Dear Alice,

Could you comment on therapists who violate boundaries with their patients — sexual and non-sexual (i.e., emotional, personal, financial, professional) boundary violations? Do you know if there are any resources for people who have been exploited by therapists? Thanks.

Dear Reader,

If something that is happening with a therapist upsets you or someone you care about, it's a good idea to explore the situation, perhaps even talking about it with a trusted family member, friend, or mentor. It's normal and appropriate for some of the work in therapy to be unsettling. In a healthy counseling relationship, issues often come up which are confusing, anxiety producing, sad, or even terrifying. Some of these feelings may even be directed at the therapist. It's also common for there to be instances during therapy when the counselor and client disagree or the client feels unsatisfied with the way the sessions are going. These can be constructive issues to discuss with the therapist — assuming that overall the relationship feels safe and supportive.

Unfortunately, however, the intimate nature of the therapeutic relationship often creates a vulnerable situation for clients, one that could be abused by an unscrupulous person. Therapists with credentialed professional training are responsible for adhering to the Code of Ethics developed by their professional association(s). Each of these organizations has a set of guidelines designed to protect clients and ensure thorough, respectful, and safe care. These include not entering into any outside relationship with a client (such as a friendship, romance, or business deal), respecting a client's self-determination and privacy, clearly communicating fees, availability, and changes in treatment, as well as many additional standards of conduct.

Something to keep in mind, however, is that not all people claiming to be "counselors" or "therapists" have professional training or affiliations. When choosing a mental health provider, it is important to consider the training (graduate and post-professional, as well as training certificates) of the person you're checking out. You can do this by asking the person directly about their credentials and experience. You can also contact the various professional organizations for a list of providers in your area, or check on the validity of a therapist's stated affiliations. This is not to say, however, that all credentialed counselors always behave in ethical ways, or that those without specific professional training exploit their clients.

Each of the recognized professional organizations for therapists has a procedure for filing complaints about members. Some suggest consumers direct their concerns to their local chapters. You can find this contact information on each of the national web sites. Some associations accept complaints by telephone or e-mail, while others require the client to submit their complaints in writing. For example, the American Psychiatric Association suggests that written complaints include a letter with a brief explanation of the situation, as well as the time-span of the treatment. It's always important to include your name and contact information so that the committee looking into your complaint can gather further details from you if necessary. For more information on filing complaints, you can check out the websites of the following are professional organizations for therapists:

If you are a student engaged in therapy at school, your first step can be to voice or file a complaint with the director of the counseling service. Keep in mind that the receipt and investigation of an ethical complaint against a therapist does not necessarily result in the removal of an individual's professional license, arrest, or any other sanctions.


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