Sexual Relationships between Therapist and Patient—different Countries,Different Treatment

Abstract

This article discusses legal and ethical problems that may result from therapists having sexual relations with current or former patients. A comparative analysis of the approach of several different countries revealed a consensus that such relationships should be absolutely prohibited. Additionally, the apparent reluctance to address the issue of sexual relationships between therapists and former patients in the United States is often reflected throughout the world.

Not intended to be an exhaustive or scientific survey, this article reviews primarily anecdotal information to raise awareness of the universality of possible harm to the patient who becomes sexually involved with either her current or her former therapist. The article proposes rules that would respond to potential harm suffered by patients. Because it has been proved that patients suffer as a result of such relationships with current therapists, the author concludes that such behavior should be legally and ethically proscribed regardless of the country in which treatment occurs. However, because there is no evidence of actual harm resulting from sexual relationships following proper termination, the author recommends that such relationships be presumed acceptable. This presumption would be rebutted by proof of actual harm to the former patient. Based on the fact that proper termination requires successful resolution of the transference and countertransference, the author suggests certain guidelines for making this determination and advocates the use of an independent therapist as the final decision-maker.