'Neutralizing the Patient': Therapists' Accounts of Sexual Boundary Violations

Sexual contact between psychological therapists and their clients is regarded as highly damaging, both to the clients and to the professions, and regulatory bodies impose increasingly severe sanctions upon those practitioners who are disciplined. The present study captured therapists' accounts of sexual boundary violations through interpretative phenomenological analysis of interviews with three disciplined practitioners about their relationships with clients and former clients. The results highlighted two key themes relating to (i) therapists' efforts to neutralize the power imbalances between themselves and the clients by minimizing the clients' mental health problems, stressing the conventionality of the relationships and not testing the appropriateness of the relationship with their supervisors, and (ii) a shifting identity of the therapist between hero, victim, perpetrator, which permeated their accounts as the relationship moved from success to failure. In order for a sexual boundary violation to occur, the therapist needed to generate a sense of equivalent status between themselves and the client. As the relationships failed, the therapists' accounts of the clients shifted and the inequality of the relationship re-emerged. The results are discussed in terms of implicit theories and the implications for both training and supervision in the prevention of sexual boundary violations. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message: In accounting for their sexual boundary violations, this small sample of therapists minimized the power imbalances between themselves and their clients. Minimizing the client's mental health problems; stressing the conventionality of the relationship; stressing the therapist's own needs-all contributed to the neutralization of the client's patient status. A relationship with a client that we are not willing to discuss with our supervisor should be a cause for concern. © 2011 John Wiley & Sons, Ltd