The ethics committee ruled in favor of the client. Professional liability insurance policies may exclude coverage pertaining to business relationships with clients. Liability insurance carriers may view bartering arrangements between mental health professionals and clients as business relationships and therefore refuse to defend a covered
therapist if complications arise in therapy that leads to litigation. Bartering arrangements have the potential for client exploitation, impaired professional judgement and objectivity, conflicts of interest, damage to the therapeutic relationship, and unsatisfactory outcomes to both parties.
SEXUAL DUAL RELATIONSHIPS
● Mental health practitioners should not engage in sexual activity with anyone associated directly with the client, such as friends, family members, or colleagues. The indecency of sexual conduct with clients is widely acknowledged. Clients who sue for damages have an excellent chance of winning their lawsuits if allegations are true. Civil lawsuits by clients in these cases may include the following allegations against practitioners: ● Malpractice ● Negligent infliction of emotional distress ● Battery ● Intentional infliction of emotional distress ● Fraudulent misrepresentation Some state legislators have passed laws that automatically make it illegal for mental health professionals to engage in sexual relationships with their clients. These laws encourage victimized clients to sue. Clients who sue must still prove the sexual relationship harmed them, but harm is broadly defined as mental, emotional, financial, or physical. Sexual dual relationships will always be clear ethical violations. Nevertheless, these relationships continue to occur. ● Breach of contract ● Breach of warranty ● Spousal loss of consortium Counselors and therapists must be aware that even the smallest form of physical contact, or even close proximity, may be perceived as threatening, suggestive, an invasion of privacy, or offensive to some clients. A client who has been sexually assaulted may be revulsed by even a tap on the back; handshake, certain gestures, or close contact may be offensive to certain cultural groups. It may become an ethical boundary violation if it is harmful, rejected by the client, or is determined to be the result of the counselor’s personal needs. and awarded a large damage award as a result of her civil malpractice complaint. Analysis ● The therapist has the burden of proving that no exploitation took place in relation to the client’s mental status and severity of their presenting issues, the ability to comprehend the risk, a level of independence, and the autonomy to act in their best interest. ● As a professional with inherent power in the relationship due to the potential to coerce or influence a client, therapists may have difficulty defending themselves against a claim of sexual misconduct. ● Any diagnosis, such as depression, previous abuse, or various personality or emotional disorders, suggests vulnerability or susceptibility to exploitation and would influence the case against a therapist. ● The therapist or counselor must, in all ways, put the client’s welfare above his or her own. ● Sexual relationships with current, former, or potential clients are always an ethical violation.
One of the oldest ethical mandates in the healthcare profession is the prohibition of sexual intimacies with clients. Clients may suffer reactions similar to victims of rape, spousal abuse, incest, abandonment, and post-traumatic stress disorder. Additionally, feelings of guilt, rage, isolation, confusion, and an impaired ability to trust may occur. Harm from sexual relationships with the practitioner is universally accepted and easy to prove. There are no credible opinions in the profession that defend sexual relationships with clients. The codes of ethics for all mental health organizations include established moratoriums, timeframes, and strict regulations concerning sexual contact with clients. The mental health practitioner must review the sections of their association’s and employing organization’s code of ethics and regulations that govern sexual contact with clients in their entirety. The following list contains information held in common among major codes of ethics regarding regulations for sexual contact between mental health practitioners and clients: ● Mental health practitioners do not engage in sexual intimacies with current therapy clients/patients. ● Mental health practitioners do not engage in sexual contact with former clients, according to the limits set in their organization’s code of conduct. ● Sexual intimacy with former clients is likely to be harmful. ● Even after the appropriate time period allowed in the professional’s code of conduct, the burden shifts to the therapist to demonstrate there has been no exploitation or injury to the client or the client’s immediate family. ● Whether such contact is consensual or forced, under no circumstances will the counselor engage in sexual activities or sexual contact with current clients. Case Study: Sexual Boundary Violation A therapist had delivered services to a client for two months and felt an attraction to her. He decided to invite her to go with him to a presentation on autism because her nephew had been recently diagnosed with the disorder. The client believed that it was not a date but rather an educational event, so she accepted. After the lecture, they went to dinner at the invitation of the therapist. When the client went to the next therapy session, she was given a DVD for the nephew that was produced by the speaker from the presentation. Following a subsequent therapy session, they again went to dinner, and after a few drinks, they returned to the client’s house, where they engaged in sexual intercourse. The relationship continued for a month and ended when the therapist started dating a previous girlfriend again. The client was hurt and angry. She ended the therapy sessions and brought a malpractice suit against the therapist on the grounds that he was unprofessional and that the relationship violated professional boundaries. She claimed that the relationship caused her such mental distress that she was unable to sleep, which subsequently affected her work. The review board ruled in favor of the client
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Book Code: PCUS1525
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