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Petitioner repeatedly testified that he made “mistakes in judgment,” rationalized his behavior with former clients, was confused about dual relationships, and misinterpreted “vague language” in the code of ethics in a way that was convenient for him. Even without a set of exact rules and regulations, surely the most educated amongst us are expected to understand values such as, honesty, integrity and honor. He described the period during which he became involved with former clients, as “ the rockiest and shakiest time of [his] life.” He explained that he did not manage that period of his life well because he was “freshly separated and freshly divorced and in somewhat of a confused state․” Despite petitioner's personal problems, which contributed to the poor judgment he exercised in relationships with his former clients, there is no evidence in the record that he sought professional assistance as required by the ethical guidelines. Professional codes of conduct set minimal standards, and are no substitute for moral and ethical judgment. The subject of physician-patient boundaries illustrates how well-intentioned policy can be written in a way that is simply too shallow to serve the goals of ethics.If you've sat on a credentials committee, disciplinary panel, or medical-licensing board, you surely reviewed cases of physician-patient sexual involvement.A therapist who gratifies his or her own needs by exploiting a patient's vulnerability destroys the trust essential to treatment." The APA seems to imply that all sexual relationships are inherently exploitative. From the administrative justice standpoint, a "no overlap" rule is simple to administer and superficially unassailable. As a credentials reviewer, I've seen this clause invoked far more often by scorned lovers than by innocent parties.The inflexible letter of the law weighs unfairly on some defendants, and sometimes compels a disciplinary body to impose sanctions that don't fit a case's nuances.Take the scenario of a single doctor practicing in a small town, one who'd like to settle in the area and raise a family — a euphemism for "find a mate." In our society, this involves romance and courtship, and — for most contemporary couples — some sexual behavior.Because our doctor is the main caregiver in the town, almost anyone is a potential patient.

In reducing human behavior to coldly formal, mechanistic terms, we tend to get tripped up. Petitioner first argues that the Psychology Board erroneously concluded that he violated Principle 6(a) of the Ethical Principles of Psychologists. The psychology profession's prohibition against dual relationships is especially necessary in light of the well documented phenomenon of “transference.” “Transference is the term used by psychiatrists and psychologists to denote a patient's emotional reaction to a therapist․” Simmons v. The psychologist is expected to recognize and understand a patient's inappropriate and loving emotions directed toward the therapist as constituting transference. During the therapeutic process, the psychologist and patient develop a relationship analogous to that of a parent and child. The harmful consequences of a sexual relationship between a client and therapist are similar to those experienced by incest victims. The experts agree that sexual intimacies between a therapist and client constitute a misuse of transference. (quoting Stone, The Legal Implications of Sexual Activity Between Psychiatrist and Patient, 133 Am. Slaughter, Misuse of the Psychotherapist-Patient Privilege in Weisbeck v. Linda Jorgenson, Rebecca Randles, and Larry Strasburger, The Furor Over Psychotherapist-Patient Sexual Contact: New Solutions to an Old Problem, 32 Wm. Petitioner next argues that the Board's conclusion that he violated Principle 2(f) of the APA's Ethical Principles is not supported by the findings or the evidence. Principle 2(f) states: Psychologists recognize that personal problems and conflicts may interfere with professional effectiveness. Common sense and good judgment should also be guideposts for members of a learned profession trained to promote mental health. Harkins, Jr., Atlanta, GA, for petitioner appellant. The psychologist who chooses to engage in such activity “bears the burden of demonstrating that there has been no exploitation, in light of all relevant factors․” Id. The revised code makes crystal clear that psychologists who engage in romantic relationships with former clients may no longer argue to professional review boards and courts that the term “client” is to be narrowly construed to apply only to current clients and not former clients. “The proper therapeutic response is countertransference, a reaction which avoids emotional involvement and assists the patient in overcoming problems.” Id. For these reasons, “[c]ourts have uniformly regarded mishandling of transference as malpractice or gross negligence.” Simmons, 805 F.2d at 1365.“[T]he factors which make sexual contact with a patient harmful and unethical do not appear to change when a professional relationship is terminated.” Molly E. Many patients continue to experience transference long after the formal termination of psychotherapy. At the time petitioner became involved with four of his former patients, the ethical code that existed gave “notice that sexual intimacy between a psychologist and a patient was improper.” Weisbeck v. We hold that under the circumstances of this case, the Board's interpretation of that principle was neither plainly erroneous nor inconsistent with the purposes of the regulation. There is no indication in this case that the Board acted in bad faith, unfairly, or without judgment.For psychiatrists, it is a violation to cross the "patient-lover boundary" with any person who has ever been in the other role.According to the American Psychiatric Association: "Sexual activity with a current or former patient is unethical.... The scope of review on appeal from a lower court's consideration of a final agency decision under the Administrative Procedure Act, N. The code specifically states that “sexual intimacies with a former therapy patient or client are ․ frequently harmful to the patient or client, and because such intimacies undermine public confidence in the psychology profession and thereby deter the public's use of needed services, psychologists do not engage in sexual intimacies with former therapy patients and clients even after a two-year interval except in the most unusual circumstances.” Id., § 4.07(b) at 1605. Patients often conduct internal dialogues with former therapists which involve imaginary conversations about feelings, decisions and self-evaluation. For these reasons, many psychologists adopt the position “ ‘[o]nce a client, always a client.’ ” Slaughter, supra, at 615 (quoting Leonard J. Malouf, Keeping Up the Good Work: A Practitioner's Guide to Mental Health Ethics 53-65 (1992)). In the case sub judice, the Psychology Board determined that petitioner was in violation of the ethical principle regarding dual relationships.


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