Date Presented 03/23/24

Investigators surveyed OT practitioners regarding sexual misconduct. Results documented that sexual misconduct and inappropriate client sexual behavior occur with regularity in OT. This study may guide policies on sexual misconduct in OT practice.

Primary Author and Speaker: Brenda S. Howard

Additional Authors and Speakers: Erin Clarke, Kaitlyn S. Ditmars, Hannah John, Ryan Smith, Sydney Wiedeman, Janel S. Williams

PURPOSE: The purpose of this study was to investigate the perceptions of inappropriate sexual behavior within OT in the US. The frequency and consequences of sexual misconduct in OT in the US are unknown. There are no standards as to whether or at what point an OT practitioner should be allowed to have a romantic relationship with a former client, and no data on how frequently OT practitioners experience inappropriate sexual behaviors from their clients.

DESIGN: Investigators conducted a survey using with permission an instrument developed by Roush et al. (2015). Recruitment (OT, OTA, L2 OTS) occurred using social media channels on Facebook and in cooperation with AOTA.

METHOD: The IRB-approved Survey included yes/no questions about encountering sexual misconduct and inappropriate client sexual behavior (ICSB) in practice; Likert scale vignettes regarding sexual and romantic relationships and OT practitioner behavior; and open-ended questions. Quantitative data were analyzed using SPSS 29.0.1.0 with descriptive statistics, Kruskal-Wallis, and chi-square. Qualitative data were examined with phenomenological methodology.

RESULTS: Of 356 respondents, 69% of females and 41.5% of males had experienced ICSB. Of all respondents, 96.6% believed that entering into a relationship with a current client was wrong; 54% believed that it was ok to enter into a relationship with a former client after 6 to 12 months; 17% admitted attraction to a client; 6.1% admitted having a relationship with a current client; 16.3% knew a colleague who had a relationship with a current client. Women were more willing than men to elevate concerning behaviors to disciplinary levels. Qualitative data yielded stories of ICSB and inappropriate relationships with clients, colleagues, supervisors, and students.

CONCLUSION: Sexual misconduct and ICSB occur with regularity in OT.

IMPACT: Results of this study may help inform policies and guidance on sexual misconduct and managing ICSB in OT.

References

Adler, M., Vincent-Höper, S., Vaupel, C., Gregersen, S., Schablon, A., & Nienhaus, A. (2021). Sexual Harassment by Patients, Clients, and Residents: Investigating Its Prevalence, Frequency and Associations with Impaired Well-Being among Social and Healthcare Workers in Germany. International Journal of Environmental Research and Public Health, 18(10), 5198. https://doi.org/10.3390/ijerph18105198

Clari, M., Conti, A., Scacchi, A., Scattaglia, M., Dimonte, V., & Gianino, M. M. (2020). Prevalence of Workplace Sexual Violence against Healthcare Workers Providing Home Care: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 17(23), 8807. https://doi.org/10.3390/ijerph17238807

Roush, S., Cox, K., Garlick, J., Kane, M., & Marchand, L. (2015). Physical therapists’ perceptions of sexual boundaries in clinical practice in the United States. Physiotherapy Theory and Practice, 31(5), 327–336. https://doi.org/10.3109/09593985.2014.1003420

Surgenor, L. J., Diesfeld, K., & Rychert, M. (2019). Consensual sexual relationships between health practitioners and their patients: An analysis of disciplinary cases from New Zealand. Psychiatry, Psychology and Law, 26(5), 766–782. https://doi.org/10.1080/13218719.2019.1640801