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Public Perceptions of Therapist-Client Sex May Be More Alarming Than You Think

Sisters in Love (2014) by Melissa Foster is a well-received “romance” novel at the heart of which is a sexual relationship between a psychologist and her client.  While the psychologist initially pays lip service to her commitment to the ethics code, her boundary violations are egregious and numerous.

Dr. Danica Snow meets Blake Carter when he accidentally elbows her in the nose at a coffeeshop.  While ostensibly helping her stanch the bloodflow, he openly ogles a woman who is trying to assist with the injury.  Readers are immediately shown that he is a callous, arrogant womanizer-which does nothing to dampen Danica’s attraction.

Despite being so physically attracted to him that lascivious thoughts intrude into her therapy sessions with other clients (prompting one woman to ask if Danica is listening to her), Danica agrees to take Blake as a client to help him address his womanizing and deal with the recent death of his best friend.  During her therapy sessions with Blake, Danica is frequently distracted by her sexual fantasies about him.  Within the space of a few weeks, she decides that she has denied herself pleasure for too long and begins a physical relationship with him.  To the extent that there is a termination session, it occurs between kisses and embraces in an alley next to a restaurant.

At no time does Danica consider the ramifications of her behavior, beyond her determination to solve the quandary by simply giving up her license.  The ethics rule was not, of course, written in order to provide a mechanism to punish therapists and strip us of our licenses.  The intent is to prevent harm to the client.  In this story, the harm to Blake is obvious.  In fact, immediately following their first sexualized interaction, he acknowledges to Danica that he still needs her as a therapist.  His presenting problem was actually one of poor sexual decision-making and disordered sexual behaviors.  Despite this, readers are meant to see a love story, rather than a tale of exploitation and abuse.

As the sexual relationship between Danica and Blake intensifies, they make flirty references to having begun their relationship while he was in therapy with her (“He wrapped his arms around her and whispered in Danica’s ear. ‘Dr. Snow, I think I might need a private session.’”…“’Look at you, all attune (sic) to someone else’s issues.  You must have had a very good therapist.’  Danica pressed her hips in to his.”…’So what should I do when I need advice?  Make an appointment?  Leave you a note?  Call you Doc?’  He laughed.”)  Again, the ethical breach is never portrayed as anything more serious than a woman throwing off professional strictures and following her heart.

Ultimately, whatever its shortcomings, Sisters in Love is just one book by one author.  More concerning than the ethical breaches and sexual exploitation portrayed in this single novel is the reader response to it.

The book has an overall rating of 3.72 on Goodreads, based on 6,191 ratings as of this writing.  8% of raters gave the book 2 stars, while 3% gave it only 1 star.  The implications are jarring: most people who read and rated this book about gross ethical violations liked it.

Of the 503 Goodreads reviews, only 6 contain the word “ethical” (and there are still 4 and 5-star ratings from some of those reviewers). 5 contain the word “ethics” and 2 of those still gave 4 stars.  None of the reviews contain the words “violation,” “exploitation,” or “harm.”

On Amazon, the book has an average of 4 stars and has been reviewed 917 times.  4% of the reviews are 2-star reviews and 4% are 1-star.  Only a couple of the 1-star reviews discuss the ethical violation, with the majority focusing on writing style, character development, and degree of explicitness.  On Barnes and Noble, the book has an overall 3.5-star rating from a total of 156 reviews.

Of course, there is no way to know how many readers didn’t read the book because of their discomfort with the theme, how many readers hated the ethical breach but didn’t bother to offer a rating, how well the group of people who rated or reviewed the book represent the greater population, and so on.  This is a cautionary note, not a controlled analysis.  In reading a book about a psychologist’s flagrant ethical violations, sexual exploitation, and unprofessionalism, most of the people who rated the book viewed it favorably.

The harm done to mental health professionals by these sorts of depictions is unquantifiable.  The exact number of sufferers who do not seek help because of their negative expectations will never be known.  What can be done, however, is the rooting out and confrontation of such misleading and minimizing portrayals of ethical violations.

If you have read a novel that features similar themes, please let me know in the comments below.

Public Perceptions of Therapist-Client Sex May Be More Alarming Than You Think

Kathryn Lawson

Kathryn Lawson, PhD is a clinical psychologist in Peachtree City, Georgia, specializing in the treatment of trauma/PTSD, grief, anxiety and depression among older adolescents and adults. Before transitioning to private practice, she worked for the Bureau of Prisons for 10 years. During that time, she also worked as an adjunct faculty member at a small college, teaching diverse groups of nontraditional students. Her private practice, teaching, and government service have all been guided by a commitment to reaching underserved populations. Dr. Lawson is passionate about issues of stigma and inclusion and how these impact individuals affected by mental illness.

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APA Reference
Lawson, K. (2018). Public Perceptions of Therapist-Client Sex May Be More Alarming Than You Think. Psych Central. Retrieved on January 19, 2019, from


Last updated: 11 Mar 2018
Last reviewed: By John M. Grohol, Psy.D. on 11 Mar 2018
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