Sexual Boundary Violations in Psychotherapy Facing Therapist Indiscretions, Transgressions, and Misconduct

Regardless of what model of psychotherapy is used, all therapists are vulnerable to boundary transgressions. This book explains why this is this case, and how to avoid such violations.

Professional attitudes toward sexual boundary violations (SBVs) have evolved over the years, resulting in ethical and legal guidance to prevent such violations. Despite this guidance, SBVs still occur in treatment, and institutions and colleagues often deny or rationalize them. Therapists need a deeper understanding of how SBVs occur in order to avoid them.

This volume examines the events leading up to SBVs, as well as what happens to clients and therapists once SBVs are discovered. The book also considers the broader effects of such behavior on colleagues, institutions, families, and others. Numerous case illustrations are included to illustrate how therapeutic relationships are compromised, sometimes in subtle and gradual ways. Authors emphasize the importance of therapist education and consultation with mentors and peers to maintain a professional frame for the therapeutic relationship.
 

Arlene (Lu) Steinberg, PsyD, is an adjunct associate professor at Ferkauf Graduate School of Psychology, where she supervises clinical psychology graduate students and teaches psychological counseling to rabbinic students, and is a practicing psychoanalyst in New York City. She is author of several articles and chapters on trauma. She recently co-edited the special issue of Psychoanalytic Psychology (2017) on sexual boundary violations with Dr. Alpert. She is past Treasurer of Division 39 (Psychoanalysis) of the American Psychological Association (APA). She is currently serving a 3-year term as Division 39 representative on the APA Council of Representatives.

Judith L. Alpert, PhD, is Professor of Applied Psychology at New York University and Faculty and Clinical Consultant at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. She has edited six books and numerous journal articles on trauma and women’s issues. She co-edited the special issue of Psychoanalytic Psychology (2017) on sexual boundary violations with Dr. Steinberg and practices psychotherapy in New York City. She was the first president and a founding member of Division 56 (Trauma Psychology) of the American Psychological Association (APA). Dr. Alpert is the recipient of the Award for Scholarship from Division 39 (Psychoanalysis) of APA.

Christine A. Courtois, PhD, ABPP, a board-certified counseling psychologist retired from clinical practice in Washington, D.C., has been an adjunct professor of psychology and social work at several universities and is now an independent consultant/trainer/author on topics of trauma psychology and treatment. She has authored, co-authored, and co-edited a dozen professional books on the dynamics and treatment of child sexual abuse, complex trauma, and PTSD. Dr. Courtois is past president of Division 56 (Trauma Psychology) of the American Psychological Association and founding Associate Editor of the division’s journal, Psychological Trauma. She has received numerous professional awards from several organizations.

Foreword
Kenneth S. Pope

Chapter 1. Sexual Boundary Violations in the Psychotherapy Setting: An Overview
Arlene (Lu) Steinberg, Judith L. Alpert, and Christine A. Courtois

I. Ethical and Legal Issues

Chapter 2. The American Psychological Association Ethics Code and Legal Statutes Regarding Sexual Boundary Violations: History and Current Status 
Linda Campbell, Linda Knauss, and Lauren Meaux

Chapter 3. Boundaries and Ethics of Professional Conduct 
Stephen B. Levine and Christine A. Courtois

II. Perspectives From Different Theoretical Orientations 

Chapter 4. Erotic Transferences and Countertransferences in Sexual Boundary Violations: An Interview with Andrea Celenza 
Interviewers: Arlene (Lu) Steinberg and Judith L. Alpert 
Interviewed: Andrea Celenza

Chapter 5. Psychoanalytic Perspectives on the Problem of Erotic Idealization 
Elizabeth Goren and Sue Grand

Chapter 6. A Cognitive Behavioral Approach to Understanding Sexual Boundary Violations 
Amy Wenzel

Chapter 7. Going Beyond the Contact Boundary: A Gestalt Therapy Perspective 
Monique N. Rodriguez

Chapter 8. The Art of  Helpful Sex Talk in Therapy:  A Psychoanalytic Sex Therapist Speaks
Elizabeth Goren

Chapter 9. Sexual Misconduct in the Feminist Therapy Realm 
Laura S. Brown and Christine A. Courtois

III. Unique Settings and Populations

Chapter 10. Sexual Boundary Violations in Pastoral Counseling 
Christine A. Courtois and Arlene (Lu) Steinberg

Chapter 11. Sexual Boundary Violations in the Digital Age: New Frontiers and Emerging Challenges 
Frederic G. Reamer

Chapter 12. Considering Racial and Cultural Context in Sexual Boundary Violations 
Pratyusha Tummala-Narra

Chapter 13. Sexual Boundary Violations Outside of Cisgender–Heterosexual Dyads 
Elizabeth Clark and Kori Bennett

IV. Dynamics and Effects

Chapter 14. Mind F*ck: The Grooming Process in “Professional Incest” 
Christine A. Courtois and Judith L. Alpert

Chapter 15. Grooming and the Dynamics of Abuse as Experienced and Viewed Through the Eyes of Victims and Peer Advocates: Cases from TELL
Janet Wohlberg

Chapter 16. Three Survivors Speak: Stories of Confusion, Shame, Anguish, and Resilience 
Christine A. Courtois, Judith L. Alpert, and Goldie Eder

Chapter 17. When Colleagues Betray: The Harm of Sexual Boundary Violations in Psychotherapy Extends Beyond the Victim 
Jennifer M. Gomez, Laura K. Noll, Alexis A. Adams-Clark, and Christine A. Courtois

V. Responding to Sexual Boundary Violations in Psychotherapy

Chapter 18. Treating Clients Who Have Been Sexually Abused by a Therapist 
Tyson D. Bailey and Laura S. Brown

Chapter 19. Supervision and Consultation With Therapists Who Have Engaged in Sexual Misconduct 
Gary R. Schoener

Chapter 20. The Treatment of Therapists Who Sexually Offend  
Philip Hemphill, Christine A. Courtois, Mark S. Gold, Alexis Polles, and Drew Edwards

Epilogue: Prevention and Intervention 
Judith L. Alpert, Arlene (Lu) Steinberg, and Christine A. Courtois