In separate cases the past two months, state licensing regulators disciplined two mental-health therapists and are investigating charges of unprofessional conduct pending against another for having sexual relationships with patients.
The fact that three cases surfaced at the same time doesn't mean a dangerous trend threatens the public. But it does reveal a serious problem in mental-health care that can do widespread damage to the profession and its clientele, therapists said."It is the most common problem we deal with," said Dr. Eugene Gibbons, chairman of the state's Board of Social Work Examiners, which hears licensing violations brought against social workers.
If any trend can be found, Gibbons said, it is in the increasing number of therapists who are willing to turn in a colleague for stepping out of line with a patient.
"In the past there was an unspoken agreement that you would personally help a colleague with a problem," Gibbons said. "Now, there is a group quick to call licensing authorities to notify them of a possible unethical conduct."
Therapists agree that when a sexual relationship occurs between a practitioner and a client, it most likely involves not just one, but two troubled people.
On one hand, there are patients desperately seeking someone to understand their problems and help them cope. When they receive that assistance it can sometimes be misinterpreted as more than professional help and a gesture of love and romantic attraction.
On the flip side, therapists with troubled marriages - or other serious personal problems for which they don't seek help - expose themselves to the possibility of taking advantage of a vulnerable patient.
Combine the two and the risk of causing further harm to both parties is high, therapists said.
In a case that was resolved when a marriage and family therapist stipulated not to renew his license, the sexual encounter he was accused of strained the patient's relationship with her husband and worsened her mental condition, a petition said.
In an unresolved case before licensing authorities, a divorced patient went on a trip to Hawaii with his therapist who had counseled him on personal and marriage problems. They had sex on the trip and had a sporadic relationship over a four-year period, the petition said, but after their most recent split-up, the patient attempted suicide.
In another case, a psychologist settled charges of unprofessional conduct by agreeing to discontinue his private practice and undergo psychological therapy himself.
Therapists noted that the ramifications of an unethical relationship can spread further as the patient and others aware of the incident harbor a distrust for the profession in general, making it difficult to respond to future therapy.
"The trust level that a patient puts into a therapist is one of the critical factors" in successful therapy, said Phil Johnson, chairman of the state's Marriage and Family Therapists board.
Gibbons, a professor at Brigham Young University's School of Social Work, said students take an ethics course that addresses the issue of relationships with patients and licensing exams include questions on the issue.
He said that in the 1960s and early 1970s there were those who advocated sex as legitimate therapy, but that is not accepted today. Utah laws and professional ethical standards prohibit it, and violators face sanctions against their professional licenses.
California law is even stricter, he said, as it prohibits sexual relationships for five years after therapy has been discontinued. "That's coming here sometime" in the future, he said.
If therapists find themselves sexually attracted to patients, Gibbons said, they should refer those patients to other therapists.
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How to protect yourself:
In selecting a therapist, check out his or her status with state licensing department.
-Shop around, use referrals from patients and select a therapist with whom you are comfortable.
If you are not comfortable with a therapist for any reason, seek a second opinion.
-Don't permit a therapist to engage in any intimate or sexual physical contact. Confront the therapist about it or report it to licensing authorities.