Exploitation and inference: Mapping the damage from therapist-patient sexual involvement.

Abstract

A growing body of evidence documents a clinical pattern of harmful effects of therapist-patient sexual involvement. In addition, surveys suggest that 1 to 12% of all therapists may have engaged in this behavior at least once in their careers. In order to develop a more comprehensive research agenda, several of these studies are reviewed in terms of inferences that may or may not be drawn. Case studies and surveys may provide for inference of clinical harm and syndrome, but they are limited in terms of generalizations about incidence in the overall population. A population approach coupled with case sampling may provide a useful tool by which to approximate a minimum level of incidence and of effects.

Therapist-patient sexual involvement: risk factors and consequences

“…This inference has been questioned because of methodological limitations (Appelbaum and Jorgenson, 1991;Williams, 1995). In fact, for both issues, there is a clear lack of controlled research based on larger samples (Williams, 1992(Williams, , 1995. The present study tries to overcome some of these methodological limitations.…”

“…The comparison group may be interested in contributing to research. With respect to the index group, Williams (1992) stated in his critical review that only patients who suffer from harm may participate in a study about therapist±patient sexual involvement, whereas patients with neutral or positive consequences may not respond to a newspaper advertisement. While different motivations to participate might not affect the results of the risk factors, it is not surprising that both groups differed in the treatment outcomes.…”

“…While different motivations to participate might not affect the results of the risk factors, it is not surprising that both groups differed in the treatment outcomes. Unfortunately, finding or constructing an unbiased sample, although an ideal approach, may be an impossibility in this research field (see Williams, 1992).…”

“…Risk factors for sexual abuse is a controversial issue (Williams, 1992). Jehu (1994) has argued that the therapist is always fully responsible for the sexual abuse.…”

Too close, too close for comfort

“…Op basis van onderzoek waarin de directe methode wordt gebruikt is wel iets te zeggen over dat risico. Uit het onderzoek van Gartrell, Herman, Olarte, Feldstein en Localio (1986) onder psychiaters, waarin de directe e´n de indirecte methode werden gebruikt, berekent Williams (1992) dat sprake is van 8,9 seksuele contacten per 1000 psychiaterjaren. Dat ligt in de orde van grootte van wat Bachmann en Ziemert (1995) berekenden op basis van pooling van verschillende onderzoeken: 5-24 gevallen per 1000 psychotherapeuten per jaar.…”