This year's Graduate Student Ethics Prize winner, Craig D. Fisher, PsyD, tackled a thorny issue for practitioners in his winning paper on the ethical dilemmas of therapists' self-disclosure of sexual feelings toward clients. Fisher presented his paper during APA's 2003 Annual Convention.
Therapists lack consensus on disclosing sexual feelings in therapy because of ethical "discomfort around the issue," said Fisher, a postdoctoral fellow at the University of Virginia's Behavioral Medicine Center and a graduate of Argosy University/Washington, D.C.
Many therapists shy away from discussing the topic with other practitioners, Fisher said, despite the high prevalence of therapists experiencing sexual feelings for a client--some studies show that 70 to 90 percent of therapists have reported having sexual feelings for a client; the number is highest for male therapists. Only half of therapists, however, have received training on how to manage these feelings, Fisher noted. He suggested that more direct discussion of this topic during graduate training would be helpful.
He also strongly cautioned that disclosing sexual feelings for a client might cause more harm than good, and noted the relevance of the 2002 APA Ethics Code's Standard 3.04 on avoiding harm, Standard 3.05 on multiple relationships and Standard 3.02 on sexual harassment.
In particular, therapists' use of explicit self-disclosure--such as discussing their erotic feelings for the client--has the greatest potential to be problematic, Fisher said. This method of disclosing might blur the boundaries of a relationship and confuse or disrupt the client's therapy, he explained.
However, Fisher said that less direct disclosure--acknowledging feelings that exist in the relationship but avoiding explicit mention of sexual feelings--might be beneficial in some circumstances.
Fisher recommended that before therapists disclose, they consider seeking additional training, explore alternative interventions and/or obtain consultations with ethics experts and colleagues.
Stephen Behnke, JD, PhD, director of APA's Ethics Office, said that Fisher's paper was an excellent submission, because Fisher went beyond a literature review to critically examine the ethical aspects of a complicated and controversial issue.
Fisher's paper was chosen for the Graduate Student Ethics Prize from 30 submissions. The prize, presented each year by APA's Ethics Committee and the American Psychological Association of Graduate Students, consists of a $1,000 award and a round trip to and two-night stay at APA's Annual Convention, where the prize-winner presents the paper. Information about next year's prize can be found at APA's Ethics.