Ethics in Psychotherapy and Counseling. Kenneth S. Pope

Readers who have had experience as therapists or patients may wish to compare their own experience to these findings.

Table 6.1. Percentages of Intense Emotions and Other Reactions in Therapy.

Behaviors	Study 1a	Study 2b	Study 3c
Crying in the presence of a client	56.5
Telling a client that you are angry at them	89.7		77.9
Raising your voice at a client because you are angry at them			57.2
Having fantasies that reflect your anger at a client			63.4
Feeling hatred toward a client			31.2
Telling your clients of your disappointment in them	51.9
Feeling afraid that a client may commit suicide			97.2
Feeling afraid that a client may need clinical resources that are unavailable			86.0
Feeling afraid because a client’s condition gets suddenly or seriously worse			90.9
Feeling afraid that your colleagues may be critical of your work with a client			88.1
Feeling afraid that a client may file a formal complaint against you			66.0
Using self-disclosure as a technique	93.3
Lying on top of or underneath a client			0.4
Cradling or otherwise holding a client in your lap			8.8
Telling a sexual fantasy to a client			6.0
Engaging in sexual fantasy about a client	71.8	28.0*
Feeling sexually attracted to a client	89.5	87.0	87.3
A client tells you that they are sexually attracted to you			73.3
Feeling sexually aroused while in the presence of a client			57.9
A client seems to become sexually aroused in your presence			48.4
A client seems to have an orgasm in your presence			3.2
aA national survey of 1,000 psychologists with a 46% return rate. bA national survey of 585 Division 42 (Psychologists in Independent Practice) members. cA national survey of 600 psychologists with a 48% return rate. *This question asked about fantasizing about sex with a client while engaging in sex with somebody else. Source: Study 1 from “Ethics of practice: The beliefs and behaviors of psychologists as therapists,” by K.S. Pope, B.G. Tabachnick, and P. Keith-Spiegel, 1987, American Psychologists, 42, pp. 993–1006. Study 2 from “Sexual attraction to clients: The human therapist and the (sometimes) inhuman training system,” by K.S. Pope, P. Keith-Spiegel, and B.G. Tabachnick, 1986, American Psychologist, 41(2), pp. 147–158. Study 3 adapted from “Therapists’ anger, hate, fear, and sexual feelings: National survey of therapists’ responses, client characteristics, critical events, formal complaints, and training,” by K.S. Pope and G.B. Tabachnick, 1993, Professional Psychology: Research and Practice, 24, pp. 142–152. Copyright 1986, 1987, 1993 by the American Psychological Association.

Therapists, of course, bring something to the work they do. Each of us has a unique personal history. Table 6.2 presents national survey results showing therapists’ self-reports of their experiences of various kinds of abuse during childhood, adolescence, and adulthood (Pope & Feldman-Summers, 1992). These results suggest that almost one-third of male therapists and over two-thirds of female therapists have experienced at least one of these forms of abuse over their lifetimes.

Table 6.2. Percentages of Male and Female Therapists Reporting Having Been Abused.

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Type of Abuse	Men	Women
Abuse during childhood or adolescence
Sexual abuse by relative	5.84	21.05
Sexual abuse by teacher	0.73	1.96
Sexual abuse by physician	0.0	1.96
Sexual abuse by therapist	0.0	0.0
Sexual abuse by nonrelative (other than those previously listed)	9.49	16.34