Broken Trust: Sexual Abuse by a Counselor or Therapist

By Kristi S. Schubert

A close trusting relationship is an essential part of successful therapy. Therapists are skilled in cultivating the trust of their patients and making them feel safe to share their deepest doubts, fears, and insecurities. When this trust is used properly, it can be powerful tool in helping the patient achieve therapeutic success. Unfortunately, a small minority of therapist take advantage of this trust by engaging in a romantic or sexual relationship with the patient. Such behavior constitutes sexual exploitation and is strictly prohibited by the ethics codes of all major mental health professionals.

According to the National Alliance for Mental Illness, more than four in ten American adults (42 percent) have seen a counselor at some point in their lives. If you have seen a therapist, and they attempted to engage in a romantic or sexual relationship with you, they have violated their code of ethics and most likely did not have your best interests at heart.

Therapist Abuse Goes Beyond Professional Malpractice

Because of the nature of the therapist-patient relationship , many victims are reluctant to report harassment, rape, abuse, or sexual assault. The same skills that allow a therapist to establish trust in the first place can also be misused to exploit the patient’s vulnerabilities and insecurities to ensure the abuse remains a secret. In some cases, the abuser uses medication to gain control over the victim; in others, the therapist relies solely on manipulation and psychological abuse, convincing the patient that sexual activity is “part of the therapy,” or is perfectly normal and won’t interfere with the therapy.

The Citizen’s Commission on Human Rights (CCHR), a group dedicated to documenting and preventing abuse of patients by therapists, advocates for the passage of laws to protect patients from abuse. Twenty-seven U.S. states have criminal statutes specifically addressing therapist-patient sexual conduct, although the laws vary significantly in scope and protection. In the absence of a law criminalizing a therapist’s abusive behavior, victims may still be able to recover in a civil suit.

Abuse Can Occur Even in Consensual Relationships

Therapist abuse doesn’t always take the form of a therapist raping, drugging, or sexually assaulting patients. Because of the nature of the power dynamic between a therapist and patient, most professional associations discourage or prohibit all sexual or romantic relationships. The American Counseling Association’s (ACA) Code of Ethics, for example, explicitly states that

“Sexual and/or romantic counselor-client interactions or relationships with current clients, their romantic partners, or their family members are prohibited. This prohibition applies to both in-person and electronic interactions or relationships.” (Section A.5.a.)

ACA ethics rules also bar therapists from beginning a professional counseling relationship with former romantic partners and precludes them from beginning romantic relationships with former clients for at least five years. The Code notes that before a counselor begins any romantic or sexual relationship with a former client (or a romantic partner or family member of a former client), he or she should examine the situation carefully and document (in written form):

“whether the interaction or relationship can be viewed as exploitive in any way and/or whether there is still potential to harm the former client; in cases of potential exploitation and/or harm, the counselor [should avoid] entering into such an interaction or relationship.” (Section A.5.c.)

In fact, the Code directs counselors to, in general, “avoid entering into nonprofessional relationships with former clients, their romantic partners, or their family members when the interaction is potentially harmful to the client.” (Section A.6.e.)

Similarly, the ethical code of the American Psychological Association prohibits treating providers from entering into sexual or other close relationships with current clients and notes that although there is no prohibition on sexual relationships that begin at least two years after therapy ends, these kinds of relationships can still be harmful.

Many medical malpractice liability insurance policies exclude coverage for therapists found guilty of engaging in a sexual relationship with a client. This means that the therapist would be solely responsible for the costs of defense and settlement of a successful lawsuit brought by a patient for sexual abuse. The Chief Professional Officer of the ACA, David Kaplan, commented on the reason for this common practice: “The fact that sexual contact is the only exclusion contained in a malpractice policy indicates how harmful sexual contact is to a client.”

What to Do if You’ve Been Abused by a Therapist

The APA can direct you to resources to report ethical violations by a therapist or counselor, including sexual harassment or abuse, although it has no power to prevent a therapist from legally practicing or obtain any sort of compensation for victims of abuse. If you’ve been raped, assaulted, or sexually exploited by your therapist or counselor you may need to file a complaint with your state licensing board and local law enforcement authorities. An experienced attorney can also help you pursue civil legal action against your abuser, giving you the opportunity to recover monetary compensation for your damages and distress.

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