Occupational Therapy Practitioners’ Experiences and Perceptions of Sexual Misconduct and Inappropriate Client Sexual Behavior

Abstract

Limited evidence exists on sexual misconduct and inappropriate client sexual behavior (ICSB) in occupational therapy, warranting investigation of prevalence and impact. The objective of the study was to examine sexual misconduct and ICSB prevalence and perceptions in U.S. occupational therapy. Investigators conducted a nonexperimental, concurrent mixed methods study in July 2023, adapting Roush et al.’s questionnaire for occupational therapy practitioners and students with Level II Fieldwork experience. There were 356 respondents. The majority of respondents (63.4%) had experienced ICSB, and 26.6% were aware of sexual misconduct in the workplace. Practitioners perceived these occurrences as wrong or concerning, based on responses to vignettes and survey questions. In open-ended answers, respondents noted that ICSB occurred on a continuum from innuendo to assault; and that consensual and nonconsensual sexual behaviors in the workplace were disruptive and concerning. Professional guidelines and preventive strategies for sexual misconduct and ICSB are critically needed in practice and education.

Plain Language Summary

A Survey of How Occupational Therapy Practitioners in the United States Experience and View Sexual Misconduct and Inappropriate Sexual Behavior from Clients

Purpose: This study investigated sexual misconduct and inappropriate client sexual behavior (ICSB) in occupational therapy in the United States. Background: Sexual misconduct involves engaging in sexual relationships or behaviors with clients, which is against the standards of the AOTA Code of Ethics. ICSB includes verbal and physical acts of a sexual nature, such as sexual remarks or inappropriate touching. Previous research has shown these behaviors are problematic, but studies in occupational therapy are limited. Methods and Research Design: The researchers conducted an online survey in July 2023 and asked questions about sexual misconduct and ICSB perceptions and experiences. There were 356 respondents. Investigators used statistics and examined written responses. Results and Importance: The majority (63.4%) had experienced ICSB, and 26.6% knew someone committing sexual misconduct at work. Practitioners thought this was disruptive and concerning. Practitioners need more guidelines, education, and support to prevent sexual misconduct and manage ICSB.