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#413 Sexual exploitation by therapists

mp3 #413 Sexual Exploitation by Psychotherapists (mp3 file)

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It is a crime in California for a psychotherapist to have any sexual touching contact with a client or patient. Business and professions code section 729 provides that a first offense may be charged as a misdemeanor, while a second offense may be charged as a misdemeanor or a felony. Fines up to $5,000, and jail or imprisonment for up to three years, are possible penalties.

This law applies when a therapist has any sexual touching contact with a current client, or when a therapist ends therapy primarily for the purpose of starting to have sexual contact with a former client. However, the law does not apply if a therapist refers a client for treatment first by an independent and objective therapist, who is recommended by another independent therapist. The recommending therapist and the new treating therapist may not be personal friends of the client's first therapist.

What psychotherapists are covered by this law? A therapist is anyone who is licensed to practice psychotherapy, or is training to become licensed, and includes physicians and surgeons practicing psychotherapy, psychiatrists, psychologists, clinical social workers, marriage/family/and child counselors, and registered interns, trainees, assistants and associates of these psychotherapists. A therapist also includes anyone who holds himself or herself out to be a psychotherapist, even if not licensed.

What is therapy?

Therapy includes any type of mental health counseling from any of these psychotherapists.

Who is a client?

A client is anyone who seeks therapy or counseling from any of these psychotherapists.

What is sexual contact?

Sexual contact is the touching of another person's intimate part -- a sexual organ, anus, buttocks, groin, or breast.

What is touching?

Touching means physical contact with another person, either through the person's clothing, or directly with the person's skin. Sexual contact can include sexual intercourse, oral sex, anal sex, fondling, or any other kind of sexual touching.

Sexual misconduct by psychotherapists covers a different type of activity, which is not sexual touching contact. Sexual misconduct includes nudity, kissing, spanking, and sexual suggestions or innuendos. Sexual misconduct of this type, which does not include sexual touching, can be both a criminal offense, and a ground for professional discipline by a state licensing board.

It is a crime in California for licensed clinical social workers, and marriage, family and child counselors, to engage in sexual relations with a client, or to solicit sexual relations with a client, or to commit an act of sexual abuse or sexual misconduct with a client. Business and Professions Code Sections 4983 and 4996.12 provide that these violations are misdemeanors, which may be punished by up to six months in county jail and by fines up to $2,500. A similar provision also applies to psychologists. It is not a crime, however, for psychotherapists who are physicians, to engage in sexual misconduct which does not include sexual touching. However, it could be grounds for professional discipline of psychotherapists who are physicians.

The California legislature passed these laws to protect clients from sexual exploitation and sexual misconduct by psychotherapists. Therapists are trusted and respected, and it is common for clients to admire and feel attracted to them. It is normal for a client to feel attracted to a therapist who is attentive, kind and caring. However, a therapist who accepts or encourages these normal feelings in a sexual way -- or who tells a client that sexual involvement is part of therapy -- is using the trusted therapy relationship to take advantage of the client. And once sexual involvement begins, therapy for the client ends. The original issues that brought the client to therapy are postponed, neglected, and sometimes lost. Many people, who are victims of this kind of abusive behavior by therapists, suffer harmful, long-lasting emotional and psychological problems as a result.

Even if the client is the one who suggests or initiates sex with a psychotherapist, that doesn't matter. The therapist is the one who is responsible for keeping sexual exploitation out of therapy. Therapists should never use the therapy relationship for their own sexual gain. This is sexual exploitation. A therapist may not use a client's consent as justification for sexual contact.

If you are in therapy now, you may feel uncomfortable if you experience certain warning signs, that your therapist may be leading up to a sexual relationship with you. Trust your own feelings. It may be time to find another therapist. Some clues or warning signs might include the following actions by your therapist:

--telling sexual jokes or stories

--giving you seductive looks

--discussing the therapist's sex life or relationships

--sitting too close to you, or lying down next to you

--inviting you to have a meal together

--asking you for a date

--scheduling appointments when no one else is around the office

--scheduling appointments away from the office

--giving or accepting significant gifts

--providing or using alcohol or drugs during therapy sessions

--hiring you to do work for the therapist, or bartering goods or services to pay for therapy.

What if you are now being sexually exploited by your therapist, or a therapist has done this to you in the past?

What are your alternatives?

Take time to carefully explore all of your rights and options. You always have the options of waiting for awhile, or taking no action. But you may want to take some action. Perhaps you want to prevent the therapist from hurting other clients. You may want to receive money to pay you for the damage you have suffered, and to help pay for future therapy sessions.

If you do decide to report what your therapist did to you, there are at least four different ways you can report a therapist's unethical and illegal behavior:

1--you may take administrative action, by filing a complaint with the therapist's state licensing board.

2--you may take criminal action, by filing a complaint with local law enforcement.

3--you may take civil action--by filing a civil lawsuit.

4--you may take professional association action, by filing a complaint with the ethics committee of the professional association to which the therapist may belong.

You may report your therapist by taking any one or all four of these actions. There are advantages and disadvantages of each type of action.

First, as to state licensing boards, they have the power to suspend or revoke a therapist's license to practice. However, you cannot receive any money from the therapist by using this option. To file a complaint, you may either write a letter or request a complaint form. If the licensing board decides to start a disciplinary action, an investigator will probably interview both you and the therapist separately. Some cases are settled by "stipulated agreements." Other cases go on to a hearing before a state administrative law judge, who makes a recommendation to the licensing board for its decision. You would probably be required to testify at the hearing, which is open to the public. Media coverage usually does not occur, unless you or the therapist is well known. There is no time limit for reporting a sexual exploitation case to a state licensing board. However, the longer the time between the incident and the report, the more difficult it will be for the board to investigate the incident. The disciplinary process may take about two years, from the time a complaint is received until a final decision is made.

What state licensing board do you contact?

The three licensing boards that license psychotherapists are all part of the state department of consumer affairs in Sacramento. Their telephone number is 1-800-633-2322. You can also reach them on the web at

Physicians, including psychiatrists, are licensed by the medical board of California.

Psychologists are licensed by the board of psychology.

Licensed clinical social workers, and licensed marriage/family/ and child counselors, are both licensed by the board of behavioral science examiners.

A second alternative you may choose is a criminal action. To file a criminal action against a therapist, contact your local police as soon as possible, and report what your therapist did to you. The police will give its report to the district attorney's office, which will decide if there is enough evidence to file criminal charges. Although most criminal cases are settled through plea bargain agreements, you may be required to testify at a public preliminary hearing and jury trial. If convicted, the therapist could go to prison for up to three years. A criminal complaint would have to be filed within one year if it is a misdemeanor, or within three years if it is a felony.

A third alternative you may choose is a civil lawsuit, in which you sue your therapist or your therapist's employer, to pay you money for psychological injuries you have suffered, and for the cost of your future therapy with a trustworthy therapist. There are different time limits for filing civil lawsuits of this type, so it is important to consult an attorney as soon as possible. Most civil lawsuits are settled by stipulated agreements, but some do go to trial, and it can take years before your case is actually tried.

A fourth alternative you may choose is to file a formal complaint with a professional association to which the therapist may belong. After investigating your complaint, the association may recommend certain disciplinary actions, or it may even remove the therapist from its membership. This action may inform other therapists of the unethical sexual behavior by your therapist, but it will not keep the therapist from practicing.

Which professional association do you contact?

Physicians may belong to the California Medical Association in San Francisco.

Psychiatrists may belong to the California Psychiatric Association in Sacramento.

Psychologists may belong to the California State Psychological association in Sacramento.

Licensed clinical social workers may belong to the National Association of Social Workers, or to the Society for Clinical Social Work, both of which have offices in Sacramento.

Licensed marriage, family, and child counselors may belong to the California Association of Marriage and Family Therapists in San Diego.

Whether or not you decide to take any administrative, criminal, civil, or professional association action against your therapist, you may still be in need of additional psychotherapy for yourself. The issues that brought you to therapy in the first place were probably not worked through or resolved, and the sexual exploitation may have created even more issues to handle. Therapy may be an important tool in your healing process. Many therapists also offer group therapy sessions where you can talk with people who have had similar experiences.

You may feel distrustful of all therapists, because of the sexual exploitation you have already suffered from your therapist. Recent studies indicate, however, that over 90% of therapists have never had sexual contact with their clients. How can you avoid the relatively small percentage of therapists who may engage in such illegal and unprofessional behavior? Here are some suggestions:

1--ask someone you know who has been in therapy, who feels good about the experience, and who has changed in ways you consider to be positive.

2--call your local sexual assault center, and ask if they can recommend some therapists who specialize in helping victims of sexual exploitation or abuse.

3--call the professional associations which have been mentioned in this SmartLaw message, and ask for some referrals to therapists who specialize in this type of therapy.

4--after getting several names, call the appropriate state licensing boards which have been mentioned in this SmartLaw message and ask if the therapists are licensed, and if any disciplinary actions have been filed against them.

5--plan on interviewing several therapists. Be sure you feel comfortable with the therapist you finally choose, and be sure the therapist answers all of your questions. Do not feel pressured to stay with any therapist, if the therapist does not seem right for you.

This SmartLaw message is based on a booklet entitled, "Professional Therapy Never Includes Sex," published by the California State Department of Consumer Affairs. To obtain a free copy of this booklet contact the Medical Board of California, procurement office, phone number area code 916-445-5357. You can also write to the Publications Office, California Department of Consumer Affairs, P.O. Box 310, Sacramento, CA 95802. You can also reach them on the web at

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