It is a psychotherapist’s ethical obligation to maintain clear therapeutic boundaries. Since the 1990s, when studies about sexual abuse of patients were published,most professional codes have considered a violation of these boundaries as professional failure (Holmes & Adshed 2009). Sexual abuse in medicine, psychiatry and psychotherapy is a relatively common problem. It can appear in 1–۱۲% of male therapists and 0–۳.۱% of female therapists (Holroyd & Brodsky 1977; Pope et al 1979; Pope et al 1986; Akamatsu 1988; Gechtman 1989; Borys & Pope 1989). A therapist’s sexual contact with a client is unethical for several reasons. The relationship is unequal from the beginning because the therapist has at least the advantage that the client comes for help, shares his/her problems and many intimate issues and is less able to understand what happened in the relation, while the therapist is a professional who was educated to understand relationships and his/her activities are paid. The main problem, however, is that the therapist puts his/her needs above the needs of the patient.The situation may be ethically difficult if the sexual relationship took place after the end of treatment. In some organizations, such as the American Psychiatric Association, sexual contacts with any former patients are considered unethical. Other associations such as the American Psychological Association consider such contact to be unethical if held less than two years after treatment. Some are convinced that when it comes to marriage, it is difficult to talk about abuse (Appelbaum and Jorgenson 1991), but for other marriage does not preclude abuse, also showing that the transference works even years after the end of therapy (Celenza 2007).
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