Posted by noa on July 18, 2003, at 22:24:46
In reply to Re: Well, I finally called my therapist, posted by pinkeye on July 18, 2003, at 21:13:03
First of all, it would affect the objectivity of the therapist. Second of all, a doctor-patient relationship, especially for psychological treatment is inherently not balanced in terms of power. The patient could be subject to being exploited by the therapist if their relationship goes beyond the therapeutic relationship. Being in an intimate relationship can cause undue influence on the patient. The therapist is supposed to work for the needs of the patient and leave his or her own needs out of it.
I found this from the APA code of ethics (http://www.apa.org/ethics/code2002.html):
3.04 Avoiding Harm
Psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients, and others with whom they work, and to minimize harm where it is foreseeable and unavoidable.3.05 Multiple Relationships
(a) A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.
10.05 Sexual Intimacies With Current Therapy Clients/Patients
Psychologists do not engage in sexual intimacies with current therapy clients/patients.10.06 Sexual Intimacies With Relatives or Significant Others of Current Therapy Clients/Patients
Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard.10.07 Therapy With Former Sexual Partners
Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.10.08 Sexual Intimacies With Former Therapy Clients/Patients
(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.(b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient. (See also Standard 3.05, Multiple Relationships.)
And, from WWLIA--from an article by an attorney (http://wwlia.org/us-prosx.htm)
Why Are There Prohibitions on Professional-Client Sexual Contact?
There are special characteristics of professional-client relationships which place the professional in a position of greater power and authority than the client and, in essence, render it "unfair" for the professional to gain any benefit at the client's expense. Legally, many professionals--therapists, physicians, attorneys, professors--are said to stand in a "fiduciary" relationship with respect to their patients, clients, or students. "Fiduciary" is a legal term describing the relationship that exists when one party reposes trust and confidence in the other, more powerful party. In a fiduciary relationship, the more powerful party has a duty to act only in the trusting party's best interest. Sexual contact may harm patients, clients, and students and therefore is a violation of the fiduciary's duty. Because of the fiduciary nature of professional-client relationships, professional-client sexual contact is prohibited.
In therapist-patient dyads in particular, specific attributes of the relationship may lead to a sexualization of the relationship. One of these attributes is transference. "Transference" describes the phenomenon in which the patient ascribes both positive and negative feelings the patient has about others in the patient's past and present life to the therapist. One court noted the difficulty this presents for the treating therapist:"The therapist must encourage the patient to express her transferred feelings, while rejecting her erotic advances; at the same time, he must explain to the patient that her feelings are not really for him, but that she is using him in a symbolic role to react to some other significant person in her life. In short, the therapist must both encourage transference and discourage certain aspects of it. This may be difficult to do and presents an occupational risk. The therapeutic alliance in this situation gives rise to a duty, imposed by professional standards of care as well as ethical standards of behavior, to refrain from a personal relationship with the patient, whether during or outside therapy sessions. This is because the personal relationship infects the therapy treatment, rendering it ineffective and even harmful."
The intimacy present in the therapeutic relationship also lends itself to sexual acting out. The American Psychiatric Association has warned: "[T]he necessary intensity of the therapeutic relationship may tend to activate sexual and other needs and fantasies on the part of both patient and therapist, while weakening the objectivity necessary for control."The likelihood of sexual contact, the harm caused patients, and the fiduciary nature of the therapist-patient relationship lead to the prohibitions on sex between therapist and patient. Other professions, such as medicine and law, note many similarities between physician-patient/attorney-client sex and therapist-patient sex, and have adopted ethical rules prohibiting such contact. Courts are following this trend and holding physicians and lawyers liable for harm caused by their sexual contact with patients.
poster:noa
thread:242783
URL: http://www.dr-bob.org/babble/psycho/20030711/msgs/243357.html