This article is derived from a teaching presentation created by Stuart Leviton, COO of Seeking Integrity and Sex and Relationship Healing.
Sadly, the behavior of sex and porn addicts, as it escalates over time, sometimes crosses both ethical and legal boundaries. Such behaviors can and often do lead to consequences beyond the usual problems that addicts (of all types) typically face. Two weeks ago, we examined what is generally the most severe category of these consequences, the violation of criminal laws. Last week, we continued this discussion with an examination of civil liability issues. This week, we look at a separate but related topic primarily applicable to professionals who work with sex and porn addicts: legal vs. clinical client considerations.
Legal vs. Clinical Client Considerations
The goals/intentions of a lawyer may or may not vary greatly from the goals/intentions of the psychotherapist.
If the legal client is an accuser, there may be a need to report a crime or harassment. Lawyers should be aware, and should make clients aware, that entering into a process of prosecution or litigation will cause the client to relive the trauma that he or she has experienced via reporting, investigations, depositions, trial preparation, trial testimony, etc. Criminal plea agreements and civil settlement agreements can lessen the impact of this, but penalties to the perpetrator may be less severe.
In therapy when the client is an accuser, the clinician should be focused on client safety, both internal and external. Then the therapist should explore the source of the complaint, regardless of whether it is a matter of illegality, a civil matter, or (perhaps) neither. With this, the clinician can help the client distinguish among criminal offending, civilly liable harassment, and non-criminal, non-civilly liable, but still boorish behavior. Then, together, the therapist and client can determine appropriate actions steps, taking into consideration the possible impact on family members and others.
Both lawyers and clinicians should make it clear to clients who are accusers that both prosecution and civil litigation are lengthy processes that tend to create recurring trauma.
If the legal client is the accused, the attorney must look into what the client is facing regarding possible criminal prosecution, and possible civil litigation and legal liability. Are there consequences to the client’s job? Professional licenses and boards? If so, there is an extra layer of work to be done. Generally, the lawyer’s goal is to help the client move forward with as few personal, familial, and professional consequences as possible.
If a therapy client is the accused, the therapist should focus first on client safety (both internal and external), as well as the safety of any actual or potential victims. Next, the clinician should help the client differentiate problem behaviors from healthy actions, regardless of legality: The client should be able to differentiate among criminal offending, civilly liable harassment, and non-criminal, non-civilly liable, yet still boorish behavior.
Once problem behaviors are identified, the clinician and client should work together to eliminate such behaviors while also addressing client guilt, shame, and remorse. Disclosure to family should be therapist guided, with support for family members as needed. The client should also be made aware of the lengthy and often traumatic nature of criminal prosecutions and civil litigation.
Some therapists can also be utilized as expert witnesses and evaluators. Qualifications for such individuals include:
- Academic – Masters, PhD, Clinical Psychology; PhD, Sexology; MD, Psychiatrist
- Licensure – LCSW, CSAT, MFT, LPC, Clinical Psychologist, Psychiatrist
- Clinical Experience – Balance between accuser and accused
- Prior Expert Experience – Acquired skills to be a legal expert
Often such clinicians are asked to conduct investigations, evaluations, and psycho-sexual assessments.
- Criminal – Sexual offending: past conduct; predicting future conduct
- Civil – Sexual harassment/discrimination
- Family – Parent as threat to child
Their findings may include diagnoses and prognoses as appropriate and helpful to the client and/or the court.
Notably, therapists may have statutory reporting obligations when it comes to sexual behavior. As such, clinicians should always tell any client about their reporting obligations before allowing a client to disclose specifics about problem sexual behavior. Common issues that clinicians must report include:
- Sexual abuse
- Suicidality
- Elder abuse
- Child porn
- Imminent threat to others
Lastly, therapists must know and always maintain professional and ethical boundaries. This means they must:
- Know reporting requirements and abide by them.
- Stay within licensure scope of practice.
- Ground all findings and opinions in fact and sound clinical theory.
- Remember who the client is.
- Always be guided by the client’s best interest, to the extent it can be ascertained.
- Help clients make informed decisions about their best interests.
It’s OK for therapists to say no, both to clients and to lawyers. When in doubt, therapists should consult with other professionals.
if you or someone you know is struggling with problematic sexual behaviors, help is available. For information, guidance, or expert evaluations and testimony, please contact us via email at this link.