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The Roles and Responsibilities of Therapists in Providing Ethical Care for Sexual Abuse Survivors
Sexual abuse can have a devastating effect on nearly every aspect of someone’s life. It’s not uncommon for survivors to have post-traumatic stress disorder and have difficulty with depression, anxiety, and interpersonal relationships. However, there are resources and help available, and therapy can offer significant benefits. In fact, two-thirds of people experienced improvements in their emotional and mental well-being as a result of psychotherapy. However, it’s important for therapists — and potential clients — to understand their roles and responsibilities to ensure they provide ethical care.
Navigating Being a Mandated Reporter
Therapists and counselors are considered mandated reporters in Maryland, which means that they must report suspicions of child abuse or neglect to the proper authorities or risk having their licenses revoked. Mandated reporters include health care providers, teachers, those working in human services, including therapists and social workers, and police officers. This can be difficult for therapists to navigate, as clients often share information assuming it will be kept in confidence. Therapists must understand how to evaluate situations where someone might be being abused and how to inform clients about what being a mandated reporter means when they start a working relationship.
Upholding Patient Confidentiality
Those who are able to form positive relationships with their therapists generally see more progress and have better outcomes than those who don’t, and much of this relationship is built on trust. Clients should be able to share about their experiences with the knowledge that everything they say will be kept in the strictest confidence. This is especially important when clients are discussing sensitive matters, such as sexual abuse and trauma. Therapists have an ethical responsibility not to share names or any details with anyone outside the clients’ care team — except in cases where someone is in immediate danger, which falls under the mandated reporter guidelines. Therapists should also not acknowledge clients in any way in a public setting, such as seeing a client out grocery shopping, that violates their right to confidentiality or privacy.
Knowing When They Have the Skills and Training to Help — and When They Don’t
Not every therapist is a fit for every client, and that’s okay. It can sometimes take clients a few tries before finding a therapist that they connect with and feel comfortable talking to. For those who have experienced sexual abuse, it can be helpful to work with a therapist who has specific training in sexual abuse and trauma-informed therapy. However, it is the therapist’s responsibility to evaluate the situation and ensure that they have the skills and training to be of benefit to the client and aid their mental and emotional recovery. In some cases, it’s best for the client for the therapist to make a referral to a more experienced colleague or one who specializes in helping sexual abuse survivors.
Making Referrals to Other Care Providers
Therapists are skilled mental health professionals, but there are times when it may be necessary to bring in other providers to join the client’s care team. For example, therapists and counselors are not able to prescribe medications, but a psychiatrist can. If a therapist believes that a client may benefit from medications, such as those designed to treat depression or anxiety, they may need to refer the client to a psychiatrist or a health care provider who can evaluate their needs and prescribe any relevant medications.
Maintaining a Professional Relationship
Traditional psychotherapy revolves around sharing deep personal details of your life with your therapist, and it’s normal and expected for this to create a certain type of bond between client and therapist. However, it’s important to remember that while a therapist can be a very positive and beneficial influence on your life, the therapeutic relationship is a professional one. And the therapist has an ethical responsibility to ensure it stays this way. This means explaining and maintaining boundaries around personal space during the therapy session and avoiding sharing about their personal lives during the client’s session.
In some cases, especially when a therapist and client have been working together for several years, the relationship can get too friendly to be of therapeutic benefit. If this happens, the therapist has a responsibility to address this and suggest a referral to another practitioner to ensure the client has the opportunity to continue to move forward with treatment.
Special Considerations for Minor Clients
Therapists who see clients who are minors have a responsibility to ensure they are informed on the minor consent laws in Maryland and abide by them in their practice. For example, there are guidelines for what information that is shared during a therapy session can or should be shared with the client’s parents. Maryland also recognizes that children 16 years of age or older are able to consent to outpatient mental health services.
However, they do not have the ability to refuse treatment if a parent or legal guardian has provided consent. Therapists are responsible for communicating this with their minor clients before beginning treatment to ensure that the client understands what rights they have and what may be shared with their parents.
If you are a survivor of sexual abuse and you want to learn more about your legal options, the team at Andreozzi + Foote Attorneys at Law is here to help. Contact our office at 866-311-8640 to discuss your situation with one of our attorneys.
