Intimate and sexual feelings in psychotherapy: educational topic or still taboo?

Abstract

Background

Intimate and sexual feelings are common within psychotherapy, with negative outcomes when not managed adequately.

Aims

This study aims to investigate the understudied topic of these intimate and sexual feelings in basic education and psychotherapy training programs.

Method

In this convergent mixed method study, both a survey (N = 786) and 8 focus groups (N = 36) were conducted among psychotherapists in Flanders, Belgium (November 2016 – June 2018), using inferential and thematic analyses respectively.

Results

The majority indicates that dealing with intimate and sexual feelings towards clients was hardly part of either their basic education or psychotherapy training. Talking about such feelings with peers or supervisors remained difficult because of concerns about being judged. Therapists indicating this topic was addressed in some way in their training indicated more often that they did not perceive it as a taboo topic. Therapists advocated a more open discussion and reflection on this topic. Education and training, as well as support from renowned key figures in their field, were regarded as important incentives to initiate change.

Conclusion

Psychotherapy training should focus on how to deal with intimate and sexual feelings, referring to introspection and exploration of these feelings in a more integrated way during training.

Keywords:

• Sexual feelings
• education
• psychotherapy training
• Belgium
• taboo

Author contributions

LV and JB designed the study, LV collected the data, LV analysed the quantitative data, LV and HVP analysed the qualitative data, and LV and JB wrote and revised the manuscript. JB supervised the study. All authors interpreted the results, revised the manuscript, and approved the final version.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted in the Medical Ethics Committee of the Vrije Universiteit Brussel (B.U.N. 143201524243).

Patient consent

Informed consent was obtained from all participants included in this study.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

The data of the survey study that supports the findings of this study are available from the corresponding author (LV), upon reasonable request. Due to the nature of the focus group study, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

The authors declare that no funds, grants, or other support were received.