Therapist-client sex: Clients' retrospective reports.

Therapists will be more effective practitioners when they understand the factors that contribute to sexual boundary violations. The authors' interviews with former victims indicated that offending therapists were mostly reputable psychologists working alone, and that boundary violations developed gradually. The clients were often victims of child sexual abuse. Many reported pleasurable feelings during the affair but saw the experience as hurtful or exploitative in retrospect. The authors' findings imply that practitioners should minimize seemingly innocuous physical consolation or self-disclosure, especially with survivors of child abuse. They are encouraged to select offices with other professionals and to participate in peer-supervision activities. Professional psychologists are cautioned, first in training and later throughout practice, against sexual involvement with clients. However, they are also not fully informed about how to avoid being drawn into such relationships because so little is known about the factors putting therapists, as well as clients, at risk. Most previous studies of therapist-cli ent sex focused on the beliefs and behaviors of psychotherapists (e.g., Gartrell, Herman, Olarte, Feldstein, & Localio, 1986). Despite wide agreement that such a relationship is never acceptable, the history of psychoanalysis and psychotherapy is laced with anecdotal, clinical, and empirical data attesting that the problem has always existed (e.g., Carotentuto, 1982; Grosskurth, 1991; Mahler, 1988). Since the early 1970s, the problem has received considerable attention in the United States (e.g., Chesler, 1972a; Pope, Sonne, & Holroyd, 1993). Early data indicated that approximately 10% of male respondents admitted that they had engaged in some form of sexual behavior with at least 1 patient (e.g., Holroyd & Brodsky, 1977), whereas later findings indicated that only 2-3% of the respondents engaged in sexual contact with patients (e.g., Pope, Tabachnick, & Keith-Spiegel, 1987). No typical profile of patients who become sexually involved with their therapists (therapist-client sex; TCS) has been empirically, established, and the process leading to this ultimate boundary violation in psychotherapy remains unclear. The meager research has searched for transference patterns gone awry. Robertiello (1975) described 8 TCS patients who were high-functioning, with