Exploitation in therapy and counselling: A breach of professional standards

Abstract

Exploitation in therapy and counselling may occur in only a minority of cases, but when it does, its effects are potentially damaging to both the client and the profession. Exploitation in therapy may take the form of psychological, covert and overt abuse. The most reported form of abuse of the therapeutic relationship is of a sexual nature. However, psychological abuse usually forms the backdrop to sexual exploitation, preceding and perpetuating the sexual involvement. Sexual exploitation in therapy is an abuse of the power imbued in the therapist by nature of his professional role. It allows the therapist a sexual grati® cation which he would not have been likely to achieve outside the therapeutic relationship. The prevention of sexual exploitation in therapy is an issue of concern to training, employing and professional organisations who seek to maintain high standards of counselling delivery. Determining the variables which may contribute to exploitation is fundamental to avoiding its incidence. This paper discusses the factors underlying the use of therapy and counselling as a medium for therapist abuse. It examines (i) the prevailing conditions for abuse to occur, (ii) how the therapist overcomes client resistance, and (iii) the implications for the maintenance of professional standards.

Patients' experiences of abuse in health care: a Nordic study on prevalence and associated factors in gynecological patients

“…Women who had answered yes to at least 1 of the 3 questions about AHC in adulthood and reported current suffering (1–10) were defined as having AAHC (dependent variable). We only included women with no or adult experiences of AHC ( n = 429; n = 3,434) in the analyses in order to create a chronological order, whenever possible, of exposure and outcome measure.…”

“…We only included women with no or adult experiences of AHC ( n = 429; n = 3,434) in the analyses in order to create a chronological order, whenever possible, of exposure and outcome measure. In total, 520 women suffered (1–10) from AHC: in childhood 65; in adulthood 429; both in childhood and adulthood 26.…”

“…Assault has also been reported in caring for patients with dementia (5). Furthermore, assault has been reported in specific relations, such as between psychotherapists and patients (6), physicians and patients (7–10), and in nurse‐patient relations (11, 12).…”

A Psychodynamic Profile of Therapists Who Sexually Exploit Their Clients

“…The exploitative therapist may attempt to decrease boundaries in an attempt to break down client resistance (Hetherington 1998(Hetherington , 2000. This may be in a variety of forms, such as seeking their advice on personal matters or meeting them socially (Keith-Spiegel & Koocher 1985;Brodsky 1989).…”

Intimate boundaries: Therapists’ perception and experience of erotic transference within the therapeutic relationship

“…There are many well‐known historical instances of therapists transgressing sexual and intimate boundaries with clients. While transgressions still occur (Hetherington, ), this is now recognised within professional ethical codes as exploitation (British Association for Counselling and Psychotherapy [BACP], 2010), and a gross abuse of power. Perhaps due to the intimacy of therapeutic relationships, an attraction between client and therapist, whether perceived as sexual or not, is commonplace.…”