Sexual Misconduct between Psychologists and Their Clients Essay Examples & Outline
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Sexual Misconduct between Psychologists and Their Clients
When people are hurting, confused, frightened or even unhappy they may often seek help from a therapist. There are times that a person might be depressed and they might even think of killing themselves. They might be unhappy when it came to their relationships and they might not exactly known how to bring about change. There are times that they might be suffering from trauma that comes from domestic violence, incest or even rape. The therapeutic relationship that exists between psychologists and their patients is a special one.
It is a relationship that is often characterized by both trust and vulnerability. The people that have come to consult the psychologist might talk to the therapists regarding their events, thoughts, feelings as well as behaviors. These are things that they might never disclose to any other person. Almost every country in the World has come to realize the special nature of this therapeutic relationship and the different special responsibilities that exists between therapists especially in relation to their clients which requires them to go for special training in order to get licensure for the therapists and by recognizing a therapist-patient privilege that enables safeguards the sanctity and privacy of what the patients can be able to their therapist.
There are however some psychologists that take advantage of the client’s trust and vulnerability and they go ahead and sexually exploit the client (Sell, 1985). The psychologist-patient sex has been introduced and has been made a civil law and therefore, offenders might be sued for malpractice, there are some areas that have criminalized the offense. The ethics codes of psychologists prohibits this offense and states that psychologists should be able to understand that sexual exploitation of their patients is a malpractice.
Extreme ambivalence can be described as one of the consequences that comes with debilitating consequences of involvement with therapist. It is caught between two sets of several conflicting impulses and the suffering of this consequence might find themselves as being psychologically paralyzed and unable to make them much progress in either direction. Another consequence that comes is cognitive dysfunction as many people that have been sexually involved with a psychologist experience intense cognitive dysfunction. This often interferes with their attention, concentration and memory. The flow of experience in many cases is often interrupted by the unbidden thoughts, the flashbacks, memory fragments and nightmares. Emotional liability often reflects disruption of the person’s characteristic way of thinking and feeling. Intense emotions might at times erupt suddenly and without case and they might lead to a completely unrelated complex situation. This emotional disconnect can often be profound and might lead to sobbing. Lastly, the people that come sexually involved with a therapist might become flooded with persistent and irrational guilt. This guilt is often irrational because it is in all instances the therapist’s responsibility in order to avoid sexually abusing a patient.
There are ethical considerations that must be examined when sexual relationships are established between the psychologist and the patient. One the relationship has been established, the question regarding the effect to the therapeutic relationship that exists between the two can be examined. The major image of psychologists is that of people that deal with mental problems and they help in solving behavior orders. It is therefore, very important and critical to ensure that the different services are rendered to clients, students and patients that are ethically responsible and are capably performed. Sexual intimacy in therapy can be described as any fondling, erotic acts such as intercourse, touching and kissing that occur between a therapist and a patient.
Basically, the relationship has to be sexualized in order for it to be described as sexual intimacies. However, non-erotic supportive or friendly hugging, kissing and greeting are often not seen as sexual intimacies In fact, intentionality as well as awareness of the consequences and the setting of limits for the different non-sexual relations must always be a part of the picture. Therefore, a friendly pat on the shoulder cannot be described as sexual intimacy. The critical factor that comes in the discerning whether the patient-therapist relationship is of a sexual nature is often determined by the context in which they occur. Any contacts that do not have any sexualizing context between the psychologist and the patient cannot be deemed as being of a sexual intimate nature in therapy.
Ethically, there is a need to create professional boundaries between the psychologist and the patient. The boundaries can be described as the framework within which the therapist and the client relationship occurs. In fact, boundaries make the relationship professional as well as safe for the client. The boundaries are important as they set the parameters by which the psychological services can be delivered. Professional boundaries often include fee setting, the time of session, personal disclosure and limits regarding the use of touch and the general tone of professional relationship. In fact, the boundary can refer to the line that exists between the self of the client as well as the self of the therapist (Kluft, 1989). The primary concern in ethical concerns of the establishment and management of boundaries in each individual can be described as being in the best interests of the client. The boundary matters are often not clear cut out and instead they are dependent upon different factors that require critical analysis and always keeping in mind the interests of the client. It is of the essence to note that there often exists an inherent power imbalance, the therapist’s power often arises from the client’s trust and the therapist is known to have the expertise to help with his or her problems.
Further, the fact that the client’s disclosure of personal information that would otherwise not be revealed also gives the psychologists more power. The fact that the therapy services cannot be provided until the clients are willing to co-operate does not in any way change the fundamental power imbalance. Therefore, it can be argued that the therapist has fiduciary duty in order to act in the best interests of the client and it is ultimately responsible when it comes to the management of boundary issues and therefore, accountable should enable violations to occur. Given the power imbalance that exists in the professional/client relationship, clients often find it difficult to negotiate several boundaries in order to recognize and defend themselves against several boundary violations. The clients may at times be unaware of the need for several professional boundaries and therefore, it might at times initiate behavior and make requests in order to constitute boundary violations.
There are often a number of areas where it might be difficult to draw a line and the boundaries might become blurred. The first is disclosure, although there are cases when self- disclosure might be appropriate and the members often need to be careful that the purpose of the self-disclosure for the client’s benefits. In this case a number of dangers might exist in self-disclosure at includes shifting of the focus from the needs of the clients to the different needs of the therapist and they move the professional relationship towards one of the friendship. The different blurring of boundaries at time might confuse the clients with respect to expectations and roles, and the primary question that is asked does the self-disclosure in order to serve the client’s therapeutic goal (Layman, & McNamara, 1997).
Ethically it is wrong to give and receive significant gifts from the patients. The giving or receiving of more than token value where is contrary to professional standards because of the different risks of changing the therapeutic relationship. In fact, a client that receives gift from the member can feel the pressure to reciprocate in order to avoid receiving inferior care. Therefore, a member often accepts a significant risk from a client risks that alters the therapeutic relationship and one can feel pressure to reciprocate by offering some special care.
Further, dual relationships should be avoided (Layman, & McNamara, 1997). This often occurs in situations where the member of a clinician can be able to handle different significant authority and emotionally relationship with the same person. There are examples such as work place supervisor, family member and course instructor. The members needs to remain cognizant with the purpose of avoiding dual relationships in order to avoid exploit the inherent power imbalance that exists between the psychologist and the patient. Overlapping relationships can be described as problematic because at many cases they might not be avoided (Pope, 2008). These factors should be avoided in order to try and maintain an ethical relationship between the psychologists and the patient.
Whether because of the recognition of the different ways in which sex with a psychologist can harm the client, or even the legal penalties studies are now suggesting that there are fewer psychologists that are sexually abusing their patients. The research that suggests that the rate of therapists sexually abusing their clients may be declining can be described as encouraging, however, this is far from enough. The time is overdue of the mental health professions to put quintessence of sex based practice. Female clients are at far greater than the male clients for the damaging for sexual exploitation by a therapist. There are ethical considerations that should always be taken into consideration when it comes to sexual exploitation by the mental health professionals (Layman, & McNamara, 1997).
In conclusion, it is difficult for a client or patient to given consent to sexual contact or boundary violations because the helping professionals often hold a great deal of power of the client and the patient. In fact 90% of sexual boundary violations often occur between the male provider with the female client and patient (Gartrell, 1986). The behavior is often regarded to as unethical and in almost every licensed profession it can be described as grounds for malpractice as well as possible loss of silence. Psychologists need to understand harms that often occur when they have sexual intimacy with their patients and therefore, they should completely avoid it.
Gartrell, N., Herman, J., Olarte, S., Feldstein, M., & Localio, R. (1986). Psychiatrist-patient sexual contact: results of a national survey, 1: Prevalence.American Journal of Psychiatry, 143, 1126-1131.
Layman, M. J., & McNamara, J. R. (1997). Remediation for ethics violations: Focus on psychotherapists' sexual contact with clients. Professional Psychology: Research and Practice, 28, 281-292.
Pope, K. S., & Bouhoutsos, J. C. (2008). Sexual intimacy between therapists and patients. New York: Praeger.
Kluft, R. P. (1989). Treating the patient who has been sexually exploited by a previous therapist. Psychiatric Clinics of North America,12, 483-500.
Sell, J. M., Gottlieb, M. C., & Schoenfeld, L. (1986). Ethical considerations of social/romantic relationships with present and former clients. Professional Psychology: Research and Practice, 17, 504-508.