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Sexual Exploitation by Helping Professionals

Sexual exploitation by a helping professional: sexual contact of any kind between a helping professional (doctor, therapist, teacher, priest, professor, police officer, lawyer, etc.) and a client/patient.

  • It is difficult for a client/patient to give informed consent to sexual contact or boundary violations because the helping professional holds a great deal of power over that client/patient.
  • 90% of sexual boundary violations occur between a male provider and a female client/patient (Plaut, S.M., 1997, p. 79).
  • Such behavior is regarded as unethical and, in every licensed profession, can be grounds for malpractice and possible loss of license.

There are three major types of sexual involvement between a client/patient and a professional:

  1. Sexual activity in the context of a professional treatment, evaluation, or service
  2. Seual activity with the implication that it has therapeutic benefit
  3. A sexually exploitative relationship

Why it is not acceptable behavior:

  • The helping professional starts from a position of great power over the client/patient and is expected to respect and maintain professional boundaries.

  • The professional has a responsibility to protect the interests of the client/patient and not to serve his/her own needs.
  • The client/patient has put his/her trust in that professional and the betrayal of that trust can have devastating consequences.

Within the Therapeutic Relationship:

  • Clients in therapy are the most susceptible because the client is already vulnerable and trusts the therapist t0 help her/him feel better.

  • Therapy relationships are particularly intimate, with clients sharing their innermost thoughts, feelings, and experiences.

Issue of Transference:

  • Transference- Way in which a client transfers negative/positive feelings about others to the therapist. Transference in and of itself is not a bad thing. In fact, it is necessary in all therapeutic relationships.
  • Countertransference- When the therapist projects his or her own feelings back onto the client.
  • Problem- When the therapist is unable to recognize transference and countertransference reactions and, instead, responds in a sexual manner.

Common Reactions:

  • Sexual dysfunction
  • Anxiety disorders
  • Depression
  • Increased risk of suicide
  • Feelings of guilt, shame, anger, confusion, worthlessness
  • Loss of trust

Very Low Report Rate:

  • It is estimated that only 4-8% of survivors of sexual exploitation by helping professionals report the exploitation (Gartrell, N., et al.,1987 per TAASA, p. 168, 2004).

  • Often there is reluctance to report because of
    • Anticipated or real pain associated with pursuing the case
    • Fear that she/he won't be believed.
  • It often takes several years for the client to recognize that she/he has been harmed.

3 Ways to Take Action:

  1. Licensing board complaints- Standards vary by state and profession. Possible punishments include suspension or revocation of a license or rehabilitation programs. In these cases the client's confidentiality is protected in any public reports of the proceedings.
  2. Civil lawsuits- Client hires his or her own attorney and sues the therapist directly. Usually this is the only way to receive payment for damages. Procedures are public, and the burden of proof is on the client.
  3. Criminal proceedings- An option in some states. In these cases, the state prosecutes (State v. Therapist). The best possible outcome is a criminal sanction (probation, incarceration).

Additional Resources

AdvocateWeb
Stop Educator Sexual Abuse, Misconduct and Exploitation (SESAME, Inc.)
Survivors Network of Those Abused by Priests (SNAP)


References:
Plaut, S. Michael. "Boundary violations in professional-client relationships: overview and guidance for prevention." Sexual and Marital Therapy, 12, 1, 1997.
Plaut, S. Michael. "Understanding and Managing Professional-Client Boundaries." Handbook of Clinical Sexuality for Mental Health. Stephen B. Levine (ed). New York: Brunner-Routledge, 2003.
Texas Association Against Sexual Assault Sexual Assault Advocate Training Manual, 2004.

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