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Title: Psychotherapists' Handling of Sexual Attraction to Clients: A Grounded Theory
Authors: Anthony Arcuri and Doris McIlwain
Setting up the project
Anthony conducted this project as part of his doctoral studies in counselling psychology, under Doris's supervision. Although a majority of the work was carried out by Anthony, Doris played an instrumental role in its conception and development. As well as providing a sounding board for Anthony's developing ideas, Doris engaged with the data to help add breadth to its interpretation and the resulting theory. We will attempt to provide a sense of this collaborative process here. Our use of the word "we" implies that we discussed the work prior to its completion by Anthony. We also specify where either of us contributed to the work individually.
We chose our topic-psychotherapists' handling of sexual attraction to clients - after Anthony stumbled upon the relevant literature, almost by chance, during a curiosity-driven search for information about the role of gender in psychotherapy. After a cursory review, Anthony realised that the literature on psychotherapists' sexual attraction to clients was underdeveloped, fragmented and devoid of a cohesive theoretical framework. Given that we both had some experience in conducting qualitative research in the past, we saw an opportunity for the development of a grounded theory that could go some way toward answering what had become our central research question: How do psychotherapists handle experiences of sexual attraction to clients?
To set the groundwork for our project, we clarified our conceptual frameworks by writing individual passages about: our research philosophies; our experiences of, training in and attitudes toward sexual attraction to clients and psychotherapy in general; and our current understanding of the relevant extant literature. The purpose of doing so was fourfold: first, to articulate some preliminary concepts (often referred to as 'sensitising concepts'), which we would use as points of departure from which to ask questions of and make comparisons among our data; second, to enable us to remain sensitive to and minimise potential areas of bias in our ways of interpreting and analysing data (commonly referred to as 'bracketing'); third, to begin the process of self-reflection, or 'reflexivity', which was to continue throughout the research process; and, fourth, to contribute to the reader's ability to identify the lens through which we interpreted and analysed our data, and thus determine the "extent to which [he or she] is able to generalize the findings ... to his or her own context" (Morrow, 2005, p. 252). To see excerpts of these passages, please visit http://www.psy.mq.edu.au/staff/dmcilwain/arcuri_collab.html.
Given the sensitive nature of our research, we took exhaustive measures to ensure that it would be conducted in an ethically sensitive manner. Nonetheless, we were concerned that an interview study inquiring directly into people's experiences of erotic desire might prove intolerably alarming for our university's Human Research Ethics Review Committee. This fear was founded on a previous experience with the Committee in which an anonymous, web-based survey of psychotherapists' experiences of sexual attraction to clients was held up for over nine months until the Committee was satisfied that the participants' identities could not conceivably be revealed either to us or to third parties.
To avoid similar delays in our present research, we proposed to explore psychotherapists' handling of 'hypothetical' rather than 'actual' experiences of sexual attraction to clients, thus minimising the potential for the participants to be identified as psychotherapists who have indeed experienced such sexual attractions - though of course attraction is not a misdemeanour. Although the Committee was agreeable to this approach, we feared initially that it may compromise the integrity of the qualitative data (a point that remains debatable). We guessed, however, that talking about 'hypothetical' rather than 'actual' erotic desires would be less confronting for our participants and would thus allow them to engage in more open dialogues.
We also suspected that people would be more likely to volunteer for research involving interviews about 'hypothetical' rather than 'actual' sexual attractions. But before our suspicions could be put to the test, we needed to reach our target group and bring our project to their attention. In the light of our 'insider' knowledge of psychologist networks, Anthony distributed a brief advertisement via two media regularly consumed by psychologists: a quarterly print newsletter sent to members of the Australian Psychological Society (APS) residing in the state of New South Wales, and the APS's internet classifieds service available to both members and non-members. In an attempt to access unaffiliated psychologists, Anthony also distributed our advertisement via group email to students enrolled in our university's postgraduate psychology training programmes, and included in all our advertisements a request that the recipient pass on the advertisement to at least one other psychologist (a technique known as 'snowball sampling').
Although we were hopeful that our advertisement would be well-received, we had concerns that some psychologists would be reluctant to discuss sexual matters, hypothetical or otherwise, with Anthony, a peer of theirs. Indeed, having seen the advertisement, two of our senior colleagues reacted less than favourably and somewhat indignantly to the nature of our study. But we were not to be discouraged: our recruitment efforts yielded interest from 36 psychologists, a number beyond our expectations. From 35 of these psychologists we were able to collect some basic screening information which we would use later to assist with our sampling decisions. Because of the delicate nature of our topic, we limited this information to the following: age, gender, psychologist registration status, psychology specialisation, length of time practising as a psychotherapist, and theoretical orientation. Please see Table 1 for a summary of this data.
Table 1.
Characteristics of psychologists interested in participating
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| Gender |
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| Male |
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| Female |
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| Psychologist registration status |
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| Full |
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| Provisional/Trainee |
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| Specialisation a |
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| Counselling Psychology |
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| Clinical Psychology |
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| No specialisation |
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| Organisational Psychology |
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| Clinical Neuropsychology |
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| Forensic Psychology |
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| Health Psychology |
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| Theoretical orientation b |
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| Learning theory-based |
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| Psychodynamic |
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| Humanistic |
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| Systemic (family therapy) |
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| Postmodernist |
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| No theoretical orientation |
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| “Eclectic” but unspecified |
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| Age |
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| Mean |
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| Range |
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| Length of practice (including internship) |
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| Mean |
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| Range |
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Note. a Three participants reported multiple specialisations: counselling/clinical, counselling/organisational, and clinical/forensic. Each is counted separately in the table. b Participants commonly reported multiple theoretical orientations.
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