An exploration of sexual contact between clinical psychologists and patients

This thesis describes the first British empirical study in relation to therapist-patient sexual contact. North American research has suggested that a substantial minority of mental health professionals engage in such contact with their patients, and that both situational and characterological variables contribute to the sexualisation of the therapeutic relationship. A number of theoretical models are relevant to developing an understanding of this problem, including reversal theory, psychodynamic theory, and Finkelhor’s (1984) four precondition model of sexual abuse. A national random survey of clinical psychologists produced 581 usable responses. Under 4% reported sexual contact with patients in therapy or who were discharged. A substantial minority reported that they had treated patients who had been sexually involved with previous therapists, or that they knew through other sources of clinical psychologists who had engaged in sexual activity with their patients. Logistic regression analysis revealed that homosexuality, sexual involvement with educators during postgraduate training, and longer postqualification professional experience predicted sexual involvement with patients. Responses to a small number of open-ended questions suggested that whilst the majority of respondents did not view sexual attraction to patients as inappropriate, a minority actively avoided it for ethical reasons. The majority of respondents who had not engaged in sexual contact with patients refrained from such behaviour for ethical reasons, but the responses of a minority suggested that were the opportunity to arise, or were negative consequences removed, they might engage in such behaviour. A minority of respondents were unaware of their duty to report colleagues engaging in such behaviour. It is concluded that efforts to prevent therapist-patient sexual contact should focus on education, particularly in respect of codes of conduct, and that further research is required to enhance our knowledge of predisposing factors