It breaks my heart and makes me furious to read yet another article about an unethical sex and relationship therapist behaving inappropriately with, and taking advantage of, their clients. As clients (yes, I'm in therapy too), we deserve better and should be better protected.

This article explains the social and physical boundaries specifically around sex and relationship therapy, as well as how to raise a concern with your therapist and make a complaint, should you want to. The aim is to support and empower you, as a client. This is not to victim-shame or blame anyone who has been on the receiving end of unethical or inappropriate behaviour from a mental health professional.

1. No Physical Touch

If your sex and relationship therapist is a member of COSRT, they are not allowed to touch you. At all. Not a handshake, nor a comforting hand on your shoulder—nothing. Sex therapy does not involve any physical touch or anyone—therapist or client—taking their clothes off.

I am a COSRT member and I'm currently only seeing clients online. However, pre-Covid, I had been known to shake a client's hand when they entered the therapy room. So, right from the get-go, you can see there can be a small discrepancy between what we're supposed to do and what we actually do.

In the UK, no major psychotherapy body permits sexual or intimate touch. Similarly, neither the client nor the therapist should be taking their clothes off or showing intimate body parts. There should be no physical demonstrations or any other body-based activity you wouldn't do if you were in any other professional public space.

The exception to this is Body Psychotherapy, which can include some consensual, non-sexual touch. This is a specific modality of therapy that also comes with strict guidelines.

Note: If you want touch-based intimacy support, you are not looking for a sex and relationship therapist. Try a Sexological Bodyworker, hands-on intimacy coach, or a sex worker. These professions can include physical touch and penetration, but they are not psychosexual therapy.

2. No Social Contact

There can be no social contact with your therapist. You see them for your sessions, and you can be in contact with them about your work together—and that is it. Anything outside of that, whether social or familial, is seen as a dual role, which is strictly prohibited.

I encourage you to ask your counsellor what communication methods they offer and where their boundaries are. Personally, I use email so I can respond during my working hours. (My clients can send voice notes as an accommodation, but these must still be sent via email.)

Life happens, and you may find your paths cross. Here is an article about why you cannot be friends with your therapist.

If your relationship feels like it is becoming romantic or sexual, and you feel safe, read this article to support you in discussing this. If you and your therapist both desire a physical relationship, you must stop working together immediately. You can find out how to 'break up' with your therapist here.

3. No Creepy or Sexual Behaviours

It is vital that you feel safe to talk about intimate things with your sex therapist. While therapists are human and can experience arousal, a qualified professional is trained on how to manage it. This is your therapy session; the focus must remain on you.

If you notice your therapist is getting aroused or acting in a salacious manner, I encourage you to say something. You are allowed to challenge the appropriateness of their behaviour. Therapists take these issues to supervision—it is their responsibility to manage, not yours.

There are times when it is appropriate to ask for detail about sexual functioning (e.g., masturbation patterns or fantasies), but this must always be done with the client's consent. This is very different from making lewd comments, such as asking about the colour of your underwear. If you feel "icky" or "perved on," take action immediately.

4. How To Raise a Concern

Therapy, by its nature, can be disruptive and occasionally leave you with emotional discomfort. This is different from ethical violations. If your counsellor does something that makes you uncomfortable, you can raise it during or after the session. You can stipulate how you would like to discuss it—for example, via email or at the start of the next session.

5. Making a Formal Complaint

Assuming you have chosen a therapist who is regulated and insured, follow these steps:

1. Contact your therapist directly: Explain what was wrong and why. A reflexive therapist should be able to reflect on their professional behaviour and offer to repair the damage.
2. Escalate to the membership body: If you are unhappy with their response, contact their governing body (e.g., COSRT, BACP, UKCP). This information should be in your contract.

You will need to explain what happened and when. Keep copies of all messages and emails as evidence for the investigation. Your safety and the integrity of the profession depend on these boundaries being held.