Therapists Vulnerable to Sexual Misconduct Accusations

Sexual Misconduct Accusations

Between October and November 2017, former film producer and entertainment biz executive, Harvey Weinstein achieved infamy as the poster child for sexual misconduct after more than 80 sexual misconduct allegations covering a 30-year period surfaced in a mere 30-odd days.

In the immediate aftermath of the Weinstein allegations, there was some initial victim-blaming backlash toward Weinstein’s female accusers who were perceived by some, if not many, as using Weinstein to advance their own acting careers as much as he used them for his own sexual gratification – contributory negligence vis a vis the proverbial casting couch.

In the truncated period following the watershed Weinstein unraveling, legions of powerful men in politics, media and entertainment have become targets of sexual misconduct allegations launched against them by primarily female peers, colleagues and subordinates.

The second wave of complaints erased any doubt about the unfolding epidemic reflecting nothing more than the casting couch phenomenon endemic to Hollywood glitterazzis and wannabes.

The seeds of sexual misconduct are planted in gardens of power, and the celebrity status arising in its wake, providing wrongdoers with a cloak of invincibility woven from the threads of power, status and influence – powerful men banking on the fact that they could take sexual liberties with impunity because powerful men could never be taken down by subordinate women. Who would believe them anyway?

Some of these men admitted the wrongfulness of their conduct in its entirety, others accepted partial responsibility for something resembling the complainants’ allegations, and others went into full denial mode.

The only thing that is certain is that victims of workplace sexual misconduct have the stage in this theatrical production. They are coming out in record numbers, and their stories are being believed in large measure, particularly in the face of admissions of culpability by the wrongdoers.

Emboldened and empowered, victims are willing to risk outing individuals perceived as having violated their physical and sexual boundaries.

What does this mean for those of us who practice as psychologists? First, not only are we not immune from being potential targets of sexual misconduct allegations, but our work makes us especially vulnerable in some unique but important ways.

The work of psychotherapy and assessment necessarily takes place “behind closed doors,” often in a relational context of a significant and palpable power imbalance; power dynamics that are exaggerated in the face of gender, race, ethnicity, religious, sexual orientation and ability/disability differences – particularly when the client holds one or more less powerful or more disenfranchised statuses.

Being keenly aware of these power imbalances and insuring that you don’t unwittingly capitalize on any of them is good risk management practice.

Second, many clients seek psychological services precisely because they have been victims of sexual misconduct in childhood and/or adulthood. Vulnerabilities from unhealed childhood sexual trauma can result in both increased risk of adult sexual revictimization and in sexual acting out or other provocative or overly sexualized behaviors. And, those behaviors might be directed toward the service provider by the client because it’s a hauntingly familiar albeit dysfunctional dynamic involving recapitulation of the original harm.

Perhaps more than any other field, we are in a uniquely vulnerable position working with vulnerable individuals entrusted to our care in a relationally charged power imbalance. We must ensure that our actions are not perceived as crossing sexual boundaries even in the most nuanced ways, like commenting on a client’s attractiveness or appearance. We must be IMPECCABLE with our boundaries.

While it might be a newsflash to celebrities, politicians, and high-profile media execs that sexual improprieties committed by the powerful against the disempowered are always verboten, as psychologists we have been taught to honor and respect personal and professional boundaries in our work – ethics that are codified in the APA Ethics Code and in state practice statutes.

Research on the prevalence of therapist sexual misconduct against clients is well documented. As a profession, we are not immune from perpetrating acts of sexual misconduct against those we are obligated to care for. Ethics boards regularly announce the names of suspended or otherwise sanctioned psychologists who have committed sexual and other boundary violations.

Touch, even minor seemingly innocuous touch like patting a client’s shoulder or giving a hug may be potentially misinterpreted as an unwanted action the client doesn’t feel empowered to rebuff. Again, the interpretation of touch is context dependent and is substantially influenced by age, culture, race, ethnicity, and gender.

Good therapeutic practice dictates cautious, limited, and mindful use of touch in the context of therapy and always with awareness of whose interests are being served by the touch.

While therapy and assessment clients and their family members are potential victims of sexual assault, best practices include being mindful and aware of any comments, actions or behaviors that might cross physical or sexual boundaries or might make colleagues, students, mentees or staff feel uncomfortable because of their sexualized nature.

Organizational climate is a significant predictor of sexual harassment. Strive to create a safe space for employees, colleagues, and clients. Prudence would suggest sexual harassment education and the development of sexual harassment policies and practices if you work in an organizational or other institutional setting. If not, develop your own policy and guidelines for a sexual harassment free workplace. There are HR consultants and risk management resources available online to assist in that process if you work as a solo practitioner and don’t have organizational resources available.

To be meaningful in practice, sexual harassment prevention policies need to identify an individual to whom sexual misconduct allegations can be reported – ideally someone in a neutral position, not someone perceived to be aligned with the power hierarchy in an organization.

A process for investigating and responding to any sexual misconduct complaints needs to be in place. In the event that someone in the workplace is found to have engaged in sexual misconduct, corrective actions must follow or the policies and other practices are moot.

Being mindful, aware, and having impeccable boundaries, along with developing effective polices, practices and education are keys to successful risk management.

Therapy Tidbits – March/April 2018Course excerpt from Therapy Tidbits – March/April 2018 – a 1-hour online continuing education (CE) course comprised of select articles from the March/April 2018 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep psychologists (and other mental health professionals) informed about practice issues. Click here to learn more.

This online CE course is sponsored by:

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Psychotherapy and Counseling are Different

Course excerpt from Therapy Tidbits – March/April 2018

Psychotherapy and Counseling are Different

In an article entitled “Master’s therapy not that different” in the Jan/Feb 2018 edition, Larry Powitz, EdD, asks what is it that doctoral level mental health practitioners do different than non-doctoral level mental health practitioners, such as master level psychologists, LCSWs, LCPCs, MFTs, and he concludes that the psychotherapy by all provided is quite the same. “I say the MA can sing the same tune as the PhD,” concludes Dr. Powitz.

I agree with him. I believe that the intervention being provided by many doctoral level (PhD, PsyD, and MD) and non-doctoral level (MEd, MA, MS, MSW, LPCC, MDiv, EAP) mental health practitioners is quite the same. For me the important questions are “How is that?” and “What’s happening?”

Psychotherapy is on the decline, and counseling is growing. The word psychotherapy isn’t even used much anymore. Or the terms psychotherapy and counseling are used interchangeably, as though they are one and the same, but they aren’t.

Psychotherapy and counseling are two different disciplines.

Psychotherapy is an in-depth, sometimes long-term, project that addresses inner and often covert core issues. It’s meant to get at and affect the understructure of a person. Carl Jung called psychotherapy treatment of the soul, which for me implies depth.

Counseling addresses important but external overt behaviors, usually for brief duration, teaching and improving areas of outward functioning.

Psychotherapy is about personal growth, and the relationship between psychotherapist and patient is critical. Counseling is about life management and adjustment, and the relationship between counselor and client is quite secondary.

For example, there is counseling for career and finances and anger management and sexual issues and grief and psychotropic usage. There is no career or financial or grief etc. in psychotherapy, because psychotherapy isn’t directly about such issues; it’s about the person underlying those issues. Psychotherapy is a life changing experience, while counseling is guidance, support, and education.

Homework isn’t typical in psychotherapy, other than encouragement to reflect on one’s experience during the session, whereas homework assignments are frequent in counseling, often with time spent in sessions reviewing and discussing lessons, similar to what happens in a classroom. Psychotherapy is heavily feeling and experience oriented, whereas counseling is heavily cognitive and behavioral focused. In traditional language, psychotherapy is a primary process activity and counseling is very much a secondary process activity.

Though psychotherapy and counseling are two distinct disciplines, there has been over the decades a homogenization of the two. For many, the two have become one, in thinking and in practice. Counseling now includes some psychotherapy, and psychotherapy includes more counseling. The homogenization has blended and even equated two different tunes into a new third tune.

I think it’s been a loss for psychotherapy. It’s like blending and equating physical therapy and surgery. Physical therapy is valuable and exactly what some people need, but it’s not surgery. Counseling is valuable and exactly what some people need, but it’s not psychotherapy. Today psychotherapy in its fullest sense is hard to find, and most mental health providers, doctoral level and non-doctoral level, are providing a service that is quite the same. Most are singing the same tune, the homogenized third tune.

Therapy Tidbits – March/April 2018Therapy Tidbits – March/April 2018 is a 1-hour online continuing education (CE) course comprised of select articles from the March/April 2018 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep psychologists (and other mental health professionals) informed about practice issues.

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document).

Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Teletherapy is the Future Norm

teletherapy

Teletherapy will be part of normal practice for psychologists in a decade, predicts leading online therapy educator Marlene Maheu, PhD.

Psychologists must embrace the change or be left behind, warns Sherry Benton, PhD, ABPP, founder of the teletherapy company TAO Connect.

“We in the behavioral world are the last holdouts for technological change in health care,” said Maheu, executive director and founder of the Telebehavioral Health Institute. “Technology is evolving, and I firmly believe we will be connecting with one another in many new ways in the future.” Maheu oversees telebehavioral health training at the institute and has been involved with teletherapy as a clinical psychologist herself since 1994.

Benton, a psychologist and former director of a large university mental health clinic, became convinced a few years ago that adding teletherapy to psychology practices could help millions of people living in areas underserved by mental health specialists. After testing the concept with college students in 2014, she launched TAO Connect to provide teletherapy to college and university counseling centers.

Both Maheu and Benton believe that psychologists who want to provide counseling via video conferencing, email or telephone need to educate themselves first about the practice. Maheu’s institute offers classes, as do the American Psychological Association and other organizations and companies.

“It’s critical to get training,” Benton said. “There are so many things you might not think about.”

That includes having a license to practice in the state where the patient is, having a crisis management plan for online patients, knowing how to keep consultations with a patient private and knowing how to rewrite consent-to-treat forms for patients you may never see in person, she said.

Equally important, Maheu said, is figuring out what population you want to serve online and identifying a way to get paid for your online work. If you work with at-risk youth and want to serve that community online, figure out what agency might pay you for the online work. Or if you want to work online with senior citizens in nursing homes, there are online employers who will hire you to do that, she said.

Similarly, if you are in private practice and want to add online work, health insurance could be your payer, she said. “This is not about reinventing yourself, but doing what you’re already good at with technology,” Maheu said.

Numerous online therapy companies have popped up in recent years, including TalkSpace, BreakThrough, BetterHelp, and iCouch, and many enlist a variety of therapists, including psychologists, to work full or part time as outside contractors.

Each company is different and any psychologist who wants to associate with one should investigate the firm carefully, Benton said. “You want to look at how they work, what your reimbursement rate is, what’s expected of you – basically what’s their deal and does it fit with the way you want to work,” she said.

TalkSpace is one of the largest and mainly provides counseling sessions through texting. BreakThrough and BetterHelp both offer videoconferencing with therapists and BetterHelp also offers messaging, live messaging chats and telephone sessions with therapists.

iCouch, while it offers therapist referrals, concentrates on providing services for therapists who want to practice online. Those include videoconferencing, therapy marketing, scheduling and billing services.

Benton’s company is similar, offering private practitioners a suite of tools they can use for their own online services. They include HIPPA-compliant video conferencing, education modules for patients, administrative tools and secure messaging.

“We just license our materials; we don’t actually hire psychologists,” Benton said. “But our tools allow psychologists to help more patients and to help their income.”

Psychologists can offer patients shorter therapy sessions, such as 20 minutes, and augment that with patient education sessions from TAO, she said. “Even after a psychologist pays for TAO they really can increase their income,” she said.

One of the newest entries into the market is LARKR, a video therapy app that launched in October through the Apple App Store. LARKR links therapists with patients for 50-minute sessions on mobile devices. The site, at larkr.com, is seeking 10,000 certified mental health therapists to join its ranks, according to its press information.

Plenty of information is available online for psychologists who are considering trying online therapy.

iCouch has several blogs that suggest ways to get started: (Add “online therapy available” to your business cards and website; ask current clients if they’d be interested in trying a session online; try online therapy several times so you become comfortable with the technology).

The APA has a 19-page Guidelines for the Practice of Telepsychology on its website that encourages psychologists to get specific training and includes information about confidentiality, informed consent and interjurisdictional practice.

This article is included in the online continuing education course Therapy Tidbits – March/April 2018. Click here to learn more.

Related Online Continuing Education Courses:

E-Therapy: Ethics & Best PracticesE-Therapy: Ethics & Best Practices is a 3-hour online continuing education (CE) course that examines the advantages, risks, technical issues, legalities and ethics of providing therapy online. E-therapy can be used to address age-old problems, such as how to reach out to those who might not otherwise avail themselves of psychotherapy services even though they are in acute need. At the same time, it is clear that many providers have embraced the new technologies without a firm grasp on the new and serious vulnerabilities that are introduced when their patients’ personal health information goes online. Included in this course are sections on video therapy, email, text messaging, smart phone use, social media, cloud storage, Skype, and other telecommunications services. This course is focused upon the ethical principles that are called into play with the use of e-therapy. Among them the most obvious concern is for privacy and confidentiality. Yet these are not the only ethical principles that will be challenged by the increasing use of e-therapy. The others include interjurisdictional issues (crossing state lines), informed consent, competence and scope of practice, boundaries and multiple relationships, and record keeping. In addition to outlining potential ethical problems and HIPAA challenges, this course includes recommended resources and sets of specific guidelines and best practices that have been established and published by various professional organizations. Course #30-87 | 2016 | 52 pages | 20 posttest questions

Ethics and Social MediaEthics and Social Media is a 2-hour online continuing education (CE) course that examines the use of Social Networking Services (SNS) on both our personal and professional lives. Is it useful or appropriate (or ethical or therapeutic) for a therapist and a client to share the kinds of information that are routinely posted on SNS like Facebook, Twitter, and others? How are psychotherapists to handle “Friending” requests from clients? What are the threats to confidentiality and therapeutic boundaries that are posed by the use of social media sites, texts, or tweets in therapist-client communication? The purpose of this course is to offer psychotherapists the opportunity to examine their practices in regard to the use of social networking services in their professional relationships and communications. Included are ethics topics such as privacy and confidentiality, boundaries and multiple relationships, competence, the phenomenon of friending, informed consent, and record keeping. A final section offers recommendations and resources for the ethical use of social networking and the development of a practice social media policy. Course #20-75 | 2016 | 32 pages | 15 posttest questions

Preventing Medical Errors in Behavioral HealthPreventing Medical Errors in Behavioral Health is a 2-hour online continuing education (CE) course that examines the ways in which clients can be harmed in mental health practice, and the many strategies for anticipating and avoiding such undesirable outcomes. This course is intended to increase clinicians’ awareness of the many types of errors that can occur within mental health practice, how such errors damage clients, and numerous ways they can be prevented. Its emphasis is on areas within mental health practice that carry the potential for “medical” errors. Examples include improper diagnosis; breaches of privacy and confidentiality; mandatory reporting requirements; managing dangerous clients; boundary violations and sexual misconduct; the informed consent process; and clinical and cultural competency. There are major new sections on psychotherapy in the digital age, including the use of social networking systems, the challenges of maintaining and transmitting electronic records, and engaging in the practice of teletherapy. *This course satisfies the medical errors requirement for license renewal of Florida mental health professionals. Course #21-18 | 2018 | 38 pages | 15 posttest questions

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Therapy Tidbits – March/April 2018

New Online CE Course @pdresources.org

Therapy Tidbits – March/April 2018Therapy Tidbits – March/April 2018 is a 1-hour online continuing education (CE) course comprised of select articles from the March/April 2018 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep psychologists (and other mental health professionals) informed about practice issues. The articles included in this course are:

  • Teletherapy is the Future Norm – Discusses the importance of educating oneself about teletherapy and introduces a variety of teletherapy companies.
  • ‘Housing First’ Reducing Homelessness – Introduces the book ‘Housing First’ and provides background information on the Housing First program of providing housing and support services for the homeless
  • Ethics of Technology and Clinician Responsibility – This article differentiates between the psychological testing and assessment of patients and highlights the dangers of relying on technology and the importance of the clinician’s expertise in the process.
  • Psychology Lags Behind Psychiatry in Health Integration Readiness – Provides an overview of the new initiative to train behavioral health care professionals to work in primary care practice.
  • ACA’s Likely Future Depends on Who’s Guessing – A brief update on the Affordable Care Act.
  • Consulting in Medical Settings Expands Practice – This course offers a description of a consulting liaison psychologist’s role in a medical setting and discusses the difficulties and rewards of taking on such a role.
  • Unique Peer Consultation Issues in Rural Alaska – The author highlights the need for developing connections with trusted peers, who can support the clinician living and working in a rural Alaskan community.
  • Psychotherapy and Counseling are Different – In a world where psychotherapy is declining and counseling is growing, Dr. Doane provides an important reminder of the difference between the two.
  • Therapists Vulnerable to Sexual Misconduct Accusations – This article reminds practitioners of the importance of having effective policies, practices and education in place to protect oneself against allegations of misconduct
  • ICD-11 to Include ‘Gaming Disorder’ – A brief description of ‘Gaming Disorder’ as described by The World Health Organization.

Course #11-19 | 2018 | 20 pages | 10 posttest questions

Click here to learn more.

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document).

Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers