HISTORY LESSON: Help For Those Exploited By A Therapist A Support Group Grows Out Of A Counselor's Anger At Some Peers

By Kitty Dumas

Philadelphia Inquirer - January 3, 1988

"I was furious, and I began looking for others who shared my outrage," she said. 

Baron formed the Association Against Client Exploitation by Professionals, a local group that provides support and referral services to those who are distressed about their relationships with their counselors. It also works with therapists and other professionals who believe that such sexual involvement with patients is an abuse of power. The group held its first meeting last April. 

The drive against therapists who become sexually involved with their patients has spread to the Pennsylvania House of Representatives, where two bills are pending that would make such conduct a crime and would enable victims to sue. 

"Most therapists are ethical and do their best and don't exploit their clients," said Baron, who holds a master's degree in psychiatric nursing and is a member of two professional organizations - the American Nurses Association and the American Group Psychotherapy Association. 

Some therapists belong to professional groups, such as the American Psychological Association and the American Psychiatric Association, that set standards of conduct forbidding sexual relations between therapists and clients. Some, such as psychologists and psychiatrists, also are licensed by the state. And still others call themselves "counselors" without any specific credentials or rules of conduct.

Stories told by those who say they have been abused by therapists sound like the basis for a TV mini-series - sex, abuse of power and emotional trauma. 

But this is a real-life problem. Statistics indicate that sexual abuse by therapists is the most frequent reason for state licensing boards to hear complaints, said Kenneth Pope, a psychologist who is chairman of the American Psychological Association's ethics committee and who was quoted on the topic in Sexuality Today, a newsletter circulated to professionals. 

According to a study last year directed by Nanette Gartrell, a psychiatrist at Beth Israel Hospital in Boston, 6 percent of the 1,423 psychiatrists who responded said they had had sex with patients. Many defended their actions by saying that the affairs helped the patients. A third of that 6 percent acknowledged having had sex with more than one patient. 

Offending therapists are "a minority but they're a minority that's a critical mass that we're concerned about," said Nancy Felipe Russo, a former director of women's programs at the American Psychological Association. 

Sharon Baron said that all of her patients who have had sex with therapists have suffered emotionally. The problems that sent them in search of counseling often were not addressed by the therapists. Instead, those problems were compounded by new ones created by their sexual relationship. 

Some of her patients have improved since changing therapists, she said, but others have not.

"They're not all better. Some of them can't trust me." 

Since she began her support group, she said, she has received calls from people who say they have been sexually abused by ministers, priests, rabbis and nuns. 

Abuse by professionals does not always involve sex. Baron said a physician who talked his patients into investing in his property in Florida would be guilty of abuse. So would be the divorce lawyer who asked his client out on a date. These examples are what psychiatrists call "boundary issues," she said, issues that walk the line between what is appropriate and what is not. 

Because people usually visit lawyers, doctors, therapists and clergy when they are suffering emotionally or physically, they are easily victimized by professionals who are seen by society as wise and ethical people, Baron said. Often the client is flattered when asked to start a relationship that goes beyond the professional one.

For four years, Rita Brown, 32, a Philadelphia nurse, carried the secret alone. A soft-spoken woman with short blond hair, she hides her anguish well beneath her calm demeanor - until she begins to talk about what happened. Then her voice is filled with thinly disguised anger. Her eyes narrow as she recounts her four-year relationship with a therapist. 

Brown, who asked that her real name not be used, began seeing a therapist when she needed help in dealing with low self-esteem and a history of family problems that included an alcoholic father. But the 50-year-old therapist, who had an office in the suburbs, told her she had "sexual hang-ups," she said. Her boyfriend warned her about becoming too involved with the man, but she began to trust him. The therapist often told her about his own problems, including the troubles he was having with his wife. 

The therapist "would call me at work and call me at home. I ended up feeling sorry for him," she said. 

After she and her boyfriend of seven years broke up, she said, she began sleeping with the therapist. 

"I was very depressed after it (the sexual relationship with the therapist). I was suicidal. I had trouble when someone asked me for a date," Brown said. "I felt sleazy. They take every vulnerability and insecurity and turn it against you." 

And to top it off, Brown said, the therapist continued to charge her for counseling sessions.

In 1984, Brown finally ended the relationship with the therapist. It was not until last year that she discovered that the therapist also had had intercourse with six or seven other women in her therapy group. 

Also last year, she learned that while her therapist had several master's degrees, he neither was a member of any professional group nor was he licensed by the state. She said that when she tried to bring the therapist before a state board, she discovered he had no license to revoke. 

When asked why she didn't take action sooner, Brown said she was intimidated by the therapist.

"Part of the reason that it wasn't talked about was because he knew so many intimate things about you," she said. "Your childhood. So many things I told him about growing up - how rotten it was. He once said to me 'I know everything about you.' " 

Brown believed that he was making a thinly veiled threat to expose some of her most painful secrets. 

"Who can I tell that he did this?" she asked sadly. "He knows everything about me."

Gary Schoener is executive director of the Walk-In Counseling Center in Minneapolis, which deals with people who say they have been abused by a counselor or therapist. Since 1974, when the center began specializing in these cases, more than 800 people have sought help. About 80 percent of the patients have been women who said they were victimized by a male therapist and about 10 percent have been women alleging abuse by a female therapist. About 5 percent have been men saying they were abused by a male therapist, while the remainder have been males accusing female therapists. 

In several states, including Minnesota, Wisconsin, Florida and Michigan, it is a felony for counselors to have sex with a client or former client. 

In creating laws, states had to define psychotherapist, Schoener said. "Our definition of a psychotherapist is very broad - licensed clergy, paraprofessionals and others who claim to offer help with personal problems - if he is doing the kind of work a therapist does." 

The Pennsylvania House Judiciary Committee is considering two bills. One of them would make having sex with a client a crime carrying fines and jail terms. The other would enable a victim to file a civil suit and seek damages for mental or physical injury; also, those with knowledge of the abuse, such as the therapist's staff members or colleagues, would be required by law to report the incident or risk fines. Those reporting would not risk liability, according to the bill. Both bills are sponsored by Rep. H. William DeWeese (D., Greene). 

Neither New Jersey nor Delaware has legislation dealing specifically with such abuse. Currently, in all states, victims may file complaints with the professional association to which the therapist belongs, if any. A complaint also can be filed with the state, which could revoke a therapist's license to practice. A civil suit or malpractice suit could be filed or criminal charges of rape can be filed. 

However, a therapist who loses a license in one state may continue to practice in other states, according to Schoener. Some continue to practice in the state where the offense occurred, simply changing their title. No law bars them from hanging out a different type of shingle, Schoener said. 

What are the warning signs for patients in therapy to look for? Beware, Schoener said, if a therapist is doing as much or more talking than the patient. 

Early on during therapy sessions, the roles seem to get reversed - the client appears to be taking care of the therapist. "The client is flattered that the therapist would trust him or her. Here this big-gun professional picks them from his entire client load," Schoener said. 

Some people find it hard to believe that they could ever be taken advantage of by a therapist. To these people, Schoener advised, "don't think of yourself now. Think of yourself at your lowest ebb, when things don't mean much anymore. You don't have anything to hang onto. That's when the sex occurs. It doesn't happen when you're on top of the world."

On May 6 and 7, (1988) the Association Against Client Exploitation by Professionals will sponsor with the University of Pennsylvania School of Nursing a national conference titled "Exploitation by Professionals: The Abuse of Power" at the Hershey Philadelphia Hotel. Attending will be national experts in the field, local professionals and victim