Sexual Abuse: A Journal of Research and Treatment, Vol. 17, No. 1, January 2005 (
Constructions of Therapist-Client Sex:
A Comparative Analysis of Retrospective
and Irit Nachmani
Former patients’ (n = 24) accounts of their experience during a sexual liaison
with their psychotherapist (Therapist-Client Sex, TCS) could be classiﬁed as ei-
ther romantic (TCS-Romance) or as an abusive encounter (TCS-Abuse). During
TCS, individuals in the TCS-Romance group reported having experienced overall
better emotional states and more favorable perceptions of both the perpetrating
therapists and the treatments they provided. Pre-TCS assessments showed that
initially TCS-Romance subjects may have had a relatively higher regard for their
perpetrators and the quality of their treatments than TCS-Abuse subjects, but these
between-group differences disappeared when the same variables were assessed for
two post-TCS periods. These periods were marked in both groups by deteriorated
indices of psychological well-being. These ﬁndings suggest that a romantic nar-
rative of TCS could have a shielding, albeit temporary, impact on the subjective
experience of what is otherwise considered an abusive relationship.
KEY WORDS: therapist-patient relationship; sexual exploitation; therapist abuse.
Most of the literature on therapist-client sex (TCS) is based on data gath-
ered solely from therapists (e.g., Bernsen, Tabachnick, & Pope, 1993; Gartrell,
Herman, Olarte, Feldstein, & Localio, 1986; Holroyd & Brodsky, 1977; Pope,
1994, 2000; Pope & Bouhoutsos, 1986). Writings in the ﬁeld provide different es-
timates on the prevalence of these offenses. They range from approximately 10%
of male psychotherapists who admitted engagement in some form of erotic behav-
ior with at least one patient (e.g., Holroyd & Brodsky, 1977) to data indicating that
only 2–3% of the respondents had engaged in sexual contact with their patients
University of Haifa, Haifa, Israel.
To whom correspondence should be addressed at School of Social Work, University of Haifa, Mt.
Carmel, Haifa 31905, Israel; e-mail: firstname.lastname@example.org.
2005 Springer Science+Business Media, Inc.