Shirley J. Siegel
Improper manipulation by
unethical therapists. The abuse of positions of power and trust by counselors.
These are themes I hear expressed by patients and clients over and over again
throughout the United States and from many other countries as well.
From a mother in Minnesota:
"Our daughter suffers from bipolar disease, and with this latest relapse,
refuses to take her medication and instead insists she suffers from Adult Child
Syndrome and comes from a dysfunctional family. She spent a lot of time going to
[an unlicensed therapist's] seminars, and buying his tapes and books. She
refuses to see or talk to any of her family. I feel like she has joined a cult
From London , England: "In a
nutshell, I took both the basic and advanced courses of [the popular
psychological training program] in New York City in early 1983. The ultimate
result of the 'training' has been really serious long-term depression."
From a Californian: "I am a
successful 44-year-old businessman who several years ago, thinking that I had
suffered a mild heart attack, sought therapy in order to reduce the level of
stress in my life. I confided to my therapist, a female psychologist, that I had
become a workaholic, the number one broker in my office, making more money than
I had thought possible, but that I was stressed and lonely and feared that I
would have a heart attack. She took a keen interest in me, saying that I was
more special to her than any of her other group members or patients. She gave me
daily advice at no charge. I began to trust completely that she had my welfare
and best interests at heart. Some months later we were married." The therapist
began verbally to abuse her husband/patient. She spent huge quantities of his
money, stayed out late at night, ceased all sexual relations with him, and let
her two sons from a previous marriage run wild. Ultimately, the therapist not
only removed property from the home but damaged it extensively as well. The
husband finally filed a malpractice suit against his therapist/wife and sought a
From New York: a former client
reports her female psychologist used her not only as therapist's "therapist,"
but got her to do thousands of dollars' worth of work for the therapist's
business and then refused to pay for it.
From a Missouri newspaper
account: "One woman's 'mom' contract, written by her therapist, stated: 'You
have to do what I say and you can have whatever feeling you have- [you can] even
say no. But you have to do what I say. I like you and love you no matter what.
You have to tell me everything. Love, Mama, and Daddy.' "
Most Americans, including a
great majority of mental health professionals, are unaware of the depth and
extent of the problem that these cases so vividly illustrate. And many who
become aware of incidents of abuse tend to see the problem as less damaging and
unethical than it is. Even in the matter of sexual relations between a therapist
and a patient, both laymen and professionals frequently see a "love affair" of
sorts, albeit possibly ill-advised and wrong, rather than what it is, sexual
exploitation plain and simple.
In 1980, seven years after
leaving a psychotherapy cult in which I had been enmeshed for a very long time,
I helped to found STOP-Stop Abuse By Counselors-in order to help deal with this
problem of indifference and ignorance, and help the victims gain redress. It
seemed to us that one line of approach would be to have the state register and
regulate counselors, essentially monitor the always potentially abusive
relationship. After our lobbying and educational work for seven years, the
Washington State legislature passed a law mandating the registration of almost
all individuals offering counseling for a fee. The law also allows for the
certification of master's level counselors. In addition, most mental health care
providers must respect the prohibitions of a special 24-point list of
impermissible areas of conduct, including, of course, sexual relations. The
law, in sum, is an attempt to bring all counselors into the light and under the
rule of law. But in order fully to achieve this, we still need to ensure that
all therapists carry malpractice insurance so that victims can collect damages
in their civil suits. (Paradoxically, this can be a problem: insurance companies
in states where therapist-patient sex is a crime sometimes say that they will
not pay damages because the therapist was not covered for criminal acts!)
STOP's activities got much
media attention, and we became a national resource-part of a growing informal
network-getting reports on the problem from every hand and providing information
to those who want to do in their localities what we did in Washington. We also
provide references to expert witnesses and attorneys experienced in litigating
lawsuits brought by victims of unethical therapists. And we speak in a variety
of public and professional forums, as well as on media panels and talk shows, to
publicize the problem and urge reform.
Granted that most therapists
are ethical, honorable human beings, many, unfortunately, are not. And so we say
to anyone who will listen: enforce the laws that are already on the books and
introduce new legislation where it is needed. Register all unlicensed therapists
and hold them to a code of ethical behavior. Require all therapists to carry
malpractice insurance. And perhaps most important of all, make literature on
"How to Choose a Health/Mental Health Care Provider (and spot signs of unethical
behavior)" a part of every health education course in the nation.
Shirley J. Siegel was
founder/coordinator of Stop Abuse by Counselors, a client/advocate organization
that was based in Seattle, WA, and author of What To Do When Psychotherapy
This article first appeared in Cult Observer,
Volume 9, Number 3, 1992.