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. Us clients, (yes, I'm in therapy too), 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, should you have any concerns. 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. 

Other counselling and therapy governing bodies have other rules, with most non-body-based psychotherapy modalities allowing minimal non-intimate touch, such as a handshake. 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, like an estate agent. 

In the UK, 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. 

If you want touch-based intimacy support, which can be hugely valuable for some people, then you're not looking for a sex and relationship therapist. Try a Sexological Bodyworker, hands-on intimacy coach, or a sex worker. These people's work can, and often does, include physical touch and penetration, but it's not psychosexual therapy.

2. No Social Contact 

There can be no social contact with your therapist. You see them for your sessions together and you can be in contact with them about your work together, and that's it. Anything outside of that, that is social or familial, is seen as a dual role, which is not permitted. 

I would encourage you to ask your counsellor what communication methods they offer clients, and where their boundaries are around client contact out of sessions. Some therapists prefer phone calls, some use WhatsApp, and some prefer SMS. Personally, I want clear boundaries around my contact with clients so I only use email, so I can respond during my working hours. (My clients can send me voice notes, as an accommodation for those people who don't like writing emails. But they still have to send it to me via email.)

However, life happens, especially if we've found a therapist who lives near us. You may find your paths cross. Here's an article about why you can't be friends with your therapist (and you're not, even if you think you are). 

If your relationship with your therapist feels like it's becoming romantic or sexual, or if you find yourself being attracted to your therapist, and you feel safe with them, here's an article to support you in discussing this with them. And if you really, really want to be in a relationship with or be physically intimate with your therapist and they share that desire, then you need to stop working together. Here's an article about how and when to 'break up' with your therapist. 

3. No Being Creepy/Pervy or Sexual Excited/Aroused/Titillated

It's important that you feel safe to talk about intimate and potentially uncomfortable things with your sex therapist. While we are all human and can experience arousal, a qualified sex therapist has been trained on how to deal with it. This is not to shame their arousal, but to recognise that it is your therapy session and the focus needs to remain on you, the client. If the therapist does get turned on, it's not appropriate for them to discuss it with you or to share their sexual excitement. (This is the sort of thing we therapists take to supervision - it's our problem to deal with, not yours.)

If you notice your therapist is getting aroused, I encourage you to say something and share how you feel about that. You might feel surprised, uncomfortable, shocked, or unsettled. It's your therapy session and you're allowed to challenge the appropriateness of your therapist's behaviour if you feel they are being salacious and/or unprofessional. 

To be clear, there are times in sex therapy when it's appropriate to ask a client to go into detail about their sexual functioning and behaviours, such as explaining how they masturbate or exploring sexual fantasies. This should always be done with the client's consent. If your sex therapist asks you something that doesn't feel relevant or comfortable to share, you can ask why they need to know. For example, if a client shows up with difficulty having an orgasm, we will talk about the different types of touch, penetration, and toys they might be using. I always check in with clients if they feel comfortable talking about the topics, so the conversation is consent-based. 

This is very different from making lewd or creepy comments, such as asking about the colour of someone's underwear or what they look like when masturbating. If you feel in any way icky, creeped out, or perved on by your therapist, I encourage you to take action immediately. But what action?! 

4. How To Complain To Your Therapist

Sometimes, after a therapy session, a client can feel like they overshared, or are left with some feeling of emotional discomfort. This can be tricky to navigate, as therapy by nature is disruptive, as we're looking to change the current situation in some way. 

If your counsellor does something that makes you uncomfortable, you can raise it during the session or after the session. You can explain what it was that made you feel uncomfortable, and also stipulate how you would like to discuss it, such as via email or during the next session.  

5. How To Make A Formal Complaint 

Assuming you've chosen a therapist who is regulated and insured, your first step is to contact your therapist. If you feel a boundary was crossed or their behaviour was inappropriate, let them know. You don't have to justify yourself, but you do need to explain what was wrong and why. This way, the therapist can address your concerns and offer ways to repair the relationship, if that's appropriate.

We are all human and us therapists are as fallible as the next human. But we should be more reflexive than the average bear, and able to reflect on our professional behaviour and how to correct, amend, and repair the damage we've done. However, sometimes we need to challenge a client who is projecting something onto us. So, just because you occasionally feel upset after therapy or don't like the challenges offered by your therapist, doesn't mean the therapy itself is bad.

If you're not happy with their response or how they handle your complaint, then you can escalate the issue to their membership body. You can usually find this information on their website and/or in their contract. 

You will need to explain what happened and when so that the governing body can investigate the therapist. You will need to have some evidence, so it's a good idea to keep messages and emails.