Sexual Boundary Violations

Sexual boundary violations are considered the most serious ethical infractions in the mental health profession, as well as in higher education and pastoral counseling. Recognized as unethical due to the power imbalance inherent in the structure of the therapist-patient and teacher-student dyads, erotic contact between therapists and patients has been revealed in prevalence studies to occur at an unacceptably high incidence rate (nine to twelve percent) among mental health practitioners. There exist few programs, teaching methods, and preventative measures that adequately address the problem of sexual boundary violations, despite the fact that discussing this problem openly is no longer taboo. Sexual Boundary Violations addresses this gap, providing educators, trainers, and clinicians with a resource to aid in developing programs, ethics workshops, seminars, and other educative or clinical teaching projects.

Andrea Celenza, PhD, is an assistant clinical professor at Harvard Medical School. She has authored and presented numerous papers on therapists who have engaged in sexual misconduct with a focus on training, supervisory, and rehabilitation issues. She is the recipient of several awards, including the Karl A. Menninger Memorial Award, the Felix & Helena Deutsch Prize, and the Symonds Prize. She is in private practice in Lexington, Massachusetts.

1 Acknowledgments
2 Foreword
3 Introduction
Part 4 I. Nature and Scope of the Problem
Chapter 5 1. How Do They Happen?
Chapter 6 2. This Couldn't Happen to Me
Chapter 7 3. Precursors to Therapist Sexual Misconduct
Chapter 8 4. When is a Couch Just a Couch?
Chapter 9 5. The Therapeutic Context
Chapter 10 6. Academic and Supervisory Contexts
Chapter 11 7. Sexual Misconduct in the Clergy
Part 12 II. Reporting, Fallout, and Recovery
Chapter 13 8. Reporting and Other Ethical Responsibilities
Chapter 14 9. Collateral Damage and Recovery
Chapter 15 10. Helping the Victims
Part 16 III. Rehabilitation
Chapter 17 11. Therapy of the Transgressor
Chapter 18 12. Helping the Helpers: Supervision of the Transgressor
Part 19 IV. Prevention
Chapter 20 13. Responsible Responsivity
Chapter 21 14. Love and Hate in the Countertransference: Preventing Violations Through Supervision
Chapter 22 15. Boundary Violations Vulnerability Index (BVVI)
Chapter 23 16. Teaching Boundaries, Experiencing Boundaries
24 Appendices: Empirical Research
25 Appendix A: Personal and Interpersonal Characteristics of Transgressors: Co-investigator: Mark Hilsenroth
26 Appendix B: A Rorschach Investigation: Co-investigator: Mark Hilsenroth
27 References
28 Index
29 About the Author