The counseling relationship is one based on trust, so we must also expect to be reimbursed by the counselor for all legal fees incurred in their defense. The client may decide to maintain the counselor-client relationship. But how ethical, legal or even practical it is for psychologists to date patients or romantic or sexual relationship between a psychologist and a current patient. Clients often develop a close relationship with therapists but is it possible to become The Facts About the Therapist-Client Relationship.
Is there a difference? If one believes that our patients grow mature and sometimes surpass us in knowledge, wisdom, and power, then it is a significant difference. Of course, of all the dual or sequential relationships that are potentially possible with patients and former patients, when the issue of sex comes up, most all therapists of all disciplines react forcefully.
Having sex with a current patient or even a recently discharged patient is not only unethical—it is illegal.
It is truly a betrayal of the trust the patient places in us. However, over time as in yearscan that change in some very special circumstances to allow exceptions to the rule?
- Can Psychologists Date Patients or Former Patients?
- Sexual Exploitation Laws
If a therapist and former patient meet some 10 or 15 years after the last therapeutic session and develop a personal relationship, get married, and have children, can we say that an ethical violation or a crime has been committed?
Washington State is one exception.
Sexual Exploitation Laws - AdvocateWeb
However, assuming the former client does not file any complaint, how enforceable would such laws be? For example, what if the former therapist and patient got married, were in a committed relationship, and had children?Patient Therapist Relationship - SCATV - Jo Zelken
Would or should an ethics committee have the authority to interfere with a marriage or union among consenting adults? What about our belief in the right to free association?
'Til Death Do Us Part: Does a Client Ever Stop Being a Client?
What is the rationale for the prohibition against sex with patients? Many believe it is the power differential. Behnke points out that many relationships have significant power differentials, including partnerships and marriages, and that we often do in fact put our own interests above those of clients when we charge fees, for example. So, neither a power differential nor putting our own needs first is in and of itself unethical. Rather, Behnke says, it is because we have a fiduciary relationship that is compromised and creates additional risks that are not a necessary part of the therapeutic relationship, making psychotherapy impossible.
Can Psychologists Date Patients or Former Patients? | Futurescopes
But fiduciary relationships are not static and change with time and circumstances. Some would argue it is based on psychodynamic theory, and perhaps those who practice psychoanalytically have a higher standard. But interestingly, there is nothing in psychodynamic theory or psychoanalysis that would state such.
This would include taking patients on vacation and conducting analysis in hotel room beds. We tend to forget that that was a different time with different standards.
Therefore, perhaps, our reactions could possibly be a way of denying and reacting against the behaviors of a previous era we find frankly embarrassing and indefensible.
Another possibility is that, whereas all of us require structure of some kind, some of us need more structure and clear inflexible rules more than others. Some fear that if they bend the rules just a little, they may go down a slippery slope and cross all reasonable bounds. To therapists who believe they are just one rigid rule away from harming their patients, I say maintain all the rules you need.
However, not everyone requires such inflexibility. Attempting to impose such rigidity on everyone is not good practice. It is not good for our clients or the field. If we hold that belief to be literally true, then it would not apply only to sex. We are responsible to protect our clients from harm to self and others.
But if we make no distinction between current and long past, can we in this litigious society be sued for the actions of a long past client? Our clients grow mature and often leave us behind.
If we do our jobs well, we have given them the tools to move on. It is unrealistic to think that, after several years, we mean the same to them as when they came to us for help. The discipline of ethics and the prohibition against becoming sexually involved with patients. Possible Consequences The Consumer information page of Association of State and Provincial Psychology Boards ASPPB — an alliance of state, provincial, and territorial agencies responsible for the licensure and certification of psychologists throughout the United States and Canada — states that sexual contact of any kind between a psychologist and a patient, and in most cases even a former patient, is unethical and grounds for disciplinary sanctions3.
Additionally, in some jurisdictions, such activity may constitute a criminal offense. All psychologists are trained and educated to know that this kind of behavior is inappropriate and can result in license revocation. Why are such relationships considered unethical? To begin with a sexual involvement makes the work of psychotherapy or analysis impossible. For this reason, A sexual involvement is unethical because the psychologist can no longer exercise beneficence in the professional relationship.
Then again, the psychologist is in a position of power over the patient. In medico-legal context, the relationship between a psychologist and a patient falls in the ambit of a fiduciary relationship.
In a fiduciary relationship, there is an overarching ethical obligation not to derive illegitimate forms of satisfaction that place the patient at risk of harm. A sexual involvement violates the fiduciary nature of the relationship and is therefore unethical.
In the end, there is no doubt that a dating relationship between a psychologist and patient is fraught with complications that can prove to be damaging to both parties if boundaries are crossed.