Abstract
An increase in knowledge among health care and counseling professionals about the complexities of the therapeutic relationship has led to a better awareness of damage which some professionals, consciously or unconsciously, can cause to their clients. Fiduciary obligations prohibit professionals from taking advantage of their special expertise to exploit clients. It is the professional's responsibility to set clear boundaries to ensure the safety and integrity of the treatment relationship. Exploitation tends to occur when the professional's needs or countertransference predominate in the intricate interactions between client and professional. Although some clients may be especially vulnerable, any client—regardless of diagnosis—is vulnerable to treatment exploitation. Whenever a client presents an apparent case of present harm caused by a previous treatment, the professional becomes a subsequent treating professional. The client who has been harmed by a previous professional needs support in reestablishing trust in the therapeutic process. Symptoms can range from mild depression to suicidality, from mistrust and confusion to an erosion of self and reality. Since much of the therapeutic work depends on where the client is in his/her discovery of exploitation, optimal timing of interventions is important. Interconnected treatment phases are identified as assessment, neutralization, and integration and healing. Self-help support groups, couples and family work may also be recommended. Professionals need to respond to exploited clients and work within professional communities to avoid the potential pitfalls of misguided and exploitative treatment.