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Psychotherapists’ attitudes to intimate and informal behaviour towards clients

Published online by Cambridge University Press:  18 March 2020

Lara Vesentini Open the ORCID record for Lara Vesentini [Opens in a new window] ,
Roel Van Overmeire ,
Frieda Matthys ,
Dirk De Wachter ,
Hubert Van Puyenbroeck  and
Johan Bilsen
Lara Vesentini*
Affiliation:
Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1090, Belgium
Roel Van Overmeire
Affiliation:
Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1090, Belgium
Frieda Matthys
Affiliation:
Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1090, Belgium
Dirk De Wachter
Affiliation:
Universitair Psychiatrisch Centrum, Katholieke Universiteit Leuven, Leuven, Belgium
Hubert Van Puyenbroeck
Affiliation:
Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1090, Belgium
Johan Bilsen
Affiliation:
Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1090, Belgium
*
Author for correspondence: Lara Vesentini, E-mail: lara.vesentini@vub.be
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Abstract

Background

To avoid harming or exploiting a client, sexual and non-sexual dual relationship is generally considered as unacceptable in the psychotherapeutic relationship. However, little is known about what therapists themselves constitute as (un)acceptable intimate and informal behaviour (IIB).

Methods

A survey among psychotherapists in Flanders (Belgium) was conducted. Opinions about the acceptability of IIB were asked. Based on these opinions attitude groups could be determined.

Results

In total, 786 therapists completed and returned the questionnaire (response rate: 39.8%). Therapists could be divided into three attitude groups. Almost half of the therapists belonged to the ‘rather restrictive group’, a third to the ‘rather socially permissive group’ and a fifth to the ‘rather sexually permissive group’. Being categorised as ‘rather sexually permissive’ is predominantly related to being male and non-heterosexual, whereas being ‘rather restrictive’ or ‘rather socially permissive’ is mainly due to the type of psychotherapy training. The ‘rather sexually permissive’ therapists more often found a client sexually attractive during the last year and fantasised more often about a romantic relationship with a client, but they did not more often started a sexual relationship.

Conclusions

Most therapists in Flanders are rather restrictive in their attitude to IIB, pointing to a high sense of morality. Having a rather sexually permissive attitude is predominantly related to more personal characteristics of the therapists, but these therapists did not start a sexual relationship more often.

Keywords

attitudedual relationshipsinformal behaviourintimacy
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 11 , August 2021 , pp. 1807 - 1813
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

American Psychiatric Association, (2013). The principles of medical ethics, with annotations especially applicable to psychiatry. Washington, DC: American Psychiatric Association.Google Scholar
American Psychological Association. (2016). Revision of Ethical Standard 3.04 of the ‘Ethical Principles of Psychologists and Code of Conduct’ (2002, as amended 2010). American Psychologist, 71(9), 900. doi: 10.1037/amp0000102CrossRefGoogle Scholar
Appelbaum, P., & Jorgenson, J. (1991). Psychotherapist–patient sexual contact after termination of treatment: An analysis and a proposal. American Journal of Psychiatry, 148(11), 1466–1473. doi: 10.1176/ajp.148.11.1466Google ScholarPubMed
Barnett, J. E. (2014). Sexual feelings and behaviors in the psychotherapy relationship: An ethics perspective. Journal of Clinical Psychology, 70(2), 170–181. doi: 10.1002/jclp.22068CrossRefGoogle Scholar
Barnett, J. E. (2017). An introduction to boundaries and multiple relationships for psychotherapists. Issues, challenges, and recommendations. In Zur, O. (Ed.), Multiple relationships in psychotherapy and counseling. Unavoidable, common, and mandatory dual relations in therapy (pp. 17–29). New York: Routledge.Google Scholar
Barnett, J. E., Lazarus, A. A., Vasquez, M. J. T., Moorehead-Slaughter, O., & Johnson, W. B. (2007). Boundary issues and multiple relationships: Fantasy and reality. Professional Psychology-Research and Practice, 38(4), 401–405. doi: 10.1037/0735-7028.38.4.401CrossRefGoogle Scholar
Baumeister, R. F., Catanese, K. R., & Vohs, K. D. (2001). Is there a gender difference in strength of sex drive? Theoretical views, conceptual distinctions, and a review of relevant evidence. Personality and Social Psychology Review, 5(3), 242–273. doi: 10.1207/s15327957pspr0503_5CrossRefGoogle Scholar
Borys, D. S., & Pope, K. S. (1989). Dual relationships between therapist and client: A national study of psychologists, psychiatrists, and social-workers. Professional Psychology-Research and Practice, 20(5), 283–293. doi: 10.1037/0735-7028.20.5.283CrossRefGoogle Scholar
European Association of Psychotherapy. (2018). Statement of Ethical Principles. Retrieved from https://www.europsyche.org/contents/13134/statement-of-ethical-principles, Belgrade.Google Scholar
European Federation of Psychologists’ Association. (2015). Model Code of Ethics. Retrieved from http://ethics.efpa.eu/guidelines/guidelines/, Brussels.Google Scholar
Gabbard, G. (2016). Boundaries and boundary violations in psychoanalysis (2nd ed.). Arlington, Virginia: American Psychiatric Association.Google Scholar
Grollman, E. (2017). Sexual orientation differences in attitudes about sexuality, race, and gender. Social Science Research, 61, 126–141. doi: 10.1016/j.ssresearch.2016.05.002CrossRefGoogle ScholarPubMed
Holroyd, J. C., & Brodsky, A. M. (1977). Psychologists attitudes and practices regarding erotic and non-erotic physical contact with patients. American Psychologist, 32(10), 843–849. doi: 10.1037//0003-066x.32.10.843CrossRefGoogle Scholar
Kardener, S. H., Fuller, M., & Mensh, I. N. (1973). Survey of physicians attitudes and practices regarding erotic and nonerotic contact with patients. American Journal of Psychiatry, 130(10), 1077–1081. doi: 10.1176/ajp.130.10.1077CrossRefGoogle ScholarPubMed
Petersen, J. L., & Hyde, J. S. (2010). A meta-analytic review of research on gender differences in sexuality, 1993–2007. Psychological Bulletin, 136(1), 21–38. doi: 10.1037/a0017504CrossRefGoogle ScholarPubMed
Pope, K. S., Tabachnick, B. G., & Keith-Spiegel, P. (1987). Ethics of practice – The beliefs and behaviors of psychologists as therapists. American Psychologist, 42(11), 993–1006. doi: 10.1037/0003-066x.42.11.993CrossRefGoogle ScholarPubMed
Rodolfa, E., Hall, T., Holms, V., Davena, A., Komatz, D., Antunez, M., & Hall, A. (1994). The management of sexual feelings in therapy. Professional Psychology: Research and Practice, 25(2), 168–172. doi: 10.1037//0735-7028.25.2.168CrossRefGoogle Scholar
Stake, J. E., & Oliver, J. (1991). Sexual contact and touching between therapist and client – A survey of psychologists attitudes and behavior. Professional Psychology: Research and Practice, 22(4), 297–307. doi: 10.1037/0735-7028.22.4.297CrossRefGoogle Scholar