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Chapter 64B4-10:
Sexual Misconduct in Mental Health
Counseling
Andreina Lugo
64B4-10.001 – Findings of the
Board
 The power differential between therapist and client is
extremely influential (consciously or subconsciously) when it
comes to such relationships.
 The effects of having this kind of inappropriate relationship with
a client can endure even after therapy is terminated.
 Therapist is responsible for acting in the best interest of the
client even after termination.
64B4-10.002 – Definition of Sexual
Misconduct
 Sexual misconduct is defined as any attempt by a therapist to
engage, attempt to engage or offer to engage in sexual
behavior. It can be verbal or physical with the intent of being
sexually arousing.
 Includes kissing, sex of any kind and touching by therapist or
client of the other’s breast, genital area, buttocks or thighs.
Clothed or unclothed.
 It is also sexual misconduct for a therapist to encourage a
client to engage in sexual conduct with a third party. There are
2 exceptions to this:
 The encouragement is consistent with the treatment plan
established for this clients specific diagnosis.
 If it is a generally accepted standard for psychotherapy in the state
you are in.
64B4-10.003 – Psychotherapist-Client
Relationship
 This relationship is established once the therapist rendered or intends to
render a mental health service.
 A formal contract, scheduling of appointment or payment are NOT necessary in
order for it to be considered a psychotherapist-client relationship but it is
considered evidence that it exists.
 SEXUAL MISCONDUCT IS PROHIBITED.
 To determine the existence of sexual misconduct, the psychotherapist-
client relationship continues for a MINIMUM of 2 years after termination.
 Just because it is past the 2 years does not mean the psychotherapist-
client relationship is over.
 The client consenting to, initiating or participating in the sexual behavior
or involvement with the therapist does not change the nature of the
conduct OR lift the prohibition.
64B4-10.003 – Psychotherapist-Client
Relationship
 Some of the ways the Board uses to determine if the
psychotherapist-client relationship is over are:
 Formal termination
 Transfer of a client’s case to another therapist
 How long the professional relationship has been
 The extent of how much the client has shared with the therapist
 The nature of the client’s problem
 How emotionally dependent the client is with the therapist
 The therapist is not to engage in or request sexual contact with a
formal client at ANY TIME IF it would be exploitative, abusive or
detrimental to that clients well being OR if that sexual contacts
comes from an exploitation of trust, knowledge, influence or
emotions, derived for the professional relationship.
64B4-10.004 – Sexual Misconduct Not
Involving Client Contact
 It is sexual misconduct for a supervisor to engage in sexual
behavior with the supervisee while the supervisory relationship
exists.
 It is sexual misconduct for the therapist to engage in sexual
behavior with the immediate family member/guardian of a
client during the period of time therapeutic services are being
provided to the client.
 Immediate family is defines as: spouse, child, parents, parents-in-
law, sibilings, grandchildren, grandparents or any other household
member.

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Chapter 64B4-10

  • 1. Chapter 64B4-10: Sexual Misconduct in Mental Health Counseling Andreina Lugo
  • 2. 64B4-10.001 – Findings of the Board  The power differential between therapist and client is extremely influential (consciously or subconsciously) when it comes to such relationships.  The effects of having this kind of inappropriate relationship with a client can endure even after therapy is terminated.  Therapist is responsible for acting in the best interest of the client even after termination.
  • 3. 64B4-10.002 – Definition of Sexual Misconduct  Sexual misconduct is defined as any attempt by a therapist to engage, attempt to engage or offer to engage in sexual behavior. It can be verbal or physical with the intent of being sexually arousing.  Includes kissing, sex of any kind and touching by therapist or client of the other’s breast, genital area, buttocks or thighs. Clothed or unclothed.  It is also sexual misconduct for a therapist to encourage a client to engage in sexual conduct with a third party. There are 2 exceptions to this:  The encouragement is consistent with the treatment plan established for this clients specific diagnosis.  If it is a generally accepted standard for psychotherapy in the state you are in.
  • 4. 64B4-10.003 – Psychotherapist-Client Relationship  This relationship is established once the therapist rendered or intends to render a mental health service.  A formal contract, scheduling of appointment or payment are NOT necessary in order for it to be considered a psychotherapist-client relationship but it is considered evidence that it exists.  SEXUAL MISCONDUCT IS PROHIBITED.  To determine the existence of sexual misconduct, the psychotherapist- client relationship continues for a MINIMUM of 2 years after termination.  Just because it is past the 2 years does not mean the psychotherapist- client relationship is over.  The client consenting to, initiating or participating in the sexual behavior or involvement with the therapist does not change the nature of the conduct OR lift the prohibition.
  • 5. 64B4-10.003 – Psychotherapist-Client Relationship  Some of the ways the Board uses to determine if the psychotherapist-client relationship is over are:  Formal termination  Transfer of a client’s case to another therapist  How long the professional relationship has been  The extent of how much the client has shared with the therapist  The nature of the client’s problem  How emotionally dependent the client is with the therapist  The therapist is not to engage in or request sexual contact with a formal client at ANY TIME IF it would be exploitative, abusive or detrimental to that clients well being OR if that sexual contacts comes from an exploitation of trust, knowledge, influence or emotions, derived for the professional relationship.
  • 6. 64B4-10.004 – Sexual Misconduct Not Involving Client Contact  It is sexual misconduct for a supervisor to engage in sexual behavior with the supervisee while the supervisory relationship exists.  It is sexual misconduct for the therapist to engage in sexual behavior with the immediate family member/guardian of a client during the period of time therapeutic services are being provided to the client.  Immediate family is defines as: spouse, child, parents, parents-in- law, sibilings, grandchildren, grandparents or any other household member.