1) Most therapist associations have a code of ethics: - "American Mental Health Counselors Association (AMHCA) Code of Ethics (2000):" "Counselors do not engage in sexual intimacies with former clients within a minimum of two years after terminating the counseling relationship. The mental health counselor has the responsibility to examine and document thoroughly that such relations did not have an exploitative nature based on factors such as duration of counseling, amount of time since counseling, termination circumstances, the client's personal history and mental status, adverse impact on the client, and actions by the counselor suggesting a plan to initiate a sexual relationship with the client after termination." - "American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct (2002):" "(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy. (b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient." Source and further information: http://www.zurinstitute.com/ethicsoftouch.html (various other codes of ethics on this page) 2) "3. Exploitation 3.1 It is unethical for Somatic Psychotherapists to use their professional relationship for the purpose of exploiting clients, trainees or supervisees, past or present, in a financial, sexual, emotional or any other way. 3.2 Somatic Psychotherapists will not accept or offer payments or other advantages for referrals, or engage in any financial transactions for psychotherapy sessions, other than the ordinary fee scale charged to clients. 3.3 Somatic Psychotherapists should not undertake individual psychotherapy with friends, family, employees, supervisees or with their own students. They should not undertake psychotherapy or supervision with anyone closely associated with a current or previous client nor with someone with whom they come into regular contact, without careful consideration and, where appropriate, consultation with a supervisor or senior colleague. 3.4 Sexual relationships between therapist and client, trainer and trainee or supervisor and supervisee are unethical. Sexual relationships are not restricted to sexual intercourse. The behaviour of the Somatic Psychotherapist should not be sexually seductive or create ambiguity or confusion about sexual boundaries. Physical touch is used by Somatic Psychotherapists for therapeutic purposes only. Physical contact, wether initiated by the client or Somatic Psychotherapist, which has as its purpose some form of sexual gratification, or could be reasonably contrued by Somatic Psychotherapists as having that purpose, is unethical. 3.5 If an attraction on the part of the therapist develops to a degree that may impair therapeutic judgment, or could lead to sexual relations occurring, it is the therapist's responsibility to immediately seek supervision / consult with a senior colleague and, where necessary, to terminate therapy and refer the client elsewhere. 3.6 It is unethical for a Somatic Psychotherapist to terminate a therapeutic relationship with his or her client in order to commence a sexual relationship with that client. 3.7 It is also unethical for a Somatic Psychotherapist to engage in a sexual relationship with a former psychotherapy client." Source and further information: http://www.somaticpsych.org.au/code_of_ethics/ 3) "Mental health practitioners, like many health providers, must adhere to legal reporting requirements related to the performance of their work. Mandates exist in many states to report elder abuse, spouse abuse and dangerous threats and behaviors. These legal requirements are mandatory and, in many states, a practitioner can be charged with a crime if they fail to report. Ethical issues, on the other hand, reflect standards of performance and practice that are usually identified by professional organizations and often provide guidance to licensing bodies. Failure to adhere to those standards can result in loss of license and/or expulsion from a professional organization. Standard of practice is the minimal national criteria recognized among similar specialists, rather than a local community based standard (Liebert and Foster, 1994). This standard often becomes the benchmark used by ethics committees and licensing authorities when trying to assess if a practioner has followed an appropriate course of action and standard of care. Common areas of difficulty include the handling of dual relationships, practicing within the scope of his or her competence and psychotherapist-patient privilege and confidentiality. In either case, whether legal or ethical, laws and ethical standards are presumably set forth with the directive of "primum non nocere", do not harm anyone, thus reminding the therapist of their responsibility to protect. Although in an ideal world legal and ethical requirements of practice should be clear, the opposite appears to be the case. Not only are there inconsistencies between states, but there are also inconsistencies within jurisdiction, within each state. For example, child abuse reporting is a statutory requirement in every state. In Massachusetts, the standard for reporting is "...reasonable cause to believe...", whereas in Mississippi the standard is "...that a child brought to him or coming before him..." Thus the standard can vary from reasonable suspicion to actually seeing the abused child. Similarly, it has been the authors experience that a child protective service worker in one county in California, when given a specific set of circumstances, will suggest making a formal report whereas another worker either in the same or different county may not recommend making a formal report. There are similar discrepancies with ethical issues. For example, prior to recently revised ethical standards that prohibit sexual relations with a "former" patient for up to two years after termination, the California Association of Marriage and Family Therapists (CAMFT) Ethics Committee would not act upon a patient's complaint stating that they had been sexually exploited by their "former" therapist when the sexual act took place after a "proper termination" (i.e., "proper termination" being generally defined as, termination not occurring for the express or implied purpose of becoming sexually intimate). In apparent contrast the California Board of Behavioral Science Examiners, who have statutory authority to administer and monitor the Marriage, Family and Child Counselor license, would routinely pursue and prosecute cases of therapists having sex with "former" clients. Similar differences in enforcement exist when discussing the controversial and often vague issue of dual relationships. Experience shows us that not only are there differences in specific laws and ethical standards but there are also differences in their interpretation across individuals. Legal and ethical standards can appear, at best, ambiguous and open to interpretation guided by such vagaries as the "unique aspects of the case", personal and professional experience, theoretical bias, and other such issues, yet statute and the teleogic basis underlying most ethics codes assume a decision rule based on predictable outcome." Source and further information: http://www.daniel-sonkin.com/LE.html Further information: - "Psychological Dynamics: Roles and Boundaries": http://mansfieldfc.com/massage/1/psych/toc.html