Dangers of Dual Relationships in Therapy

Often, people who seek the help of a therapist are vulnerable in a number of ways, and the unique relationship of client and therapist is built on a great deal of trust and openness where a number of issues are exposed. This situation can often leave a patient or client feeling more vulnerable than ever before, and depression, anxiety, and other mental health concerns can easily cloud a client’s judgment. Because the client-therapist relationship is a relationship of power, it is more important than ever that therapists do not give into seduction or sexual attraction that may exist for a client, and that sexual relationships with clients and patients not be allowed to develop.

Although some studies have been done on the existence of client therapist sexual relationships, it is evident that many of the results of these surveys are unreliable due to the nature of the situation. Even when confidentiality is assured, many therapists are fearful of the repercussions of being exposed and are reluctant to divulge such information. Still, these studies confirm that sexual relationships still often do occur between therapists and clients, more frequently in male practitioners than females. Furthermore, these studies have also revealed that these kinds of relationships can be further detrimental to clients and patients who seek the help of professional therapists.

Sexual relationships between counselors and clients has existed probably since the beginning of time, being noted as far back as the fifth century B.C., when the Hippocratic Oath originated, stating, “In every house where I come, I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women and men.”

However, recent studies and even court cases have confirmed that this phenomenon continues and in many cases, is further detrimental to the mental health of the clients who enter into these types of relationships. For clients who are dealing with issues related to domestic violence, abuse, rape, or incest, the abuse of trust and power that occurs with sexual client-therapist relationships can increase feelings of trauma and psychological distress, often triggering symptoms of post-traumatic stress disorder. Even in clients who are not dealing with these kinds of issues, increased depression and anxiety can occur, and a patient who has been involved in a sexual relationship with a therapist is often more likely to attempt suicide and further resistant to additional treatment.

Also, studies have revealed that sexual relationships between therapists and patients are frequently associated with cognitive dysfunction, feelings of emptiness and isolation, an impaired ability to trust, increased feelings of guilt, confusion regarding boundaries, and suppression of anger. Although these types of symptoms are not noted in every client who has been involved in a sexual relationship with a therapist, many of these symptoms were seen as common in clients who had engaged in this type of relationship. In short, therapy is the most successful when boundaries and trust of the client are not violated and a professional relationship is maintained, and in nearly every jurisdiction, it is the responsibility of the therapist to maintain this professional relationship.

In fact, the legal consequences for therapists who do enter into a sexual relationship with a client can be severe in many states. In order for therapists and other mental health professionals to maintain their professional licenses, most states not only mandate that there be no sexual relationships with clients, but also that there is no sexual relationship with a former client as well. While in some states the requirement is that the client has not been a patient for at least two years, in others the guidelines stipulate at least five years. In addition, the mental health professional may be obligated to prove that the relationship is not exploitative in nature and that the client is fully capable of making their own decisions regarding the relationship.

For therapists and mental health professionals who do engage in a sexual relationship with a client, the penalties can be severe. Not only can a therapist lose their professional license for such acts if the relationship is discovered, but they can also be sued for malpractice and violation of trust in many instances. Maintaining a professional relationship at all times is not only in the best interest of the client and their mental well-being, but also in the best interest of the practitioner and their professional reputation.