Sexual Relationships Between Patients and Their Counselors, Psychologists, and Therapists

As a psychologist, marriage and family therapist, or professional counselor, you use your education, knowledge, and experience to assist your clients to the best of your ability. However, as one of these licensed professionals in Texas, you also must follow all professional and ethical standards that apply to your practice. As a result, if you are accused of developing a sexual relationship with a patient, your license may be at risk. In this situation, you should protect your license by enlisting the help of an experienced psychologist license defense lawyer.

The Texas Behavioral Health Executive Council (the Council) is the umbrella state agency for the individual boards that establish the licensure qualifications and ethical standards for psychologists, marriage and family therapists, and professional counselors in Texas. The Council also handles all complaints and disciplinary action concerning individuals licensed in these occupations.

Professional Counselors

22 Tex. Admin. Code §681.42(b) prohibits professional counselors from engaging in sexual contact with or sexual exploitation of a person who is a client. Sexual contact that occurs more than five years after the termination of the client relationship will not violate this section if the contact is consensual, not the result of sexual exploitation, and not detrimental to the client. The professional counselor must prove a lack of sexual exploitation based on all relevant factors, including the following:

  • The amount of time that has passed since therapy terminated;
  • The nature and duration of the therapy;
  • The circumstances of termination;
  • The client’s personal history;
  • The client’s current mental status;
  • The likelihood of adverse impact on the client and others; and
  • Any statements or actions made by the licensee during therapy suggesting or inviting the possibility of a post-termination sexual or romantic relationship with the client.


22 Tex. Admin. Code §465.13(b)(4) prohibits licensed psychologists from providing psychological services to individuals with whom they have sexual relationships. Likewise, they are not permitted to terminate psychological services with a person to have a sexual relationship with that person. The same rule applies to persons whom the psychologist knows to be a parent, guardian, spouse, significant other, child, or sibling of a client to whom they provide psychological services. 

Furthermore, under 22 Tex. Admin. Code §465.33, licensed psychologists may not engage in sexual harassment, sexual impropriety, a sexual relationship, or a dating relationship with a current patient or a former patient over whom they have influence due to a therapeutic relationship. They also may not have sexual or dating relationships with individuals they know to be parents, guardians, spouses, significant others, children, or siblings of current and former patients for at least two years after the termination of services. Additionally, a psychologist may never engage in a dating relationship where there is potential harm to any of these individuals. 

Finally, psychologists may not provide psychological services to individuals with whom they have had a sexual relationship. 

Marriage and Family Therapists 

Under 22 Tex. Admin. Code §801.45, licensed marriage and family therapists may not engage in sexual contact with a person who is a current or former client. They also may not provide therapeutic services to a person with whom they have had a sexual relationship. They also may not practice sexual exploitation or therapeutic deception, which represents to the client that sexual contact with or sexual exploitation by the therapist is consistent with or a part of the client’s therapy. 

Furthermore, it is not a defense for therapists accused of these types of violations to allege that the sexual contact, sexual exploitation, or therapeutic deception occurred under any of the following circumstances:

  • With the consent of the person;
  • Outside the therapy or treatment of the person; or
  • Off the premises used for therapy or treatment of the person. 

This code section also defines sexual exploitation as used in these rules as any of the following behaviors:

  • Sexual harassment, sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual and:
    • is offensive or creates a hostile environment, and the licensee knows or is told this; or
    • is sufficiently severe or intense to be abusive to a reasonable person in the context.
  • Any behavior, gestures, or expressions which may reasonably be interpreted as inappropriately seductive or sexual.
  • Inappropriate sexual comments about or to a person, including making sexual comments about a person’s body.
  • Making sexually demeaning comments to or about an individual’s sexual orientation.
  • Making comments about potential sexual performance except when the comment is pertinent to the issue of sexual function or dysfunction in therapy or treatment.
  • Requesting details of sexual history or sexual likes and dislikes when not necessary for therapy or treatment of the individual.
  • Initiating conversation regarding the sexual likes and dislikes when not necessary for therapy or treatment of the individual.
  • Kissing or fondling.
  • Making a request for non-professional social contact.
  • Any other deliberate or repeated comments, gestures, or physical acts not constituting sexual intimacies but of a sexual nature.
  • Any intentional exposure of genitals, anus, or breasts.
  • Encouraging a client or former client to masturbate in the licensee’s presence.
  • Masturbation by the licensee when a client or former client is present.

Additionally, sexual contact, as used in this section, constitutes “any touching of the anus, breast, or any part of the genitals of another person with intent to arouse or gratify the sexual desire of any person.” (See Tex. Penal Code §21.01.)

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Find Out More About Successfully Handling Your Disciplinary Proceedings 

We want to help put you in the best position possible to protect your license. As a result, you will need immediate legal representation to take the steps necessary to defend your license from these potentially severe consequences. At Bertolino LLP, you will find a professional counselor license defense attorney to assist you with your disciplinary proceedings. Contact us today by calling (512) 515-9518 or contacting us online. We can analyze the circumstances that led to the complaint against you and determine the legal strategy that is best calculated to reach the best possible outcome in your case.

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