Managing feelings of sexual attraction in therapy: An instructional program for therapists -in -training.

Abstract

This study was designed to develop a training program for psychotherapy students for managing feelings of sexual attraction in therapy. The effect of the program on (1) subjects' verbal responses to a confederate client's expression of feelings of sexual attraction, (2) subjects' knowledge of sexual ethics, and (3) subjects' self-report of anxiety during two clinical role-plays with the confederate was measured. A convenience sample of female social work students, composed of 14 experimental subjects and 15 control subjects, completed the study. Experimental subjects participated in a four-week, eight-hour didactic and experiential training program. Control subjects were wait-listed for participation in a seven-hour training. Before and after the training program, all subjects completed self-administered questionnaires about anxiety, comfort with sexuality, knowledge of sexual ethics and educational program atmosphere concerning sexual feelings in therapy. Subjects also participated in a five-minute videotaped clinical role-play pre- and post-intervention during which a confederate client expressed sexual thoughts and feelings about the therapist. The training program contains a review of the literature on therapist-client sexual involvement, ethical guidelines, risk factors for therapists, information on boundary crossings and violations, and suggestions for how to discuss feelings of sexual attraction with clients. A unique component of this program was the opportunity for experiential learning by participation in several role-plays after facilitator demonstration of clinical situations. Significant differences were found between the control and experimental groups on post-intervention verbal responses to the confederate client and knowledge of sexual ethics. Post-intervention, the experimental group eliminated their use of negatively scored verbal responses (e.g., self-disclosure and challenge client's statement) and increased their use of the positively scored verbal response categories, particularly reflection and request for more information. The experimental group also showed an increase in their knowledge of sexual ethics scores. Both groups had a significant decrease in self-reported anxiety post-intervention. Results suggest that experiential learning techniques should be incorporated more into graduate training curricula on sexual ethics.