National survey of psychology internship directors regarding education for prevention of psychologist–patient sexual exploitation.

Abstract

All directors of psychology internships accredited by the American Psychological Association (N = 410) were surveyed about the status of internship education related to prevention of psychologistpatient sexual exploitation. Virtually all responding directors (99% of 230) reported that thenprogram provides at least 1 session on this topic, and the same number indicated that such education should be part of the mandatory internship curriculum. Ninety-four percent of responding programs had instituted the reported training within the prior 10 years and 60% had done so within 4 years. A national mandate requiring education for prevention of psychologist-patient sexual exploitation can consolidate the apparent trend toward greater inclusion of this topic in training programs.Sexual feelings in the course of psychotherapy, both transferential and countertransferential, are ubiquitous. In one survey, 87% of psychologists reported experiencing sexual attraction toward a client at some point during their career (Pope, Keith-Spiegel, & Tabachnick, 1987). Yet, 55% of these same respondents also reported they had received no education on the issue of sexual attraction, and 24% reported ' 'very little'' such education; only 9% of survey respondents believed that they had had "adequate" training to deal with such feelings. Thus, although the criteria for accreditation of doctoral training programs and internships in professional psychology include explicit requirements for instruction in ethics and in the ethical code of the profession (Committee on Accreditation, 1996), it is by no means clear that adequate instruction is actually being provided STEVEN E. SAMUEL received his PhD from Temple University in 1987. He is an associate clinical professor in the Department of Psychiatry and Human Behavior at Jefferson Medical College and is a member of two Pennsylvania Governor's Boards concerning domestic violence and child abuse-child neglect. He has a practice of psychotherapy, psychoanalysis, and forensic psychology in addition to teaching courses at Jefferson Medical College on minorities and psychotherapy, boundary violations, and psychological testing. His upcoming book on barbecue is titled Grilling in the Dark. GREGG E. GORTON received his MD from Tufts University in 1981. His residency training was at Boston City Hospital and The Cambridge Hospital, followed by a fellowship in psychoanalytic psychotherapy at The Austen Riggs Center in Stockbridge, Massachusetts. He is currently assistant professor of psychiatry and human behavior at Jefferson Medical College, where he codirects the Outpatient Training Clinic. His principal scholarly interests are ethics and personality disorders. PRELIMINARY RESULTS OF THESE SURVEY

What we know about predoctoral internship training: A 10-year update.

“…A variety of other topics were investigated, including education for the prevention of psychologist-patient sexual exploitation (Samuel & Gorton, 1998). Internship directors reported that their programs provided at least one session devoted to this topic and agreed that such education should be mandatory.…”

Sex in the consulting room, the examining room, and the sacristy: Survivors of sexual abuse by professionals.

“…Until we live in a world in which there are no hunters, vulnerable children and adults will be sitting prey for perpetrators seeking an easy mark. Samuel and Gorton (1998) argued for prevention of sexual exploitation of clients via substantial education in graduate school and in continuing education in psychology. This is good advice for all professions.…”

Trainee Impairment

“…We agree with other authors (Crewe, 1994;Fly et al, 1997;Kramen-Kahn & Hansen, 1998;Lamb et al, 1987Lamb et al, , 1991Stadler et al, 1988) who have called for the intro-duction into the curriculum of psychology training programs a module (perhaps in ethics courses) on the conceptual and empirical knowledge about the evaluation, identification, remediation, and prevention of impairment, and the professional issues associated with these topics. Introducing topics such as the effects of psychological distress on professional functioning (Ackerley et al, 1988;Sherman & Thelen, 1998) and the responsibility to monitor levels of stress, develop strategies for coping and self-care, and maintain professional functioning would alert students to the professional demands and the need to develop preventive strategies for avoiding impaired performance (Coster & Schwebel, 1997;Hebert, 1992;Kramen-Kahn & Hansen, 1998;Samuel & Gorton, 1998;Schwebel & Coster, 1998;Skorupa & Agresti, 1993). Introducing topics such as the effects of psychological distress on professional functioning (Ackerley et al, 1988;Sherman & Thelen, 1998) and the responsibility to monitor levels of stress, develop strategies for coping and self-care, and maintain professional functioning would alert students to the professional demands and the need to develop preventive strategies for avoiding impaired performance (Coster & Schwebel, 1997;Hebert, 1992;Kramen-Kahn & Hansen, 1998;Samuel & Gorton, 1998;Schwebel & Coster, 1998;Skorupa & Agresti, 1993).…”

“…Current students need to have full and accurate information about historical and current efforts to assist distressed psychologists and the anecdotal and empirical evidence about the difficulties both psychologists and trainees have in responding to impaired colleagues (Bernard & Jara, 1986;Bernard, Murphy, & Little, 1987;Chauvin & Remley, 1996;Good et al, 1995;Kaslow & Rice, 1985;Kilburg et al, 1986;Smith, McGuire, Abbott, & Blau, 1991;Steward, Know, & Satterfield, 1988;Thoreson et al, 1986;Wilkins, McGuire, Abbott, & Blau, 1990;Wood, Klein, Cross, Lammers, & Elliott, 1985;Zemlick, 1980). Introducing topics such as the effects of psychological distress on professional functioning (Ackerley et al, 1988;Sherman & Thelen, 1998) and the responsibility to monitor levels of stress, develop strategies for coping and self-care, and maintain professional functioning would alert students to the professional demands and the need to develop preventive strategies for avoiding impaired performance (Coster & Schwebel, 1997;Hebert, 1992;Kramen-Kahn & Hansen, 1998;Samuel & Gorton, 1998;Schwebel & Coster, 1998;Skorupa & Agresti, 1993). Similarly, instruction on the legal requirements of the ADA will help students understand prejudicial attitudes and biases about disability that result in discrimination and denial of access or opportunity as well as the relationship among functional limitations, appropriate accommodations, and essential functions of the profession (Crewe, 1994).…”