Sexual abuse prevention: the rules for psychotherapists

1What the law counts (Code s. 1 (3))

1. Sexual intercourse or other forms of physical sexual relations between the member and the patient.
2. Touching, of a sexual nature, of the patient by the member.
3. Behaviour or remarks of a sexual nature by the member towards the patient.

2The clinical exception (s. 1 (4))

• "Sexual nature" does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided, such as discussing sexuality relevant to treatment.
• CRPO: any form of disrobing or sexual touching of clients is inappropriate, even where some touch may be part of therapy.

3After care ends

• A person remains a patient for five years from the date they ceased to be one (O. Reg. 202/25, s. 1, under Code s. 1 (6)).
• CRPO: even beyond five years, a romantic or sexual relationship with a former client may never be appropriate; in most cases it is inappropriate, inadvisable and potentially damaging.

4Standard 1.8

• 1.8.1 Refrain from verbal, physical, psychological, emotional and sexual abuse of clients.
• 1.8.2 The same respect toward clients' representatives, family, partners and others close to them.
• 1.8.3 Do not unduly influence clients or those close to them, including personal life decisions, wills or powers of attorney.

5Power and boundaries (1.8 commentary)

• Understand the power dynamic: clients may feel pressured to consent or give positive feedback, and dual relationships magnify it.
• Boundary violations can be a precursor to abuse; a crossing must be clinically indicated and consented to.
• Talk about boundaries early, and set policies such as after-hours contact.

6Mandatory penalties (Code s. 51 (5))

• Any finding of sexual abuse: a reprimand, and a suspension unless the certificate is revoked.
• Revocation for the acts the Code lists, including intercourse, genital or oral contact, masturbation and certain sexual touching.
• CRPO: registration revoked for at least five years for those acts.

7Reporting another professional (ss. 85.1, 85.3)

• Report if you have reasonable grounds, from your practice, to believe another regulated professional sexually abused a patient.
• In writing to that person's Registrar within 30 days; forthwith if the abuse may continue or others may be abused.
• The patient is named only with their written consent.

8Funding for therapy (Code s. 85.7; CRPO)

• A client who alleges sexual abuse by an RP, in a complaint or report, may apply for therapy and counselling funding: up to about $20,000 over five years, after other sources such as insurance.
• A primary support person may get up to $600.
• They are free to choose a therapist or counsellor who is not a relative and has not been found guilty of sexual abuse.