People who contact us about this almost always arrive carrying the belief that they participated — that they agreed, encouraged it, or were old enough to know better. That belief is usually the most damaging thing the therapist left behind.
The professions take a clearer view than their patients do. Sexual contact between a therapist and a patient is prohibited outright across psychiatry, psychology, social work and counseling. It is not a matter of degree or of who initiated it.
Why "I agreed to it" is not the answer you think
Therapy deliberately creates an imbalance. The patient discloses everything; the therapist discloses nothing. The patient is unwell; the therapist is the person they are relying on to get better. Strong feelings toward a therapist are a recognized, expected feature of the process — and managing them is the therapist's professional job, not the patient's.
That is why the prohibition does not turn on consent. A patient cannot meaningfully consent to a relationship with the person holding that role, and the entire responsibility for maintaining the boundary sits with the professional. Who suggested it first does not transfer that responsibility.
If you have been carrying the idea that you caused this, it is worth knowing that the professional standards were written by people who anticipated exactly this dynamic, and placed the duty on the clinician.
Boundary drift is a pattern, not an event
These relationships rarely begin with an incident. They begin with changes to the frame of therapy, and those changes are usually documented:
- Appointments moved to the end of the day, or to times when nobody else was in the building
- Sessions running long, or becoming more frequent without a clinical reason
- Meetings outside the office — a meal, a car, a home visit
- The therapist disclosing their own problems, reversing the roles
- Contact between sessions: texts, calls or messages that were not about treatment
- Gifts, favors or money in either direction
- Stopping billing, or seeing you off the books
- Ending therapy so a relationship could begin
Each of those is a recognized warning sign in the professions' own literature. Together they establish that the boundary eroded over time, which is the shape of the claim.
Therapy generates its own evidence
Unlike most abuse settings, this one produces a continuous documentary record while it is happening:
- Session notes, which frequently record the drift — including the therapist's own account of their feelings about a patient
- Billing and insurance claims, which independently establish frequency, duration and timing of appointments, and show when billing stopped
- Scheduling records, showing appointments moved out of hours
- Messages and call logs outside session times
- Supervision and consultation records, where a therapist raised the situation with a supervisor — or conspicuously did not
- Prior complaints held by the employer or the licensing board
Patients rarely hold any of this. It belongs to the clinician and the practice, and obtaining it is a substantial part of what a claim does.
When the relationship started after therapy ended
This is the most contested pattern in the area, and the most common one we are asked about. A therapist ends treatment, and a relationship begins shortly afterwards.
The professions treat post-termination relationships as restricted rather than permitted, with the restrictions varying by profession and by how the therapy ended. What matters is whether ending treatment was itself part of the conduct — and the records usually show whether the ending was clinically indicated or arranged.
We will tell you how it applies to your situation rather than publishing a general rule, because the answer varies by profession and by facts.
Who a claim can be brought against
- The clinician, whether a psychiatrist, psychologist, social worker, counselor or therapist in training
- The employing practice, clinic or hospital, for supervision, for how it responded to concerns, and for what it knew when it hired or retained them
- A supervisor, where a trainee was involved and supervision failed
Licensing boards for each of these professions can investigate and discipline, and their actions are generally public. A board complaint is a route that exists separately from a civil claim and from the police, and using one does not commit you to the others.
One procedural question we do not guess at: whether a claim of this kind falls inside Maryland's special procedure for medical injury claims, which is the same open question described on our doctor and hospital abuse page. It affects the steps, the timing and which insurance responds.
The particular harm here
A claim covers the consequences, and in this setting they are specific: the loss of the treatment you needed, the difficulty of trusting a clinician again, and the fact that the condition you sought help for is often worse than when you started.
Subsequent treatment — with someone else — is both part of recovery and part of the documented harm.
Deadlines
For a patient who was an adult, ordinary limitation rules govern, and the procedural question above can affect which period applies. A patient abused in therapy as a child or teenager is in a different position: Maryland has placed no time limit on those claims since October 1, 2023, as our Child Victims Act page explains.
Ask us which of those describes you. People assume they are out of time far more often than they actually are.
Support, whether or not you call us
If you would rather speak to someone who is not a lawyer, the national sexual assault hotline is 800-656-4673, at any hour.
