Document Detail

Post-termination sexual boundary violations.
MedLine Citation:
PMID:  12232973     Owner:  NLM     Status:  MEDLINE    
In this essay, the author has focused on the rationale for an absolute prohibition of sexual contact between psychiatrists and former patients. The role of an ethics code is to proscribe professional misconduct that may have the potential to harm the patient. Because we know that in many cases of psychiatrist-patient sex there is serious exploitation of the patient's vulnerability, we have clear prohibitions against sexual relations between a current patient and his or her psychiatrist. The same considerations apply to former patients. The transference (and countertransference) feelings established in the relationship persist well beyond termination. Even in the absence of a treatment that acknowledges the existence of transference, a power differential is unmistakable because of the fiduciary nature of the relationship. Moreover, the therapeutic relationship is effective because it will never be anything but a treatment relationship. The possibility of a future sexual affair between psychiatrist and patient erodes the conditions necessary for effective psychiatric therapy. Finally, most patients will feel the need to return to treatment at some point in the future, and the psychiatrist needs to preserve that potential as part of the duty to the patient. For all of these reasons, the current position of the APA on an absolute prohibition against sex with former patients is a sound and sensible one.
Glen O Gabbard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Psychiatric clinics of North America     Volume:  25     ISSN:  0193-953X     ISO Abbreviation:  Psychiatr. Clin. North Am.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-17     Completed Date:  2003-02-13     Revised Date:  2006-07-14    
Medline Journal Info:
Nlm Unique ID:  7708110     Medline TA:  Psychiatr Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-603     Citation Subset:  E; IM    
Baylor Psychiatry Clinic, Baylor College of Medicine, Houston-Galveston Psychoanalytic Institute, Houston, TX, USA.
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MeSH Terms
Mental Disorders / therapy*
Mental Health Services / ethics
Patient Advocacy
Professional-Patient Relations / ethics*
Psychotherapy / ethics*
Sexual Behavior / ethics*
Transference (Psychology)

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