NAU Directory

Sexual boundary violations (SBVs) perpetrated by clinicians in psychotherapy are a long-standing problem, indicative both of a fundamental abuse of power and mismanagement within the therapeutic relationship and complex harms that often extend beyond the primary victim to family members, colleagues, institutions, and the field at large. This chapter begins with a vignette that illustrates SBVs and various betrayals. It then briefly highlights the relevant ethics codes from the American Psychological Association (APA; e.g., 2017). Next, the chapter provides overviews of the literature on betrayal trauma theory, institutional betrayal, and colleague betrayal, with a brief introduction to cultural betrayal. It details the implications of this problem for clinicians, organizations, and professional training programs, with an emphasis on suggestions that both reduce the likelihood of SBVs and mitigate harm when they do occur.