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The following is excerpted from the booklet Professional Therapy Never Includes Sex published by the California Department of Consumer Affairs.

Warning Signs
In most sexual abuse or exploitation cases, other inappropriate behavior comes first. While it may be subtle or confusing, it usually feels uncomfortable to the patient. Some clues or warning signs are:

  • Telling sexual jokes or stories.
  • “Making eyes at” or giving seductive looks to the patient.
  • Discussing the therapist’s sex life or relationships excessively.
  • Sitting too close, initiating hugging, holding the patient or lying next to the patient.

Another warning sign is “special” treatment by a therapist, such as:

  • Inviting a patient to lunch, dinner or other social activities.
  • Dating.
  • Changing any of the office’s business practices (for example, scheduling late appointments so no one is around, having sessions away from the office, etc.).
  • Confiding in a patient (for example, about the therapist’s love life, work problems, etc.).
  • Telling a patient that he or she is special, or that the therapist loves him or her.
  • Relying on a patient for personal and emotional support.
  • Giving or receiving significant gifts.
  • Providing or using alcohol (or drugs) during sessions.

Signs of inappropriate behavior and misuse of power include:

  • Hiring a patient to do work for the therapist, or bartering goods or services to pay for therapy.
  • Suggesting or supporting the patient’s isolation from social support systems, increasing dependency on the therapist.
  • Any violation of the patient’s rights as a consumer (see “Patient Bill of Rights”).

Therapy is meant to be a guided learning experience, during which therapists help patients to find their own answers and feel better about themselves and their lives. A patient should never feel intimidated or threatened by a therapist’s behavior.

If you are experiencing any of these warning signs, trust your own feelings. Check on the therapist’s behavior with a different therapist, or with any of the agencies in “Where To Start” (below). Depending on what you find out, you may want to find another therapist.

What If It’s Me?
If you have been sexually abused or exploited by your therapist, you may be feeling confused. You may feel:

  • Guilty and responsible — even though it’s the therapist’s responsibility to keep sexual behavior out of therapy.
  • Mixed feelings about the therapist — protectiveness, anger, love, betrayal.
  • Isolated and empty.
  • Distrustful of others or your own feelings.
  • Fearful that no one will believe you or understand what happened, or that someone will find out.
  • Confused about dependency, control and power.

You may even have nightmares, obsessive thoughts, depression, or suicidal or homicidal thoughts. You may feel overwhelmed as you try to decide what to do or whom to tell.

It’s essential that you face what happened. This may be painful, but it is the first major step in healing and recovering from the experience. You may have positive and negative feelings at the same time, such as starting to feel personal control, being afraid of what may happen in the future, remembering the experience, and feeling relieved that the sexual relationship is over.

The second step in the healing process is to decide what YOU want to do next. Try to be open-minded about your options.

Remember: It doesn’t matter if you, the patient, started or wanted the sexual involvement with the therapist. Therapists are responsible for keeping sexual intimacy out of the therapy relationship and are trained to know how to handle a patient’s sexual attractions and desires.

Where To Start
You may need to (1) talk to someone who will understand what you’re going through, (2) get information on whether the therapist’s behavior was illegal and/or unethical, and (3) find out what you can do about it. Three places to get help are:

  • Licensing Boards — In the Department of Consumer Affairs, three different boards license therapists. They can give general information on appropriate behavior for therapists and your rights for reporting what happened, as well as how to file a complaint.
  • Sexual Assault/Crisis Centers — These centers have staff trained in all types of sexual abuse and exploitation. They can provide general information on appropriate behavior for therapists, crisis services, your rights for reporting what happened, and names of therapists and support groups that may be helpful. Look in your telephone book under “sexual assault center” or “crisis intervention service.”
  • Professional Associations — Each licensed therapy profession has at least one professional association. Associations can provide general information on appropriate behavior for therapists, your rights for reporting what happened, and how to file a complaint. They can provide names of therapists who may be helpful.

What You Can Do
You can deal with your situation in several different ways. Take time to explore all of your rights and options. It may help to decide what your goals are:

Reporting the Therapist — Perhaps you want to prevent the therapist from hurting other patients. You may want to make it known that sexual exploitation is always wrong. If this is your decision, you have several reporting options. It is important to note that reporting misconduct is time-sensitive. What can be done in response to the report of misconduct usually depends on:
— who the misconduct is reported to, and
— the length of time between the misconduct and when the report was filed.
Such a time limit is called a “statute of limitations.” As you consider your options, be aware of these time limits.

Your Recovery — You may also want to explore and process what happened between you and the therapist. If you decide to do this, you can look into therapy or support groups.

Moving On — You may wish simply to move on past this experience as quickly as possible and get on with your life. Remember — you have the right to decide what is best for you.

Your Reporting Options
If you decide to report a therapist’s behavior that you believe is unethical and illegal, there are four different ways to do so. All of these reporting options are affected by time limits, so you should consider reporting misconduct at the earliest appropriate opportunity. You may choose one or more of the options listed below.

  • Administrative Action — File a complaint with the therapist’s licensing board.
  • Professional Association Action — File a complaint with the ethics committee of the therapist’s professional association.
  • Civil Action — File a civil lawsuit.
  • Criminal Action — File a complaint with local law enforcement.

From Professional Therapy Never Includes Sex Copyright 2004, California Department of Consumer Affairs.

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