisken, Past President, American Psychology-Law Society


The prohibition against physicians having sexual relations with patients is thousands of years old. The oath of Hippocrates is a clear injunction against sexual congress between the physician and the patient. It is equally unethical for mental health therapists of all types to have sexual contact with their patients. The injurious effects on patients of this form of sexual exploitation caused both the American Psychiatric Association and the American Psychological Association to revise their ethical codes specifically to prohibit sexual contact between therapists and patients.

As Pope and Bouhoutsos point out, sexual intimacy between therapists and patients received relatively little attention until the last decade or so. A number of surveys have demonstrated that this sort of therapeutic miscarriage occurs frequently enough to be a scandalous matter. A nationwide survey of psychiatrists, reported in May 1986, found that 6.4 percent of respondents acknowledged sexual contact with their patients. Three national surveys of psychologists reported a range of explicit sexual contact between male therapists and patients from 9.4 percent to 12.1 percent (2 to 3 percent of female therapists had been sexually intimate with their patients). Social workers reported a smaller prevalence rate. Surveys of marital, family, and sex therapists have not been reported, but there is no reason to anticipate that these professional groups would be very different from the three professions just cited.

This is a book for mental health professionals concerned about the moral, legal, and therapeutic aspects of the problem. It is the first comprehensive account of the motivations and personalities of the involved therapists and patients, the consequences for the actors in this painful and often sordid drama, and the difficulties encountered by therapists who attempt to repair the damage. The book includes three chapters dealing with the treatment of the patient sexually abused by a previous therapist. Pope and Bouhoutsos offer suggestions intended to help patients file complaints, as well as guidelines for lawyers and expert witnesses. A section dealing with prevention, providing checklists of warning signs for both patients and therapists, should prove to be most useful in warding off potential trouble.

The timing of this book is fortunate but hardly fortuitous. The mounting concern, the crescendo of criminal and civil lawsuits, the refusal of insurance carriers to protect therapists against liability created by allegations of sexual misconduct, the increasing number of studies reporting injurious consequences of therapist/patient sexual intimacy provided the background for the book and the motivations of the authors. Their scholarly approach is made eminently readable by the inclusion of many hypothetical and actual case histories. It is hardly necessary to enliven a topic of such intrinsic . . .

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