Ethics and Sex, Part 2

Part 1 of this topic touched upon the reasons why sexual contact between therapist and patient is harmful, and covered the standards in the Code of Ethics that dictate proper sexual behavior between therapist and patient.

There are additional guidelines for sexual contact with colleagues:  

The Code prohibits sexual contact with a colleague who is your supervisee, student, trainee, or anyone else over whom you have authority (standard 2.07[a]). 

It’s advised against having a sexual relationship with other colleagues if there is any potential for conflict of interest (standard 2.07[b]). 

Sexual harassment between colleagues is also prohibited (standard 2.08).

How should you go about answering exam questions about sexual content?

If there is a question on the exam about you as the therapist having romantic or sexual feelings for a client, obviously don’t select answers that involve you acting on your feelings. 

However, the correct answer usually isn’t to terminate immediately, either.  You can’t realistically terminate everyone to whom you feel attraction.  

Sometimes the best answer on the test includes talking about the sexual/romantic attraction with the client.  However, the “best-best” answer usually involves seeking consultation with a colleague to process your feelings.

Specifically for California test-takers, if you learn someone has previously had a sexual relationship with their therapist, you should give them the booklet entitled Professional Therapy Never Includes Sex.

Also important to note -- If you learn that a minor client has had sexual contact with their therapist, that is a mandated report of child abuse.

The booklet states that “A national study revealed that probably fewer than 10 percent of all therapists have had sexual contact with their patients,” though it does not give a citation for that study.  Anyone know it? 

Regardless, any number of therapists having sexual contact with clients is too many, and up to 10% is an astonishingly large number.  So although this topic may seem obvious, it bears reminding – don’t do it!

Ethics and Sex, Part 1

Focusing in on ethics for the short-term.  One common topic on both the ASWB Clinical exam and the BBS Law & Ethics exam is sex.

The very first thing discussed in the Code of Ethics is that we as social workers have a “primary responsibility to promote the well-being of clients” (standard 1.01). 

Engaging in a sexual relationship with a client is unethical because it gets in the way of promoting that very well-being.  For a pretty thorough description of the ways clients can be harmed via sexual contact with their therapist, check out Kenneth S. Pope’s article, “Sex Between Therapists and Clients.”

Image Credit Kate McHugh Akbar

The Code of Ethics spells it out pretty clearly.  Paraphrased below:

Don’t have a sexual relationship with current client, either consensual or nonconsensual (standard 1.09[a]).

Don’t have a sexual relationship with clients’ relatives or friends when there is a risk of exploitation/potential harm to the client.  This type of relationship could be harmful to the client and difficult for the social worker to maintain appropriate professional boundaries (standard 1.09[b]).

Don’t have a sexual relationship with a former client.  Again, even though the therapeutic relationship has been terminated, there is remaining potential for a sexual relationship to be emotionally harmful to the client (standard 1.09[c]).

You also shouldn’t treat people with whom you used to have a sexual relationship.   Even though the therapy is in the past, same reasons: It can be harmful to them and hard to maintain appropriate professional boundaries (standard 1.09[d]). 

Also, don’t terminate with a client in order to pursue a sexual relationship (standard 1.16[d]).

Related—don’t sexually harass clients (standard 1.11). 

Be careful about physical contact—don’t do it when there’s potential for harm, and it’s the social worker’s responsibility to discuss appropriate boundaries (standard 1.10).

Part 2 of this topic will cover a few more standards relating to sexual contact between colleagues, and also discuss how to answer questions about sexual relationships on the exam.