to his friend not to blame himself and stated, “It was not your doing but hers” (McGuire, 1988). Kenneth S. Pope has written extensively on sexual behavior between mental health professionals and their clients. He asserts that sexually abusive psychotherapists are well represented in the mental health profession. As a matter of fact, as Jung’s letters to Freud make clear, there is nothing new about sexual contact between mental health practitioners and their clients. Assalian and Ravart (2003) have identified two types of sexually offending professionals. They are described as affective or predatory . Affective offenders tend to have unresolved emotional problems and may engage in counter-transference, be depressed, or have substance abuse issues. They may have underlying and unresolved abandonment issues. Predatory offenders tend to have personality disorders that include narcissistic, borderline, or psychopathic features. Predatory offenders have integrated their behaviors to use and exploit others in order to meet their needs. Assalian and Ravart have identified seven subtypes within the affective and predatory types. They include: ● Sadistic : Offenders who enjoy using their power and authority to control and dominate the victim, receiving marked pleasure from being cruel and provoking suffering. ● Exploitative : Offenders who purposely use their power and authority to fulfill their needs, including the need to dominate and control. ● Incidental : Offenders who have impulsively behaved in a sexually inappropriate manner one time. ● Narcissistic : Offenders who demonstrate a need for attachment, admiration, approval, validation, love, and attention. ● Angry : Offenders who persistently sexually harass and offend against women. ● Compensatory : Offenders who offend to fulfill unmet needs for closeness, affection, and sexual relations. ● Interpersonal : Offenders who are motivated to establish a close, intimate and long-lasting relationship. The relationship appears to be authentic without clear signs of exploitation or abuse. In a Swiss study, Moggi and colleagues (2000) sought to understand what risk factors might make some women more vulnerable to sexual exploitation by therapists. They found that the women who had experienced sexual exploitation had experienced more parental rejection as children than a control group of women who had been in therapy but who had not experienced the exploitation. They had also experienced more sexual violence. Most offending therapists are male and most exploited clients are female (Capawana, 2016). Ravart and Assalian (2003) reference Sealy (2002) concerning the three severity levels of professional sexual misconduct: 1. Sexual impropriety : Violations such as inappropriate sexual remarks. 2. Sexual transgressions : Violations such as inappropriate touching. 3. Sexual violations : Violations that include sexual relationships.
In the same article, Ravart and Assalian report on a colorful categorical system developed by Irons and Schneider (1994, 1999) to describe mental health professionals who engage in sexual misconduct. This system – which offers another, simpler perspective on professionals who offend in this way – groups offenders into six types: ● The Naïve Prince (8% of Irons and Schneider’s sample of 137): These individuals are new to the profession and develop a privileged relationship with one or more clients, blurring the boundaries. They are psychologically healthy and feel remorse for their sexual misconduct. ● The Wounded Warrior (22%): These individuals are generally psychologically healthy, but they are trying to escape professional demands, internal struggles, and unresolved childhood and adolescent issues with their sexual relationship. They feel remorse over the relationship. ● The Self-Serving Martyr (24%): These professionals are in mid- to late career, and have become isolated and resentful over sacrifices they have made and what they perceive as a lack of appreciation. The sexual misconduct is meant to relieve their suffering. These individuals are often dealing with addictive disorders. They may also have a personality disorder. ● The False Lover (19%): These individuals display creativity, intensity, and charm. They indulge in drama and lack impulse control. For these people sexual misconduct fills a need for excitement. They usually have a personality disorder, which is often their primary diagnosis, often with narcissistic, histrionic, and dependent features. ● The Dark King (12%): These professionals need to control and dominate and are driven by grandiosity. These people are often highly intelligent, but have a number of personality disorders. ● The Wild Card (15%): These people often have severe mental disorders and may even be suffering from dementia. Anyone working in mental health practice has experienced different relationships with clients. Sometimes it is nearly impossible not to form respect and even affection for clients. However, practitioners must work diligently to avoid problems, i.e., either crossing the boundaries of the professional relationship or even appearing to do so. In addition to other previously discussed actions designed to prevent harm to the client, workers can proactively address this issue by doing the following: ● Limiting practice to those populations that do not cause your own needs to surface. ● Seeking clinical supervision to effectively deal with personal feelings. ● Documenting surroundings and who was present during sessions and visits. ● Avoiding seeing the client at late hours or in locations that are atypical for routine practice. Reporting sexual misconduct by a colleague is an ethical responsibility of mental health practitioners. Many states have laws that require licensed professionals to report such misconduct, as well as other ethical violations to their State Boards. It is the responsibility of every professional to protect clients by reporting a reasonable knowledge or suspicion of misconduct between the client and colleague.
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Book Code: SWTX1524
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