Treating clients who have been sexually abused by a therapist.

Abstract

Therapy provides a powerful space in which to explore emotions, thoughts, identity, and experiences in the context a relationship in which trust and safety can be built and deepened over time. In fact, the connection between therapist and client has consistently been shown to be one of the most robust predictors of positive psychotherapy outcome (Norcross & Lambert, 2011. However, when therapy shifts from close, empathic connection to sexual communication and contact, the fundamental ethical principles creating the safe container of the therapeutic process have been broken

The use and misuse of informed consent in reporting sexual intimacy violations.

“…Other areas of harm may occur when the victim decides to report the sexual assault and is not believed. Thus, treatment of sexual assault and boundary violation victims is complicated and requires specialized training in trauma-specific intervention (Bailey & Brown, 2021; Courtois & Alpert, 2021; Walker, 1994).…”

“…If a client does present with such an issue or wants to address it when it comes up during treatment, the most effective therapeutic approach may be to listen carefully and validate the client’s feelings, including any ambivalence about the previous therapist (Bailey & Brown, 2021; Steinberg et al, 2021). Thus, the recommended approach is for psychologists to inform the client about the options, help them to consider the implications of each, and assist them in choosing the timing of a report should they decide to make one (Steinberg et al, 2021).…”

“…A client’s reluctance to take action could stimulate anger toward the client or an impulse to use information gained through therapy to mobilize the client’s guilt to encourage reporting. Conversely, the psychologist may know the accused colleague and have difficulty believing the allegations (Bailey & Brown, 2021). These responses illustrate how a psychologist’s agenda might supplant the client’s therapeutic needs and inadvertently reenact the dynamic from the previous therapy (Thomas & Hung, 2018).…”

“…We can offer continuing education and graduate student training geared toward prevention. We can learn about the impact of sexual exploitation on clients (Gabbard, 2016) and about therapeutic interventions for those who have been exploited (Bailey & Brown, 2021) and for the psychologists who have violated these boundaries (Hemphill et al, 2021). And finally, we can commit to examining and monitoring our own vulnerabilities and blind spots to decrease the likelihood of inadvertently transgressing boundaries ourselves.…”