Table of Contents
Section I
Section II
Section III
Task Force to Study
Health Professional-Client
Sexual Exploitation
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Cover Table of Contents Section I Section II Section III |
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| Report of the Maryland Task Force to Study Health Professional-Client Sexual Exploitation |
Section III: IMPLEMENTATION AND EVALUATIONOVERVIEWCatherine D. Nugent |
The Task Force has proposed 54 recommendations for preventing and intervening in incidents of sexual exploitation. The Task Force's recommendations are presented on the List included at the beginning of this section.
Successful implementation is dependent on continuing efforts on the part of the many groups with concern for the problem. Chapter 12 discusses some of the necessary steps that will need to be taken and identifies the groups who seem best equipped to carry them out.
Chapter 13 describes the Task Force's structure and organization, documents its process, and discusses results of a November 1995 process evaluation. Members' assessments of their experience with the Task Force are offered in the hope that other groups established to address sexual exploitation may benefit from the Maryland Task Force's experience.
At the last Task Force meeting, members shared their thoughts and feelings about having served together over the two-year life of the Task Force. In the piece, Boundaries Mantained, Barriers Crossed, the Task Force Chair offers reflections of that last meeting.
Finally, the voices of victim-survivors close this report. In addition to the brief impact statements interspersed throughout these pages, some survivors submitted lengthier statements. These are included in the final pages.
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It was not until more than 10 years after the abuse that I learned the therapist was responsible and I had grounds for filing a complaint with the Licensing Board, and discovered that my responses to being abused by a therapist I trusted were characteristic for persons who have been abused. Exploited by a Social Worker |
Recommendation 1: Applicants for licensure or certification in the health professions must demonstrate knowledge of appropriate clinical boundaries and their importance in avoiding sexual exploitation of clients in order to be licensed or certified to practice in Maryland.
Recommendation 2: A cycle of continuing education emphasizing clinical boundaries in professional-client relationships should be designed and made available to the various health professions.
Recommendation 3: All health professional licensing or certification boards in Maryland should grant continuing education units on the topic of clinical boundaries and sexual exploitation and should require licensees to document that they have received such continuing education before they may renew their license to practice in Maryland.
Recommendation 4: All health and mental health institutions in Maryland should develop and implement, as part of their orientation and ongoing inservice training for employees, a program that provides a thorough explanation of the institution's policy on employee-patient sexual contact.
Recommendation 5: Education included as part of the rehabilitation plan of a health professional who has been found guilty of sexually exploiting a client should be tailored to the specific needs of the professional seeking rehabilitation.
Recommendation 6: The law should require training on the dynamics of sexual misconduct for all professionals having a role in the investigation, prosecution, or disposition of licensing board complaints (e.g., board members, investigators, attorneys, and administrative law judges).
Recommendation 7: Educators and leaders of religious organizations should adapt the foregoing educational recommendations to their particular settings to accomplish the following:
A. Ensure that students, particularly those who will be counseling clients, receive academic preparation to manage professional-client boundaries;
B. Provide continuing education concerning professional-client boundaries and sexual exploitation to practicing members of the clergy, particularly those who counsel clients;
C. Provide orientation to clergy and other relevant employees in institutional settings regarding the institution's policy on sexual exploitation; and
D. Provide specialized training to all who have a role in the church or synagogue complaint process.
Recommendation 8: A brochure to educate health care consumers regarding health professional-client sexual exploitation should be developed.
Recommendation 9: Copies of the consumer education brochure should be distributed to health and mental health facilities and public libraries and should be made available to religious institutions throughout the State. These brochures should be displayed for clients or patients. Distribution to facilities should be funded and administrated by the Department of Health and Mental Hygiene.
Recommendation 10: Licensing boards should be required by Maryland law to include copies of the consumer education brochure in initial license or license renewal mailings to health professionals.
Recommendation 11: Any health professional in Maryland learning from a client of an incident of alleged sexual exploitation should make available to the client a copy of the consumer education brochure.
Recommendation 12: On receipt of a complaint of sexual exploitation, all licensing boards in Maryland should send a copy of the consumer education brochure to the complainant.
Recommendation 13: All Maryland institutions, organizations, and governmental agencies should have clear policies, procedures, and guidelines concerning sexual exploitation by health professionals whom they employ.
Recommendation 14: Employees holding licenses from the State or covered under provisions for professional associates must be held accountable by the institution to those licenses and standards.
Recommendation 15: Employees not license-eligible must be held accountable to the guidelines and policies of the employing institution.
Recommendation 16: An institution employing a health professional who sexually exploits a client should provide consumer education resources to the victim. These materials should include examples of appropriate and inappropriate health professional behavior, definitions of boundary violations, relevant reading materials, resources for support groups, and options for recourse.
Recommendation 17: Employers should be held civilly liable to clients who are victims of sexual exploitation because of the employers' failure to act under the following circumstances:
A. The employer fails to investigate the employee's background before hiring, and the investigation would have disclosed sexual misconduct by the employee in the last five years;
B. The employer does not take reasonable action when the employer knows or has reason to know of health professional-client sexual misconduct; or
C. The employer fails to disclose the occurrence of sexual misconduct by the employee to another employer or prospective employer.
Recommendation 18: DHMH should gather existing training programs and related materials on professional-client boundary violations. DHMH should then convene a work group of experts--to include representatives of the health professions, the community of consumers and victim-survivors, the academic community, and others--whose task will be to review existing curricula and advise on the development of a model professional education curriculum for use in the State. Once developed, the curriculum should be disseminated throughout Maryland--to health and mental health facilities; colleges, universities, and other health practitioner training programs; law schools; professional associations; churches and synagogues, and other religious organizations.
Recommendation 19. All State-administered facilities should be required to offer the professional education program, with annual updates.
Recommendation 20: DHMH should develop and conduct the training required in Recommendation 6 (for all licensing board members, board administrators, investigators, and administrative law judges. A work group--consisting of representatives of the health and other relevant professions; the community of consumers and victim-survivors; experts in adult and continuing education; and other groups as appropriate--should advise on the development of this training.
Recommendation 21: DHMH should develop consumer-oriented educational materials, such as brochures and fact sheets, on sexual boundary violations. The educational materials should be field-tested with consumers, including victim-survivors of sexual exploitation. These materials should be disseminated to health and mental health facilities and made available to religious organizations throughout the State.
Recommendation 22: All curricula and educational materials should include, among other topics, information on the impact of sexual exploitation on associate victims, such as the families and colleagues of victims and perpetrators, and, in the case of clergy, congregants.
Recommendation 23: DHMH should serve as a central resource clearinghouse and provider of technical assistance to education institutions; health, mental health, and related agencies; managed care organizations; consumer groups; professional associations; and others who seek assistance in developing and conducting educational programs to prevent or address client sexual exploitation by health professionals.
Recommendation 24: DHMH should make available the necessary human, fiscal, and material resources to accomplish the educational campaign recommended in this report.
Recommendation 25: DHMH should expand the priority target populations for its mental health centers to include victim-survivors of sexual exploitation by health professionals, so that survivors can access low-cost treatment at State-administered mental health facilities. This treatment should be provided only by mental health professionals who have received training in treating clients who have been sexually exploited.
Recommendation 26: Sexual assault recovery centers should provide specialized training in treating victims of professional-client sexual exploitation for their clinical staff and hot-line counselors and should conduct outreach and case identification to target victim-survivors and their families for services.
Recommendation 27: DHMH, in a central location, should house a collection of survivor materials, such as the technical assistance start-up kit developed by Boston's Therapy Exploitation Link Line, the meeting materials developed by Maryland's Treatment Exploitation Recovery Network, the organizing folder developed by STOP Abuse by Counselors in Washington State, and similar resources for organizing and conducting a survivor-run group. The availability of these materials should be published in local newspapers and other media. The materials should be available, on loan, to consumer groups wishing to organize a recovery group or other network.
Recommendation 28: DHMH should direct State-administered health and mental health agencies to (and religious organizations are encourage to) make their facilities available, free of charge, for survivor-organized meetings. Such State facilities should also provide, as resources allow, assistance to survivor groups, by helping with start-up, providing telephone use, and underwriting mailing costs and other minimal start-up expenses for survivor groups.
Recommendation 29: DHMH should constitute and coordinate a Rehabilitation Consultants Group (RCG) from which four-person groups will be assigned to serve on panels that develop and monitor rehabilitation plans for health professionals who have sexually exploited a client.
Recommendation 30: Ad-Hoc Rehabilitation Oversight Panel (ROP) consisting of the case manager, an assessment specialist, a same-discipline member, and a consumer drawn from the RCG will oversee each case.
Recommendation 31: All costs for services rendered by the case manager and the assessment specialist will be paid by the individual seeking rehabilitation.
Recommendation 32: The RCPs and ROPs should be available to each health professional licensing board, to churches and synagogues, and to any other potential referring entities, such as individual practitioners seeking rehabilitation and those referred by criminal courts.
Recommendation 33: Referral will be initiated by an Order from the licensing board of the practitioner who sexually exploited a client.
Recommendation 34: An assessment will not be undertaken unless all of the following conditions, based on suggestions made by Schoener (1995, p. 97) are met:
A. The practitioner admits wrongdoing and understands that there was harm to a client.
B. The practitioner believes that he or she has a problem that requires rehabilitation.
C. The practitioner is willing to agree to the assessment and realizes that its outcome may not be favorable.
Recommendation 35: ROC rehabilitation plans may include but need not be limited to personal psychotherapy, educational activities,
clinical supervision, practice limitations.
Recommendation 36: The ROP will establish a procedure for monitoring the practitioner's adherence to the prescribed rehabilitation plan.
Recommendation 37: In consultation with the appropriate licensing board, the ROP may establish a minimum length of time for the practitioner in rehabilitation to be involved in the rehabilitation process before he may request a reevaluation.
Recommendation 38: All health professional licensing statutes should include a specific disciplinary ground prohibiting sexual misconduct.
Recommendation 39: Disciplinary statutes should require boards to define sexual misconduct by regulation.
Recommendation 40: Boards should be required by law to impose minimum discipline in sexual misconduct cases:
A. For a first offense, boards should impose a minimum suspension of six months to one year, with no power to stay the suspension. The period of required suspension is a minimum and does not affect the board's authority to impose additional, appropriate discipline to protect the public.
B. For a second offense, after the first and following rehabilitation, the license should be revoked. The law should specify that for this purpose, "revocation" means that a licensee cannot practice in Maryland again and that any future petition for reinstatement may not legally be considered by the board.
Recommendation 41: Boards should have the statutory authority to require the offending health professional to pay the costs of a victim's therapy and for damages up to $50,000. For purposes of this section, "costs" include a refund of all past payments made to the provider by the victim, and all present and future medical expenses and other monetary damages caused by the sexual misconduct.
Recommendation 42: Consent should be legally eliminated as a defense to sexual misconduct.
Recommendation 43: Evidence of a victim's sexual history should be made inadmissible at a hearing.
Recommendation 44: Licensing laws should require minimum procedures for all sexual misconduct cases:
A. Boards should provide sexual misconduct complainants with specific written information regarding the disciplinary process that specifies the steps of the process, the duration for each step, who will contact the complainant, and what information is available to the complainant during the process;
B. Charges should be brought against the licensee within 45 days of the filing of the complaint and a hearing date set no later than 45 days thereafter;
C. All complainants should receive face-to-face interviews with board investigators and/or prosecutors;
D. All cases should be heard by an administrative law judge; and
E. Boards should provide complainants with the names and addresses of support groups.
Recommendation 45: The law should require boards to submit annual reports to the legislature documenting complaints of sexual misconduct and the boards' handling of them.
Recommendation 46: A mental health practitioner whose license is revoked for sexual misconduct should not be allowed to practice as an unlicensed psychotherapist.
Recommendation 47: The Health Claims Arbitration Office should be required to refer complaints of sexual misconduct to the appropriate licensing board.
Recommendation 48: The Task Force recommends that the legislature enact a law or laws to make criminal:
A. Sexual acts and sexual contact by means of therapeutic deception by a health professional;
B. The treatment or examination of a patient by a health professional for other than bona fide health care purposes or in a manner substantially inconsistent with reasonable health care practices; and
C. Sexual acts and sexual contact during psychotherapy if the actor is a psychotherapist and the victim is a client of the psychotherapist. Consent by the client to the sexual act or contact shall not be a defense in such cases.
Recommendation 49: Maryland should establish a separate cause of action allowing a victim to file suit against a health professional who engages in sexual misconduct:
A. The cause of action should include psychotherapists only.
B. The cause of action should include not only licensed psychotherapists but also anyone who performs or purports to perform psychotherapy.
C. The statute should prohibit touching by the plaintiff or defendant of the plaintiff's or defendant's intimate parts and should include requests by the defendant for such contact.
D. Plaintiffs should include patients and former patients.
E. The statute should prohibit sexual contact with a former patient if the former patient was emotionally dependent on the psychotherapist or the sexual contact was by means of therapeutic deception.
Recommendation 50: Maryland should eliminate consent as a defense to sexual misconduct.
Recommendation 51: Maryland should eliminate unnecessary restrictions or hindrances to victims of sexual misconduct who wish to file suit:
A. The statute of limitations should be amended to eliminate the five year rule for these cases.
B. Confidentiality agreements should be prohibited.
C. A victim's sexual history should be neither discoverable nor admissible at trial.
D. A victim should be allowed to file suit under a fictitious name (e.g., Jane Doe).
Recommendation 52: Insurance carriers should not be required by law to include coverage for sexual exploitation, but professional associations should strongly encourage their members to negotiate for this coverage.
Recommendation 53: DHMH should appoint a staff member to serve as the focal point within DHMH for implementing the Task Force recommendations and for coordinating the efforts of others involved in implementation activities.
Recommendation 54: The Task Force recommends that the Governor have an Implementation Committee, comprised of representatives of the health and legal professions, clergy, consumers, and legislators, as soon as possible.
CHAPTER 12
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After the Task Force submits its final report to the Governor, the focus shifts from developing recommendations to implementing those recommendations. The previous chapters presented the recommendations promulgated by the Task Force. With the official conclusion of the Task Force on December 31, 1995, two critical questions emerge: Who will coordinate the process? What steps are needed to implement the Task Force's recommendations?
The Task Force recommends that the Department of Health and Mental Hygiene (DHMH) designate a person to coordinate the many activities that fall within DHMH purview. This includes such activities as convening groups to develop professional and public educational programs and materials, establishing the offender rehabilitation process, and coordinating with the licensing boards the development of language for regulatory changes. It is not intended that this person will perform the actual work, but, rather, that the person will be the focal point within DHMH for carrying out the recommendations and will coordinate the work of others, such as staff, consultants, and volunteers with direct responsibility for these activities.
The Task Force recommends that an Implementation Committee, composed of volunteers with specialized knowledge of or experience with the problem of sexual exploitation by health professionals, be established by March 31, 1996. Membership should include Task Force members who want to continue their work by focusing on implementating these recommendations and others with an interest in helping to impelement the recommendations. Participation by some Task Force members will provide continuity in addressing these issues and will draw upon the knowledge they have gained through their work on the Task Force. The composition should be similar to that of the Task Force--including health professionals, consumers, clergy, attorneys, and legislators--but could have fewer members than the Task Force did.
The members of the Implementation Committee will need to assess each Task Force recommendation to determine the authority necessary for implementation. Some recommendations will require statutory or regulatory changes. Some will require policy change or program development--either within DHMH or by other organizations, such as professional associations or health care or religious institutions.
Implementation of many recommendations aimed at prevention, education, and victim-survivor recovery will not require statutory or regulatory authority. Those implementing these recommendations can proceed to work with professional associations, health care institutions, religious institutions, and consumer groups to effectuate these recommendations. The potential impacts are high because preventing occurrences of sexual exploitation benefits the professions, consumers, and society.
Most of the recommendations for intervention and some recommendations for prevention and education require that the law be changed through legislation or regulation. This includes the recommendations for rehabilitation of sexually exploitative health professionals, licensure discipline, criminalization, and civil litigation. Some require that legislation be passed. Others can be effectuated through changes to regulations. Once the necessary laws or regulations have been passed, some recommendations, especially in the area of rehabilitation, require program development.
For those recommendations that require legislative authority, the concept and language for the legislation must be developed and legislation must be drafted. Coordination with interested groups such as licensing boards and professional organizations is needed. Recommendations that are expected to require legislative authority include many on licensing procedures, criminalization and civil law, at a minimum.
For those recommendations that require regulatory authority, changes needed must be identified. Some issues are common to all boards and will need to be addressed globally while others will have to be addressed by each board so that it can be tailored to the profession. Coordination with the licensing boards will be needed.
Some recommendations will require policy changes by health care organizations or religious organizations. Others will require efforts by interested educators, attorneys, clinicians, and consumer and consumer advocates. Efforts to involve these groups, possibly through outreach to their professional organizations and to organized survivor groups, will be needed.
Recommendation 53: DHMH should appoint a staff member to serve as the focal point within DHMH for implementing the Task Force recommendations and for coordinating the efforts of others involved in implementation activities.
Recommendation 54: The Task Force recommends that the Governor have an Implementation Committee, comprised of representatives of the health and legal professionals, clergy, consumers, and legislators, as soon as possible.
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I contracted a sexually transmitted disease from my therapist which still plagues me. My gynecologist told me it was infectious to other partners, so despite the passage of many years, I have not had another sexual partner. Exploited by a Social Worker |
CHAPTER 13
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The charge of the Task Force was to study the problem of sexual exploitation by health professionals in Maryland and to develop comprehensive recommendations for addressing it. To accomplish this purpose, the Task Force needed a structure and mode of operating that would support members' efforts on this complex and challenging assignment.
This chapter documents the process of the Maryland Task Force. The first section describes the way the Task Force was organized and how it operated. The second section presents results from a process evaluation completed in November 1995. By describing and analyzing Maryland's Task Force experience, the chapter offers insights and ideas that may be helpful to other states, provinces, or municipalities that convene a similar group to study the problem in their area.
Appointed by the Governor, the Task Force Chair carried responsibility for the overall leadership and administration of the Task Force. The Chair is a psychologist and university faculty member who has an extensive background in teaching and consulting on clinical boundary issues. The Maryland State Department of Health and Mental Hygiene (DHMH) provided administrative and secretarial support by apportioning a percentage of two positions--an administrator and a secretary--to assist the Chair. The Chair asked a consumer member, an educator with ties to the community of sexual exploitation survivors, to serve as Vice-Chair.
The Chair formed a Steering Committee to serve as an advisory group--to consult on Task Force priorities, help develop policy and procedures, and offer advice on content and process issues. The Steering Committee consisted of the Chair, Vice-Chair, Administrator, and three other members, all with backgrounds in the topic of health professional-client sexual exploitation. These other members were the legislator who sponsored the bill authorizing the Task Force or his designee, his former aide; a former Deputy Counsel in the DHMH Office of the Attorney General, who is now with a private firm and represented the legal community on the Task Force; and the current Deputy Counsel in the DHMH Office of the Attorney General.
All of the Steering Committee members had extensive knowledge and experience in various aspects of the problem of sexual exploitation. Additionally, each brought a specialized understanding of the needs of the particular constituency he or she represented, and all but one had been members of the Ad Hoc Advisory Group that proposed the Task Force's formation. Thus, the Steering Committee members brought to their roles not only content expertise but also a familiarity with the political climate surrounding the dialogue regarding this issue in the State.
The Steering Committee met monthly, usually approximately one week in advance of the scheduled monthly Task Force meetings. Conducted informally, Steering Committee meetings focused on resolving policy or procedural issues emerging from the previous Task Force meeting, setting the priorities and agenda for the upcoming meeting, planning public hearings and educational events (see below), and monitoring the Task Force's ongoing progress. Others, especially Work Group Chairs, were invited to attend, but none did.
The Task Force was composed of the following members: two senators appointed by the President of the Senate of Maryland; two delegates appointed by the Speaker of the House of Delegates; a designee of the Attorney General; and eighteen members appointed by the Governor, as follows: seven health care clients or consumers with specialized or personal knowledge of or experience with the problem of sexual exploitation of clients by health professionals; two members of the religious community of the State; and one member recommended to the Governor by the appropriate State professional associations representing each of the following professions: medicine, psychiatry, nursing, professional counseling, psychology, physical therapy, law, social work, chiropractic, and dentistry. (For personal reasons, one consumer member withdrew from the Task Force in November 1995, leaving six consumers.)
Several members had experience with various aspects of the problem of sexual exploitation. For example, some of the consumer members had been on the Ad Hoc Advisory Group and had worked as advocates in local survivor recovery networks. The psychiatrist appointed to the Task Force had experience with sexual exploitation cases as a member of a peer review board, and the physical therapy representative had addressed such cases during her tenure on the physical therapy licensing board. Other members of the Task Force had concern and commitment, but they had little or no direct experience working on the problem in their professional communities.
The authorizing legislation stated that the Task Force's purpose was to "develop a comprehensive strategy for preventing and reducing the incidence of sexual exploitation of clients by health professionals" - Md. Code Ann'd, Art. 41, § 18-304 (c) (7) (1993 Cum Supp.). The original bill authorizing the formation of the Task Force required the group to submit its final report and recommendations at the end of one year (by January 1, 1995).
However, at the first meeting (in January 1994), the Task Force voted to seek a one-year extension. This decision was prompted by recognition of the complexity of the issues to be addressed, and because, although the authorizing legislation stipulated that the Task Force could begin in October 1993, the nominations process and other start-up issues took longer than expected. The Task Force did not actually meet until January 1994. An amendment allowing the Task Force to submit its final recommendations one year later than originally required (that is, on January 1, 1996) was sponsored by one of the legislators on the Task Force and passed during the 1994 legislative session.
The Task Force usually met every month, on the second Wednesday. The meetings were held in Annapolis, Maryland, a geographical site that was centrally located with respect to members' various locations throughout the State. Members voted on the most convenient time to schedule the meetings and decided to alternate meetings between afternoons and evenings to accommodate members' schedules.
The Chair, or in his absence, the Vice-Chair presided. The meetings were conducted following parliamentary procedure, according to Robert's Rules of Order (Patnode, 1989). Although Task Force meetings were open to the public by law, members of the public were asked not to participate in the Task Force's deliberations and were not allowed to vote. Victim-survivors of sexual exploitation and other consumers attended several of the meetings; professionals and representatives of the media attended one or two others.
On each occasion that members of the public were present, the Chair advised them that their role at the meetings was restricted to that of observer, and he encouraged them to participate in the public hearings, the forum provided for the public to express its views and opinions to the Task Force. The Chair also advised meeting observers that they were free to consult individually with Task Force members outside of the meetings and that educational and other resource materials (e.g., readings on sexual exploitation, information on support groups, Task Force roster, meeting minutes) were available from the Task Force Administrator. (Agenda and Minutes of the Task Force meetings are included in Appendix P.)
In carrying out its charge to study the problem of sexual exploitation in Maryland, the Task Force sought opinions from all concerned stakeholders. To provide a forum for members of the professions and the public to voice their perspectives, concerns, and opinions, the Task Force held six public hearings throughout the State. The hearings served the dual purpose of giving the public a chance to speak to the Task Force and of allowing the Task Force an opportunity to explain its role and function to the public.
The public hearings were scheduled approximately one month apart, beginning in May 1994, in different geographical regions of the State. The schedule of public hearings appears as Appendix Q. (Originally, five hearings were planned, but when only one individual attended the hearing in Easton, Maryland, a second hearing was scheduled there.)
To help ensure an orderly process, the Chair presented a set of guidelines at the beginning of each hearing. These ground rules, which appear as Appendix R, explain the purpose of the hearings and set out two prohibitions. The first prohibition was that those testifying should not disclose names of providers related to individual allegations or cases. The second was that those present at the hearing should not solicit the opinion of individual Task Force members or ask for projected recommendations, because giving such information at this early stage could have been precipitous.
With assistance from the DHMH Public Relations Office, the public hearings were publicized in press releases to local media. Additionally, announcements were posted on bulletin boards in heavily trafficked areas and sent to a mailing list of interested individuals and groups. Task Force members also made individual contact with persons they knew were concerned with the issue. The hearings held in Rockville, Towson, and Columbia were all attended; however, no one attended the hearing in Hagerstown and only one individual, a member of the press, attended the first hearing in Easton. Additional efforts to publicize a second hearing in Easton still produced no attendees.
In addition to the public hearings, the Task Force made several other efforts to involve individuals and groups having concern about this issue. Early on, the Task Force established a mailing list of such persons, and the Administrator sent regular notices of meetings and public hearings to them. To involve leaders and members of professional groups, the Chair sent a letter to each health professional association and licensing board. In addition, members of the health and legal professions and members of the clergy were asked to participate in meetings with several Work Groups. Individual Task Force members consulted with the professional associations they represented to keep them apprised of Task Force developments. And the community of consumers and sexual exploitation survivors was asked to offer perspectives and opinions in the public hearings and at Work Group meetings.
The Task Force also interacted with the community of experts and other concerned persons outside of the State. For example, three of the Task Force members--the Chair, a clergy representative, and a consumer member--participated in the Third International Conference on Sexual Exploitation by Health Professionals, Psychotherapists and Clergy that was held in Ontario, Canada in October 1994. The Chair spoke on a panel that discussed ways of organizing a task force and offered lessons learned by the Ontario, British Columbia, and Maryland task forces. The Chair also participated on a panel on educational issues where he presented a paper on teacher-student boundaries. The clergy representative presented on the topic of clergy sexual exploitation. On their return, the three members who participated in the Conference shared their learning and conference resources with the other Task Force members.
By design, the Task Force was composed of a heterogeneous group. The vision for the Task Force was that diverse stakeholders would join in the spirit of mutual respect and cooperation to study this vexing problem. To ensure that all concerned groups would have a voice, 24 members--legislators, consumers, attorneys, clergy, and members of the health professions--were appointed to the Task Force.
In addition to role differences, Task Force members had many other differences. These arose from the diversity of personal and professional backgrounds, different motivations and expectations for participation, and varying levels of familiarity with the issue.
The Task Force leadership recognized the diversity as a valuable resource. At the same time, it understood that this same asset, if not properly managed, could become a liability. To help the diversity become an advantage, the Task Force members needed to identify a shared vision and framework to guide their work over the long period ahead. Also, the need to establish a common language for the dialogue and a cooperative way of working together was recognized. To help establish these basic processes, a one-day workshop was held on January 4, 1994.
To help members prepare, a compendium of background materials was compiled and distributed approximately two months prior to the workshop. The compendium was designed to provide a general background on the purpose of the Task Force and the issues it would consider. Readings from the professional and popular literature, information on prevalence rates in Maryland and throughout the United States, examples of reports developed by other Task Forces, and impact statements by victim-survivors in Maryland were all included.
To facilitate the introductory workshop, the leaders recruited a consultant with expertise in organization development, who generously contributed her time as a community service. The goals of the workshop were to orient members to the Task Force's purpose and goals, provide an opportunity for members to become acquainted with one another, offer an overview of the problem, propose a common framework for understanding it, and establish norms of behavior that would facilitate working together as a Task Force.
To accomplish these objectives, the workshop agenda included didactic and experiential activities, such as group development exercises, a conceptual presentation, a video and discussion, and small-group case discussions. The agenda for the workshop appears as Appendix S.
To build a base of knowledge, the Task Force invited experts to speak at meetings and small group sessions. One such speaker was a nationally known attorney with expertise litigating sexual exploitation cases, who gave a presentation on fiduciary theory. Several other attorneys, all with specialized knowledge of legal and policy considerations important to the Task Force's work, met with one of the small work groups, and mental health professionals with expertise in offender rehabilitation consulted with another. Task Force members received numerous articles during the meetings and conducted research themselves.
As the Task Force completed its first year, the leadership proposed the idea of having a second process-oriented workshop, similar to the 1994 introductory event. The Task Force members agreed that such a session could help assess the progress to date and prepare for the challenging work of the year ahead. The same consultant who conducted the earlier workshop, joined this time by her partner, again volunteered to facilitate.
The goals for the 1995 workshop were to help members work cooperatively in formulating the recommendations by reflecting on the group process, especially as it related to the norms established at the 1994 workshop; by practicing decision-making, communication, and conflict resolution skills; and by reviewing the action plan and timetable for the work of the second year. (See Appendix T for the workshop agenda.)
As the Task Force came to an end, the Steering Committee recognized that members might appreciate the opportunity to express their thoughts and feelings about the shared experience with the others. In addition to providing an opportunity for members to offer insights, personal experiences, and acknowledgements of others, it was thought that such a process could also facilitate a sense of closure to this intensive two-year experience. To accomplish this, the Chair facilitated a process at the last meeting (December 1995) that offered members the opportunity to share with the collective the meaning that the experience of serving on the Task Force had for each individual.
At the initial (January 1994) Task Force meeting, members identified several important areas the group would need to address to carry out the mission. To study these, the Task Force decided to specialize by forming subgroups (called "Work Groups") that focused on particular topics related to preventing the occurrence of and intervening with sexual exploitation.
Task Force members joined one or more Work Groups that represented topics of personal or professional interest. (A listing of the Work Groups and their membership is included in Appendix U.) Each Work Group was to research its topic thoroughly, present its findings to the rest of the Task Force, and suggest ways to address problems and build on strengths discovered through its investigation.
At the first Task Force meeting, five Work Groups were established. (During year two, a sixth Work Group, the Report Drafting Committee, was also established.) Each Work Group was responsible for developing its own approach and strategy for studying the topic area within its purview. The Work Groups each selected a Chair or Co-Chairs to organize the group's efforts, present the group's findings and progress at Task Force meetings, and serve as liaison to the Steering Committee. Work Group Chairs were invited to participate in Steering Committee meetings as a way to improve coordination and communication between and among Work Groups and the Steering Committee. Although the suggestion was made to invite experts not on the Task Force to sit on some of the Work Groups, the decision was made to limit the Work Groups membership to Task Force. However, consultants and other concerned individuals and groups were invited to participate in special Work Group meetings on specific topics.
During the first year, time was allocated on the agenda of each Task Force meeting for Work Group reports, which were succinct briefings on each group's efforts and findings to date. At the end of the first year, each Work Group presented an outline of the issues that the Work Group had examined and expected to address in its proposed recommendations. The entire Task Force critiqued the Work Group outlines, suggesting topics or issues that should be added or deleted, identifying potentially complex or controversial issues, and noting areas of possible overlap among Work Groups. During the final eight months of the Task Force, each Work Group presented first a draft and then a revised version of its findings and recommendations that incorporated any changes.
During the meetings, Task Force members examined issues and debated questions identified by the Work Groups. In those instances that an individual or group held views that diverged from the majority's perspective, the differing individuals were encouraged to draft a minority opinion for the report. Through the Work Group sessions, discussions at Task Force meetings, and circulation of multiple drafts of documents, the Task Force tried to ensure that the report would accurately reflect the perspectives, beliefs, and opinions Task Force members held concerning these complex issues.
The Professional and Public Education Work Group offered recommendations to the Task Force on ways to inform and educate professionals and consumers about the problem of sexual exploitation and its effects, as well as ways to prevent, treat, and redress it. This group met monthly throughout the first year, including a full-day meeting in February 1995 devoted to working on the proposed consumer education brochure (see Appendix E).
To gain consumer input, the Education Work Group requested that members of Treatment Exploitation Recovery Network (a self-help recovery group for victim-survivors of sexual exploitation by psychotherapists, clergy, and other health care providers) review and comment on an early draft of the brochure.
In collaboration with a University of Maryland medical student, the Education Work Group also helped develop a survey for medical and physical therapy students regarding their educational experience in the area of professional-client boundaries. They also assessed educational curricula and materials currently available.
The Institutional Work Group surveyed Maryland health, mental health, and religious institutions to learn what policies and procedures for preventing and dealing with sexual exploitation are currently in place.
The Institutional Work Group first created a prototype that outlined those institutional policies and procedures members consider essential for dealing with incidents of sexual exploitation. Next, they mailed out a request to administrators of approximately 130 health institutions, religious denominations and organizations, and governmental jurisdictions, asking them to forward relevant policies and procedures. Then this Work Group created a matrix that allowed them to compare materials received with the prototype. Finally, they proposed strategies that can help institutions prevent and remediate sexual exploitation in Maryland. The Institutional Work Group gave special attention to policies covering employees of institutions not governed by professional codes of ethics or licensure regulations.
The Administrative Work Group contacted all of the groups that play a role and have a stake in the licensing board complaint process to ask their views of the process and its problems. Administrative Work Group members developed a protocol for conducting structured interviews with administrators and members of the various health licensing boards. This involved distributing a questionnaire to board administrators and a hypothetical case (see Appendix V) for discussion to board members. These were then discussed during face-to-face meetings. The Work Group also met with investigators, prosecutors, a chief administrative law judge, and victim-survivor groups. In addition, the Administrative Work Group obtained data from the licensing boards and from the Office of the Attorney General concerning disciplinary actions taken against health professionals who had sexually exploited clients.
On the basis of their findings, the Administrative Work Group offered recommendations for refining the complaint process, including shortening the time from complaint to hearing, stipulating mandatory sanctions, and allowing for victims to be compensated through fines imposed against the offender.
The Civil and Criminal Laws Work Group studied issues related to criminal and civil proceedings against health professionals who sexually exploit their clients. To examine the complex policy and legal questions surrounding these issues, the Work Group took the following steps: They examined Maryland Law concerning sexual assault and related offenses; studied relevant criminal and civil laws in other states, as well as those laws' impact on the incidence of client sexual exploitation in two states; collected statistics from the Office of the Attorney General concerning the incidence of health professional-client sexual exploitation; consulted with experts to discuss the effect of criminal, civil, and administrative laws on clergy sexual misconduct; and met with legal experts and victim-survivors to discuss criminalizing health professional-client sexual exploitation.
The Civil and Criminal Laws Work Group concluded that current Maryland law does not provide adequate redress for clients victimized in this way, and they proposed that both criminal and civil statutes be developed. This Work Group's topic also required that they study the issues of whether professional liability insurance should cover sexual exploitation and whether professionals should be required to report cases. The Civil and Criminal Work Group also discussed the issue of how to regulate unlicensed practitioners.
The Rehabilitation and Recovery Work Group studied rehabilitation for professionals who have sexually exploited clients and sought ways to enhance the process of recovery for those so victimized.
To explore offender rehabilitation issues, the Rehabilitation and Recovery Work Group gathered information on current practice among the various health disciplines in Maryland, by inserting four questions into the questionnaire that the Administrative Work Group used for their interviews with board administrators. The Rehabilitation and Recovery Work Group also reviewed the professional literature and consulted with two experts on this topic. In meetings with two health professionals who had sexually exploited clients, the Work Group elicited these individuals' perceptions of the effectiveness of various components of their assessment and rehabilitation plans.
On the basis of their findings, the Rehabilitation and Recovery Work Group recommended a standardized procedure for assessing offenders and for developing and monitoring rehabilitation plans.
To educate themselves regarding survivor recovery issues, the Rehabilitation and Recovery Work Group members requested a didactic presentation from the co-founder of a self-help recovery group. The presentation offered a framework for understanding the experience of victim-survivors and covered core issues and stages in recovery.
This Work Group also held a special meeting to which consumer members on the Task Force with personal experience as a survivor or family member of a survivor were invited. The meetings focused on identifying strategies for improving the recovery environment for survivors.
On the basis of its findings, the Rehabilitation and Recovery Work Group developed a series of recommendations for empowering consumers, equipping mental health and other professionals with the knowledge needed to intervene sensitively, and building an infrastructure to support survivor-oriented networks.
Some of the Work Groups held joint meetings. These joint meetings minimized the possibility that groups working independently on related topics or areas would not duplicate or contradict each other's efforts. For example, the Rehabilitation and Recovery Work Group met with the Administrative Work Group to discuss how the proposed rehabilitation procedures would fit within the context of the licensing boards' disciplinary process. The Education and Administrative Work Groups met to discuss educational initiatives for board members and others involved in the complaint process.
Task Force members' collective efforts over the past two years have resulted in a series of well-considered proposals for preventing and addressing sexual exploitation in Maryland. However, in addition to these recommendations, the Task Force wishes to make another contribution that may also advance ongoing efforts to address the problem: By describing and evaluating the process by which the work was carried out, the Task Force may serve as a model for and guide to similar collaborative groups, in Maryland and elsewhere.
Coordinating the efforts of a highly diverse, 23-member, volunteer group represents a major undertaking. Such an inclusive approach offers many possibilities for diversity of perspective and approach. Because all groups with concern for the problem have the opportunity to contribute their particular views and opinions, many innovative solutions can emerge. However, collaborative work by such a heterogeneous group can also present challenges.
The very fact that the Task Force accomplished its purpose, as reflected in the recommendations, testifies to its effectiveness. However, by reflecting on various components of group and organizational process and by analyzing the relative strengths and weaknesses, the Task Force believes its experience with this process may be instructive to others. By evaluating its process, the Task Force provided feedback to itself and, more significantly, documented ways that others can benefit from their experience and the lessons they learned.
To evaluate the Task Force process, a simple 18-item questionnaire was developed and distributed to the members in November 1995. The questionnaire included 11 items that asked participants to use five-point scales to indicate their assessments of the effectiveness of various components of the Task Force's leadership, structure, organization, and related issues. Seven open-ended questions elicited respondents' perceptions of the Task Force's strengths and weaknesses and their suggestions for enhancing the effectiveness of this or a similar group. The Task Force Process Questionnaire appears as Appendix W.
Eighteen of the Task Force's 23 members returned their completed questionnaires. When the questionnaires were returned, it became apparent that three questions (actually sub-questions appearing under Question 7 and marked as "Work Group 1, Work Group 2, and Work Group 3") did not yield useful information because of a typographical error on the form (i.e., there was no direction to indicate the name of the Work Group). Mean scores for each item and a compilation of respondents' written comments are included as Appendix X.
In general, respondents' perceptions of the various components of the Task Force process were positive. Respondents' ratings of the level of commitment and effort of the Task Force leadership and staff were especially favorable; the mean scores for the ratings of the Steering Committee and Administrator were each 4.9 (on a five-point scale).
In written comments, respondents commended the Chair, Vice-Chair, Steering Committee, and Administrator for the range of skills, level of effort and dedication, and content expertise they brought to the Task Force. One member noted that the Administrator "performed exceptionally well, not only in handling administrative matters but especially in offering well-thought opinions on these issues."
The leadership also received high ratings (mean score = 4.2) on the item that asked for participants' judgements of how skillful the leaders were in organizing the work, conducting the meetings, and keeping the Task Force focused. One respondent described the leadership style as "supportive" and "nurturing" and noted that the leaders "inspired others to work." Another Task Force member commented that the Chair and Vice-Chair did a "great job...keeping us motivated and on track."
However, some respondents pointed out areas that might have been handled more effectively. For example, some respondents thought that the meeting agenda were overly ambitious and that, as a consequence, "sometimes discussions of important issues were cut off prematurely." Some members also expressed frustration that, at times, discussions were repeated for the benefit of those who had not been present at previous meetings.
Two members thought that the leadership should have offered more guidance to some of the Work Groups; one saw the leaders' "biggest weakness" as failure to "keep the Work Groups on track." This person offered that using a "timeline that showed each activity and due date, preferably in graphic format" might have helped. This individual thought, too, that the leadership should have addressed the lack of consistency in the quality of the work group reports, by letting some Work Groups "know that additional work was needed."
Another comment was that the "leadership did not pay enough attention to outreach." The person offering this criticism thought the leaders failed to make it clear that "each health professional was representing his or her profession" and had a duty to "keep their organizations or boards apprised of what was going on and get their input."
One question that received a relatively low rating by a few members (mean score = 3.7) was Question 2, which asked respondents to assess the extent to which members had a shared understanding of the mission and goals of the Task Force. One individual noted that the group seemed to gain and lose focus and that understanding of the mission and goals was inconsistent. Another Task Force member's comment seems to imply that this person felt at a disadvantage because she or he had "very limited knowledge of the work preceding [the formation of] the official Task Force."
A related item (Question 5) that also yielded some lower ratings (mean score = 3.4) asked respondents to indicate the extent to which they thought members had a clear understanding of the methods and processes by which the Task Force would carry out its mission. One member indicated surprise that other members should lack such understanding because the work methods and process were discussed during the meetings and in the meeting minutes. Another respondent suggested that perhaps some members were uncomfortable with the degree of ambiguity involved as the Task Force's methodology evolved. Someone else observed that the degree to which members understood the work process varied from Work Group to Work Group and that the leadership should have provided guidance at regular intervals. One member suggested that the task seemed so "overwhelming" that it was hard to imagine that "anybody had a clear idea of what we would need to do."
On the item that asked respondents to judge how comfortable members were expressing their views during the meetings (Question 3), the results suggest that the leaders and members did establish an atmosphere in which people generally felt comfortable expressing their ideas and opinions (mean score = 4.1).
However, in their comments some participants indicated that they sometimes experienced difficulty speaking or sensed that others did. One person, who observed "considerable variation in the comfort level of Task Force members" attributed this to some members' "personalities" or to the fact that some may have been "intimidated" by others' greater knowledge of the issue or their "assertiveness." Two members noted that using the technique of inviting each person at the table to speak in turn proved helpful on the occasions this was tried during the meetings.
Question 4, which asked Task Force members to rate their assessments of the effectiveness of the organizational structure (Steering Committee and Work Groups), yielded a wider distribution of responses than did most of the other questions. Some of those who gave this item an unfavorable rating (less than 3.0 on a five-point scale) offered reasons for their perceptions. For example, one person stated that the structure was less than optimally effective because some of the Work Group members did not participate in the meetings or help with the task. Another thought more guidance might have been offered by the Steering Committee, and someone else felt that more preparatory work by Work Group Chairs might have helped.
Those who rated Question 4 favorably (4.0 or 5.0) cited positive elements of the organizational structure such as the flexibility it offered for Task Force members to "specialize in areas of personal/professional interest" in the Work Groups and to determine "how various issues were addressed." A comment also noted that the Steering Committee was able to "handle issues behind the scenes" that facilitated the work of the entire group.
The ratings showed a variability among the Work Groups with respect to members' perceptions of the level of commitment and effectiveness of their own Work Groups (Questions 7 and 8). (The questionnaire asked Task Force members to rate only their perceptions of the Work Group(s) in which they participated.)
Respondents noted that not all Task Force members contributed equally and that other members had "to carry a disproportionate load to compensate." One individual felt that the variability among the Work Groups resulted from differences in the "commitment of leadership or commitment to the issues." Another noted that "participation diminished as time went on," that "the legislators generally did not participate," and that "some members missed far too many Task Force and Work Group meetings, and this impeded the group in hearing all perspectives."
Some participants expressed their regret at not being able to contribute more time to the Task Force. For example, one member noted that "the heavy load of the...practice with all the problems of unpredictability and urgent cases" made it impossible to participate "as much as I would have liked." Another member noted that "sickness prevented" that person "from attending the last few meetings."
Regarding the two process workshops, Task Force members generally favored the January 1994 event (mean score = 4.4) over the 1995 workshop (mean score = 3.8). Of the first workshop, four members commented on its effectiveness in helping the Task Force develop a "common vision," "cohesive identity," and "shared sense of purpose." One observed that "members started with varying levels of knowledge of the subject which the informational part of the agenda addressed." This person also noted that "the team building exercises helped us get to know one another"; however, another member thought that the first workshop should have been more interactive.
Responses to the second workshop were more mixed. Some members found the session very useful, noting that it offered a chance to "look at our work and our process and to share observations, concerns, and goals." These same respondents also expressed the wish that there had been more time for "process-oriented" work. In contrast, two other members found the session "not to be useful," and one thought that the "time would have been better spent working on the report."
One person found the workshop "more helpful in terms of individual feelings about the Task Force and in reinforcing the fact that we are a team than in assessing progress and clarifying what we need to focus on next." Two respondents indicated that they wished the workshop design had allowed an opportunity for members to meet in small groups, and to discuss ways to organize the work of the second year.
In assessing the Task Force's overall performance, the respondents' ratings were favorable (mean score = 4.3). One individual noted that the Task Force has been "a very dedicated and productive group," and another said that "we have developed some useful and well-considered recommendations...some of which...are especially unique."
Question 11 asked members to indicate the likelihood of their continuing to work on the issue of sexual exploitation. Through their ratings, the Task Force members all indicated that they would be likely to continue working on the issue of sexual exploitation. In fact, eight of the 18 respondents gave the highest rating on this item (5.0), and seven gave the second highest (4.0). One noted said that "the recommendations will not be implemented unless some Task Force members continue to press for their implementation."
Questions 12-18 were open-ended questions that asked respondents to reflect on their experiences and to identify the insight and learning they acquired through the process. These questions also asked Task Force members to offer advice and guidance that might be helpful to a similar group.
Question 12 asked members to indicate the insights they take from their two-year experience as a Task Force member. Although responses were as varied as the membership itself, several themes emerged. One theme centered on the importance of taking an inclusive and collaborative approach. For one member, the Task Force experience "affirmed...the importance, value, and absolute necessity of taking an inclusive approach that involves all stakeholders when addressing a problem of this sensitivity and complexity."
Another theme was the importance of one's perspective in studying complex issues, such as those with which the Task Force struggled. One member put it this way: "Life depends in large part, but not finally, on your standpoint: as victim, professional, attorney and educator. We can learn, move, change upon interaction with others." Also offering an insight on changing one's perspective, another member said: "When I came to the Task Force my only concern was for the victims, but after studying the materials given to the Task Force members, I came to realize that perpetrators also need attention."
Some members focused on the ways that the Task Force experience stimulated their learning or personal growth, as in the following comment: "This has been a wonderful learning experience for me--personally and professionally." Another member, a self-identified victim-survivor of sexual exploitation, observed that the Task Force experience had helped her to "see myself in the role of advocate, rather than victim." She went on to say that the experience had helped her "move on in the healing process."
Others mentioned learning about how a task force operates, understanding how the legal system works, and realizing how widespread the problem is, and recognizing how damaging it can be to victims. One member realized "that the public understanding and concern is not as great as some would like to think."
Question 13 asked members to indicate what was most significant to them, personally and professionally, about their role on the Task Force. This question also prompted many different responses, but, again, some themes are evident. Several members commented that the experience had offered various forms of validation. For example, one member noted: "It has been beneficial and validating...to work with...other victims, whom I deeply admire and respect...[and]...other people who care about the problem and are spending much time and effort to try to do something about it." For another member, the experience validated that the person "can think and think well." Another member was deeply moved because she felt her personal experience had been validated when another Task Force member seemed to "really understand the seriousness of the problem and the devastating impact on victims and their families."
Other Task Force members expressed their appreciation for the opportunity to be involved in such an important and meaningful activity. One individual's comment is representative: "the opportunity to contribute to an effort that may make society a safer place" was most significant.
Some members identified as most significant their interactions with others. For example, one person expressed appreciation for the "interactions with some members" that "moved" the member "to reconsider some of my positions." Another individual was "most impressed by the way the members have interacted with one another--with personal concern, humor, and respect, and without status or turf becoming issues." Yet another member experienced playing the of "Devil's Advocate" as highly significant. The member went on to say that even though "I felt a lot of resentment at times,...I said what I truly believed and still stand on those convictions."
Some members observed that the their role on the Task Force has influenced their professional lives in significant ways. For example, one person said that participation "increased my knowledge and understanding...I now feel...capable of initiating a ministry for victims of sexual abuse and exploitation." Someone else observed that having a role on the Task Force represented somewhat of a mixed blessing: "Professionally, my participation both helped establish my expertise, and was a liability because of the great resistance to the problem."
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My disappointment in the legal system is so intense that I tend to mistrust all prior learning about the "American way of life" and fairness. Exploited by a psychiatrist |
In response to Question 14, members identified several Task Force strengths. The group's diversity and inclusive approach were seen as major strengths by several members. For example, respondents commented on the "ability to work together as a unit," "the non-adversarial approach," and "the contributions and efforts of a diverse group of people, all with a stake in this." Three members saw the leaders' skills and abilities as important strengths, and the support provided by DHMH was also mentioned. Member characteristics, such as "enthusiasm, intellect, concern, focus on getting the job done" and members' "commitment and openness" and the "variety of [their] experiences and skills," were mentioned as well.
In response to Question 15, which asked participants to identify the Task Force's major weaknesses, members reported many different perceptions. Some of the responses cited problems with other members' behavior as a weakness. For example, several individuals thought that some members' "lack of regular attendance" or "low level of participation" represented the major weakness. One member suggested that to "reconsider the nominations process and make sure that each person understood the time required...before signing on" might help to address this problem.
One individual thought that some participants "were engaged mostly on a personal 'revenge' type of measure, instead of trying to understand others' points of view and what would be fair for all concerned." Another Task Force member cited "closed mindedness and/or obstructiveness" on the part of a "small number of members" as the major weakness.
Still other members reported the weaknesses as not enough time, too large a group, and an overly ambitious agenda. One person identified "the conflict between what is politically correct and what may be good judgement" as the major weakness. Someone else thought that insufficient attention was given to the issue of clergy exploitation, and two members thought that the Task Force was hindered, conceptually, by including the non-mental-health professions within its purview.
Question 16 (If we could begin again, what might you want to do differently?) stimulated various responses. One member thought that "we started off on the wrong foot in the organization of the work groups." This person observed two major problems: "An imbalance in the workload, particularly for the Civil/Criminal Work Group" and "[a]llowing members to join more than one work group and/or the failure to assign certain members to certain groups."
Several members mentioned they would change the length and frequency of the meetings if given the chance to start over. However, those who identified this as an issue did not agree about what changes would be needed. One individual suggested monthly four-hour meetings alternating with eight-hour bimonthly meetings, and another recommended half-day meetings held on Saturdays, quarterly. In contrast, another member advocated for "less travel and less time at meetings," which could be facilitated by "conference calls and paper discussions." Another member recommended fewer meetings for the entire Task Force "with some months scheduled for work groups."
Two members thought that having additional speakers, "like Linda Jorgenson" (an attorney with expertise in litigating sexual exploitation cases) and "speakers from other states who have looked into this subject" would have been a good idea. Two individuals recommended a different Task Force composition: One thought there should be more attorneys, and another suggested including "more professionals in the categories where the incidents are frequently found." This person also thought that there should be "more opportunities to explore their positions for defense lawyers, insurance companies, etc."
Three individuals expressed interest in having "more input from legislators." One expressed frustration that, in accepting their role as Task Force members, some legislators seemed not to accept the "responsibility [that] goes along with it."
One Task Force member recommended including regular "process checks" and using "structured techniques," such as going around the table "to encourage the quieter members to speak." Two members suggested finding a more effective way to inform the public of the hearings. Two also cited staying in closer contact with one's professional board as an issue to consider. Establishing a work group to focus on issues related to sexual exploitation by clergy was another suggestion.
Question 17 was closely related to Question 16: "Based on your experience with this Task Force, what advice would you give to a similar new group that could help them function effectively?" Responses that differed from those already reported for Question 16 included advice to have a well-designed introductory workshop. Two members advocated this, stating that such an event could help "build rapport and trust" and "develop a shared sense of purpose and group identity and norms."
Three people focused on the importance of the fit between work group topics and members' interests and skills. One cautioned that members should join work groups "on topics you really care about." Another suggested building in "a structure that allows members to join a work group, but then after a designated time (say, 6 weeks) to change to another group if they find that the work group topic does not engage them." A third suggested that assigning "certain members to certain groups" might help ensure a good fit between member and work group topic.
One member stressed that "selecting members for integrity, commitment, and balance is the most important element." Another member thought that members new to the issue could be "paired with someone who has done preliminary work to orient them to the past history, issues, etc."
One Task Force member suggested that other groups "use our statement of the issues to make findings" rather than "reinvent the questions." Another person thought that a new task force might consider establishing a "three-year task force"--with fewer requirements for long-distance travel on work days. One member advised to "have process checks on a regular basis. Possibly even have a brief (5 question) check-list for members to fill out and hand in at the end of every three or four meetings. Then discuss at next meeting and plan, as a group, for how to increase members' satisfaction and involvement."
Question 18 (Any additional comments?) also prompted some thoughtful comments. One individual thought that having an initial meeting with survivors and "members of other related fields that work with the problem...could help focus the members on the work to be completed instead of relying so much on written materials."
Other members pointed to future efforts that need to be taken to advance the ongoing work in this area. One individual suggested the importance of identifying risk factors for perpetrators and victims. Another observed that "there is a paucity of research on this topic" and advocated for "quantitative and qualitative studies that are gender- and culturally-sensitive."
One Task Force member cautioned against rushing to enact legislation, observing that "the passage of good bills takes time and work behind the scenes." Finally, a member underscored how important it is that "others be involved and recruited to carry the recommendations of the Task Force forward."
In their responses, the members offered many insights about the Task Force process, and they presented numerous ideas and suggestions that could help similar groups organize themselves for success. Overall, members' ratings and comments reflect the common perception that the Task Force was characterized by a high level of cooperation and well-coordinated teamwork.
In view of the many personal, professional, and role differences, it is striking that, with a few exceptions, the members saw each other--individually and as a group--as talented, dedicated, caring, and productive. The degree to which participants were able to avoid posturing, polarization, and territoriality is also impressive, and speaks to the group's success in realizing the vision for the Task Force as a true collaboration among the stakeholders.
However, there were some problems. The variability among members' levels of attendance, commitment, and participation was one. One member noted on the evaluation that such problems are not uncommon among volunteer groups whose members are typically juggling the multiple priorities of their personal and professional lives against the demands of the voluntary organization.
To help offset the problems of low commitment and high absenteeism, it is critically important that all who accept a role on a task force understand the levels of seriousness, commitment, and contribution of time and effort that must accompany their membership. Perhaps it would be helpful to provide potential appointees or nominees with a written statement of the purpose, scope, and products to be delivered, as well as a tentative schedule for the meetings before they accept a position on the task force. It would have been useful if the Maryland Task Force's Process Evaluation Questionnaire had included a question that asked the members to estimate the number of hours, monthly, they devoted to Task Force activities; this information then could have been made available to others considering membership on a similar group.
Providing potential members with a realistic idea of the demands that membership entails might prove helpful, but there may be other, more potent ways to maximize members' commitment and participation. One is to be sensitive to the fact that members have different motivations for their participation and these may influence their level of commitment and the amount of time and effort they are willing to contribute. To the extent that members can meet personal and professional goals through their participation, they will be more likely to be involved and stay involved in the task force's efforts.
Providing opportunities for members to reflect on the ways the task force experience can add meaning or value to their lives can be helpful. Activities that allow members to share their expectations of their own and others' participation can also increase the chances that others will respond in ways that help members satisfy their interests and needs. Workshops, such as the two offered for the Maryland Task Force, can help accomplish this, as can some of the other process-oriented suggestions offered in the evaluation comments.
Although it seems self-evident, it is worth noting the absolute importance of establishing an environment where members feel comfortable expressing their perspectives and opinions. One way to help create such an atmosphere is to have group members articulate specific norms of behavior that they think will support the development of an environment in which members feel respected at the same time that ideas can be rigorously debated. It is also important that all of the members feel responsible and empowered to help ensure that everyone adheres to the group norms.
Revisiting the norms periodically to determine whether they should be revised and to discuss how well the group is embodying them can also help enhance the organizational climate. Using techniques that structure interactions--such as going around the table or having members work in pairs or small groups--can also help by providing more air time to all and by encouraging participation among members who might feel less comfortable speaking in the larger group.
To avoid polarization on issues, various decision-making techniques can be useful. For example, members can rate alternatives on a continuum ranging from least desired to most desired choice, rather than simply voting for or against various alternatives. This can help minimize the absolute thinking and rigid posturing that sometimes accompany voting. Providing information and opportunities to practice essential skills, such as active listening and conflict resolution techniques, can also prove useful.
The Maryland Task Force was able to incorporate these activities into the two process workshops that were facilitated by a highly seasoned trainer and consultant who volunteered her time as a community service. Other groups may wish to consider calling on local resources to help them manage the complex process issues that inevitably emerge in a task force or similar work group.
In addition to having a supportive, comfortable environment, a task force must have a viable organizational structure and work approach. Members must feel confident and empowered to tackle their complex and challenging assignments by having a clear understanding of the group's purpose and how it will operate. This may be less obvious to some members than one might think. For example, early on in the Maryland Task Force, some members were unclear about the Task Force's purpose, thinking that our job was not only to recommend but also to implement recommendations. Until this was clarified, it was difficult for some members to orient themselves to the task.
Individual working units and the entire task force must have a clear understanding of the specific steps that will be taken to accomplish the task. In the Maryland Task Force's experience, some members sustained confusion about this in spite of the fact that the plan for accomplishing the task was presented several times in the meetings.
There may be a number of reasons for this apparent breakdown in communication. Perhaps the action plan was not clear to some members. For some, maybe the plan was not as detailed and specific as they would have liked, or perhaps it reflected an approach that was not their preferred way of working. Others simply may not have heard the action plan because of poor attendance at meetings and failure to read the minutes. Finally, because the Task Force's approach was at least partially evolutionary, some members may have been uncomfortable with the degree of ambiguity involved.
Coordinating efforts among work groups and between the smaller groups and the larger task force is also a challenging, and critically important task. The Maryland Task Force instituted several measures to help accomplish this. First, Work Group Chairs and Co-chairs were invited, but in deference to their busy schedules not required to attend the Steering Committee meetings. The Steering Committee thought this would enhance coordination and communication, and provide an opportunity for the Chairs to raise issues and concerns. This proved not to be a viable method, however, because only the two Work Group chairs who were already on the Steering Committee came to the meetings. At the same time, the Work Groups did have solid representation on the Steering Committee, because at least one member of the Steering Committee participated on each of the Work Groups. Additionally, either the Task Force Chair or the Vice-Chair participated on each Work Group.
Another method used to coordinate efforts between and among working units was joint meetings among work groups. These sessions provided opportunities for subgroups of the entire Task Force to hear others' developmental thinking and to resolve conceptual or practical issues that cut across Work Group boundaries. Finally, by having the Work Groups report at nearly every Task Force meeting, those present were routinely apprised of the thinking and efforts of the smaller working units.
As noted in the evaluation results, some members thought that the Task Force leadership might have given more direction and structure to some of the Work Groups. Perhaps this might have been done by providing additional written guidance (for example, on Work Group start-up issues, on important issues the groups should consider in organizing themselves, or in response to early outlines and drafts of the recommendations). At the same time, the formal leaders need to guard against becoming overly directive or controlling. It is challenging to find the proper balance that allows informal leaders to emerge, encourages independent functioning among the work units, and provides sufficient support, structure, and guidance.
The Maryland Task Force was fortunate to have excellent support from the DHMH. DHMH provided fiscal and staff resources. Task Force members were reimbursed for all travel expenses and for other expenses incurred in the course of conducting Task Force business (for example, telephone calls, duplication, and fax charges). The DHMH-assigned Administrator and secretary provided invaluable assistance coordinating arrangements for the meetings, preparing the meeting minutes, preparing mailings, making phone calls to members, scheduling public hearings, and skillfully handling many other tasks that facilitated the smooth operation of the Task Force.
Because the Task Force was comprised of volunteers, all with demanding schedules, the DHMH administrative and secretarial support was a major asset. Similar groups might consider establishing a formal tie with their state, county, or municipal governments, not only to avail themselves of potential staff and fiscal resources but also to take advantage of the enhanced credibility and status that association with an established entity in the community can lend.
Engaging the wider community in the task force effort is essential to success. Hearing the views of all relevant stakeholders allows the task force to consider and integrate the concerns and suggestions of those who, ultimately, will be affected by the recommendations. Moreover, inviting such participation helps garner the support and investment that, later, will help ensure that the task force's proposals are implemented.
The Maryland Task Force involved the public and various professional communities in numerous ways: by inviting their participation in public hearings, encouraging Task Force members to serve as liaisons between the Task Force and their professional community, sending a letter from the Chair to relevant health professional associations and boards, providing a briefing for legislators and a formal one-year interim report to the Chairs of the appropriate legislative committees, and inviting members of the professions and from the community of consumers and victim-survivors to provide input to the Work Groups.
In addition, the Chair and Vice-Chair presented several lectures and workshops for professional groups during the two years they served on the Task Force, and the Chair and a clergy representative presented at an international conference on sexual exploitation. As part of these presentations, these Task Force members discussed the Task Force and its efforts to prevent and remediate the problem of sexual exploitation in Maryland. The Chair, Vice-Chair, and a Steering Committee member also published papers on this topic, both in local newsletters of the health professions and in national professional journals.
However, in spite of the various methods implemented to involve the professions and the public, at least one Task Force member thought that further steps should have been taken to sustain an ongoing dialogue between the Task Force and its constituent communities. In particular, the Task Force might have been more effective in publicizing the public hearings. One suggestion for future groups is to be highly proactive in reaching out to members of the media.
Educating the media about this issue can result not only in increased coverage but also in more informed and sensitive reporting. Members of a task force might consider sending briefing packets to members of the press, as the Maryland Task Force did early in its life, and then sending periodic updates. In addition, face-to-face meetings or even a media seminar might prove helpful. Given the important role that the media can play in shaping public perceptions and opinions, the efforts involved in reaching out to the press seem well worth the investment of time and energy.
Ultimately, time will tell to what extent the Maryland Task Force members' time, energy, and efforts produce significant and lasting changes in the way the problem of health professional-client sexual exploitation is viewed and handled in Maryland. The final test of effectiveness will be the extent to which the recommendations are accepted, implemented, and institutionalized.
A psychiatrist and early researcher on sexual exploitation, Judith Herman (1992), has observed that an experience such as exploitation by a trusted professional not only precipitates an individual traumatic response but also creates a breach between the victimized person and the larger community. Viewed in this context, sexual exploitation represents a wounding to the entire community, including the victim, perpetrator, and associate victims, the professions, and the general community.
According to Herman (1992), restoring the breach between the traumatized person and the community depends first upon public acknowledgement of the traumatic event, and second, upon some form of community action. Once it is publicly recognized that a person has been harmed, the community must take action to assign responsibility for the harm and to repair the injury. These two responses--recognition and restitution--are necessary to rebuild the...sense of order and justice. (p. 70)
In their evaluation comments, some of the Task Force members observed that their participation on the Maryland Task Force represented a restoration of the bonds of trust that personal experience with sexual exploitation had destroyed. Other members reflected on the great significance for them, personally, to be involved in so meaningful a task as guarding the public safety, ensuring the integrity of the professions, and helping to restore the trust and genuine caring that must be present in a professional helping relationship.
The Task Force members' work has ended. It is now time for the wider community of governmental agencies, health professionals, clergy, attorneys, legislators, and consumers to continue the work. The entire community must do its part to help prevent and solve this problem, with each individual contributing according to his or her role, talents, and abilities. When the greater community becomes so engaged, the Task Force members' vision of a true collaboration will be fully realized. Then the Task Force's efforts will have helped to restore "the sense of order and justice" in Maryland.
Herman, J.L. (1992). Trauma and recovery: The aftermath of violence--from domestic abuse to political terror. New York: Basic Books.
Patnode, D. (1989). Robert's rules of order: The modern edition. New York: Berkley.
BOUNDARIES MAINTAINED, BARRIERS CROSSED |
December 13, 1995
On a lightly snowy evening, nineteen of us gathered for our last formal meeting, to ratify our report and to say our good-byes. It had been two years of struggle with a highly emotional and controversial topic, and we had wanted to do it all. At times our work seemed fragmented, as we each concentrated on aspects of the problem that grabbed at us most. Life went on for all of us, however, and there just wasn't time to attend all the meetings or do all the reading or think things through the way we might have liked.
But here we were, with a 150 page draft in our hands, painstakingly organized, written, rewritten, proofread and checked for every possible detail by Cathy, Sue, Jane, and a handful of other task force members. Somehow it was coming together--a scholarly, well considered, comprehensive study of a thorny problem. It was easy to see that we had a lot to be proud of. And despite our diversity and our debate and our sometime differences, there had not been one minority report submitted. By the end of the evening we were to understand why.
After the unanimous ratification, we recognized a few who had supported our work in a central way and then we went around the horseshoe table one last time to share our reflections on the two years past. For some, this became a reflection on ten or fifteen or twenty years' past for which this evening represented something of a milestone of growth or accomplishment or empowerment, and possibly a reminder of the continuing struggle toward recovery. Fond memories and sometimes surprising insights were shared, often tearfully. A survivor spoke of her understanding of an offender's experience. A health professional movingly spoke of her sincere empathy for the pain of the victim/survivors in our midst. An attorney's strong legal position on a major issue had been turned around. More than one person reminded us with appreciation of the personal crises that had affected many of us throughout our time together and how we'd been so supportive of one another at those times. We acknowledged also that for all we had accomplished, in many ways this was only the beginning, as our recommendations had yet to be implemented. We planned a celebration dinner in January.
All of this spoke well for kind of group this was. We had hoped that the diverse membership we had planned would temper possibly adversarial positions. I doubt that we would ever have predicted what had happened here this evening. And we realized that our report merely symbolized the maturity, openness, empathy, caring, and sincerity that characterized our group. Judy and David, who had charged our process two years ago and again mid-way, would have been proud!
We thought and spoke also of other memories we had shared over our months together. Our very first meeting on a snowy January day. Wondering whether a closed task force retreat would violate the Public Meetings Act. The arrival of little Frank, one of our two honorary task force members. Carolyn, our other honorary member, who gave us a sense of legislative reality and helped to organize our two summer picnics. The monthly work group meetings at a local Chinese restaurant. Stan, our gracious host, with his shopping cart full of goodies. I-97 looking somewhat different every time we made the drive to Annapolis. The air conditioning at the Heritage Center going off at 5:00 pm when our meeting began at 6:00. The monthly reminders from Margaret to submit our travel vouchers. Carl's scholarship and his meticulous efforts to guide us through a morass of legal options. Manny's puns. Joe's ability to lighten us up when we most needed it. Some of us not being sure for awhile whether it was really okay to be on a first name basis, or whether it would be okay to ask for a hug. The public hearings to which nobody came, and others to which we wished some hadn't. An interstate conference call on a Saturday morning as we struggled with our most difficult decision as a group. We spoke in twos and threes after the meeting ended, and it seemed as if no one wanted to leave.
If anyone asks what the experience of being on this task force was like, I will be only too happy to share our report with them, with its reviews and references and justifications and recommendations and victim impact statements and acknowledgements, and its multitude of appendices. I will say that we learned a lot and that we made some constructive recommendations--more than fifty of them. But that won't be the half of it.
| Mike Plaut |
VICTIM IMPACT STATEMENTS |
Butterfly on My KneeBig, open scar -- reinforced We all may not understand but though I had said nothing to my Oma, and now heretofore not acknowledged by either law, politics, or those who still believe Exploited by a professor |
Be Near Me
My name is ___ _______. I am 32 years old. I live in Columbia, Maryland, and tonight is a very special one in my healing; it is the first time that I have publicly told my story. If you have ever experienced a traumatic event in your life, you have probably wondered, "Will I ever be the same again?" I'm here tonight to share the good news that "No, you will never be the same again, but you will be better." "You no-good, dirty, rotten son of a bitch." "You filthy, dirty, little tramp." "Obey your parents in the Lord: for this is right. Honour thy father and mother (which is the first commandment with promise), that it may be well with thee, and thou mayest live long on the earth." (Ephesians 6:1-3) "Pull down your pants!" This was followed by stings of my father's leather belt on my bare bottom until the welts bled and his rage was spent. "C'mere, I'll learn ya somethin!" This was followed by being forced to hold on to wires as my father turned over the engines of cars and lawn mowers sending electrical jolts through my small-child's body. Year after year, teachers asked about the bruises, but I never told anyone. I kept the secret. "Be near me Lord Jesus, I ask thee to stay, close by me forever; and love me, I pray." That's the third verse of "Away in a Manger." I had it memorized at the age of four and have recited it as a silent mantra throughout my life. From the time I can remember, the only thing that I've been able to count on in this life is "Jesus loves me--THIS, I know." I brought with me tonight a tiny King James New Testament that was given to me by my Sunday School teacher in 1971, when I was just eight years old. The homemade bookmark that she placed in it has a sticker on it that reads, "I was glad when they said unto me, 'Let us go into the house of the Lord.'" (Psalm 122:1) I read my New Testament all the way through at the age of eight, and there I discovered Ephesians 6:4 (the verse immediately following those that my mother had used to make me feel so small). Ephesians 6:4 says, "And ye fathers, provoke not your children unto wrath; but bring them up in the nurture and admonition of the Lord." From that time on, I have clung to the scriptures, because God speaks to me there. When I was little, I wanted to be Roman Catholic so that I could be a nun and be married to Jesus. As I grew in the church, I was nurtured and encouraged in my deep spiritual relationship with Christ and in my study of the scriptures by a wonderful pastor who gave me my first communion, confirmed me, and married my former husband and me. That pastor took me under his wing and taught me so much. He challenged me to let my light shine, and by the age of 15 or 16 years, I knew that I wanted to go to seminary and that God had something very important for me to do in the church. When I told my mother that I wanted to go to seminary, she snarled, "What makes you think you're good enough to go to seminary?" I responded by saying, "Well, Jesus came for sinners, and I'm certainly one of those." Outwardly, it was a good answer, but inwardly, she had stirred up feelings of shame deep within me. I went on to college where I drank too much, used drugs, and fell into one relationship after another until I was nearly date raped. After that, I didn't date anyone for a long time, and then I met the man I would marry; he seemed perfect. But after six-and-one-half years of living with my perfect husband, I was in terrible emotional pain. My husband forbade me to go to church except on Christmas Eve and Easter morning, and then only one of those could be spent worshipping in the denomination that I had grown up in and loved so deeply. I was a spiritual wreck. I was searching for a new job, and while lost on my way home one June night in 1989, I found my former congregation. In the golden light of the setting sun, I saw this beautiful stone church with bright red doors across the road from a cow pasture. It reminded me of the church I'd grown up in and the love that I had known there. I pulled into the parking lot, and I prayed, "Lord, show me the way to go." We should be careful what we pray for--we might get it. I am here tonight because the pastor of that church sexually abused me. In September of 1990, I went to my former pastor and told him of my desire to go to seminary. His first question was, "Would your husband support this?" I began to cry and said, "No." He told me about an order of deacons in Baltimore and encouraged me to take their three-year program of classes because this would be a way for me to learn more about the church, the Bible, and God while I worked on the problems in my marriage, but he refused to sign my application for seminary because of my strained marriage. He began to schedule me as a communion and worship assistant. I began teaching a Sunday School class for adults and attending the pastor's Bible study on Wednesday evenings. I felt the joy of letting my light shine again, and I felt uncomfortable when his thigh would sometimes touch mine as I sat next to him in front of the entire congregation on Sunday mornings, but my deep, deep shame made me discount my thoughts. I was bad, as bad as I had been for not honoring the parents who abused me. How dare I even wonder whether the pastor had done such a thing on purpose? Also, my husband rarely touched me and had only unkind things to say to me, so it felt really good to be near my pastor who was teaching me so much. It felt really good until that warm summer evening in 1992 when I sat with tears streaming down my face telling him how I longed for my husband to hold me and to just touch me. As he slipped his hands inside the sleeves of my short-sleeved dress on to my shoulders, he said, "Sue, sexuality is a gift from God, and it's a sin that you're not using yours." Then he french kissed me. "You no-good, goddamned, dirty, rotten son of a bitch." "You filthy, dirty, little tramp." "It's a sin that you're not using yours." "Sexuality is a gift from God." "I just want my husband to hold me." "It's been years since I've been kissed like that; it felt wonderful." "This is wrong; I'm married. He's married; he's my pastor." "I need to be held." "What's wrong with me?" That night, the man I looked up to as a mentor, whose signature I had to have to get to seminary, and who I thought was truly nurturing my spirituality the way my childhood pastor had done took away the only place of safety and love that I had known in my life, but I didn't know that then. It wasn't until some nine months later on Palm Sunday 1993 when the church council president told me that the pastor had come to the church council and told them that I was pursuing him and that I would no longer be permitted to serve at worship or teach my Sunday school class that I realized I'd been abused. I told the church council president that I had seen the pastor naked. He said, "How dare you say that about my pastor?" That night, the pastor called me and said that he had told his wife and the bishop about my lies and that if I ever set foot in that building again that he would have me excommunicated. It was Holy Week, and I could not live without communion; so the next night, I went to the church in Baltimore where I was taking my deacon classes. The pastor of that church was in the sacristy. I went to the doorway and asked if I could attend services in his congregation. He looked confused and said that I didn't have to ask. I told him that I did have to ask because my pastor had said he'd excommunicate me if I ever came back. The pastor of the Baltimore church asked me why my pastor would say such a thing. I began to cry and said, "Because we had a sexual relationship. Well we never had intercourse, just oral sex because he said that having intercourse would mean that he had been unfaithful to his wife." The pastor and members of the Baltimore church have welcomed me and supported me in healing. I later learned that my former pastor had resigned from the clergy roster in lieu of facing sexual misconduct proceedings in another state in 1985. He was reinstated on the roster in Maryland in June or July of 1989, and I met him on Christmas Eve 1989. In the fall of 1993, I testified for hours in front of the bishop's advisory panel, which found that "boundaries that should prevail between pastors and members of that pastor's congregation were crossed." However, in my church, the bishop is under no obligation to follow the recommendations of his advisory panel, and he took no action against the pastor. I tried to appeal the bishop's decision not to take action against this repeat sex offender, but an attorney from the national level of the church said essentially that as a mere member of a congregation I had no right to appeal a bishop's decision. Backed into that corner, I filed suit in Howard County Circuit Court in March 1994. The pastor has denied his misconduct and filed a counter suit against me. In March 1995, one year after I filed suit, my bishop wrote the following article on sexual boundaries and mailed it to all of the clergy and lay leaders in two states:
When a friend of mine, angered by the bishop's article, wrote to him and revealed an incident that had once happened to her, the bishop wrote back to her saying, "The incident you related...was disgusting and inexcusable.... You could have slapped his face--about as hard as you could swing." I am deeply distressed that any Christian, but especially one in a leadership role in the church, would advocate committing assault and battery as a means of addressing the problem of sexual boundary violations. However, I am also deeply delighted that the bishop would commit such views to writing while involved in litigation on this issue. For me, healing began when I realized that the church is not God, and as St. Paul wrote in the first chapter of his letter to the Philippians, "I want you to know Beloved that what has happened to me has actually helped to spread the gospel.... Having been made confident in the Lord,...I...dare to speak the word with greater boldness and without fear." (Philippians 1:12, 14) Friends, the church is not God. We are told in Romans that "the Holy Spirit prays for us with sighs too deep for words." "And not only that, but we also boast in our sufferings knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not disappoint us because God's love has been poured into our hearts through the Holy Spirit that has been given to us." (Romans 8:26, 5:3-5) I attend services at the church in Baltimore where for the first two years I did nothing but sit in the pew and cry every Sunday morning. Now, however, my light is beginning to shine again. I created a Christian education program for the children in my new church home. I was set apart as a Deacon in the order--the three-year program took me five years to get through, but I made it. I minister to battered women and children in my new congregation, and I co-facilitate a support group for persons who have been sexually exploited by a helping professional. Through all of this, I have clung to the words in my favorite hymns, "It Is Well With My Soul" and "Oh Jesus, I Have Promised." But mostly, I have clung to Our Lord Jesus and the words he gave to his disciples in John 16:22 on the eve of his betrayal: "So you have pain now, but I will see you again, and your hearts will rejoice, and no one will take your joy from you." Friends, the church is not God. The church is a collection of broken, sin-filled human beings who can only love in ways that are limited and often limiting. However, like St. Paul, "I am convinced that neither death nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation will be able to separate us from the love of God in Christ Jesus Our Lord. (Romans 8:38-39) Let us pray. "Be near us Lord Jesus. We ask you to stay, close by us forever, and love us, we pray. Amen. Exploited by a clergymember |
Lost YearsI was a self-conscious 21 year old when I went to see the psychiatrist. As a direct result of his sadistic suggestions and put-downs, I quite literally lost my mind. I lost any connection to normal life. For 10 years I suffered from blinding confusion, depression, hideous nightmares, panic attacks, severe generalized anxiety, drug and alcohol dependence, and self-mutilation. I was unable to connect with others on a normal level because all of my conversations were cloaked in a desperateness that most people were uncomfortable with. My family and I were further alienated by their anger and mine as I continued to defend the man who had obviously cause me so much harm. The abuse by the psychiatrist ended in 1980. Then I started to deal with a legal system that failed me over and over. I found the system lacked any understanding of the devastating effects of this man's actions and that his title and money seemed to allow him to laugh at my efforts to stop him. Typically, my 20s should have been a period to learn about my adult self, but instead they were spent overcoming paralyzing despair. Most of the time, I can offset the shame and embarrassment I feel, attempting to accomplish those tasks that should have been accomplished in my 20s. I do this by reminding myself that I stayed alive, and I stopped drinking, smoking, drugs, tranquilizers, sleeping pills, and many other self-destructive behaviors. I now understand the horrendous impact that the psychiatrist had on my life and why that was so. That process has taken 15 years, is still ongoing, and without it I would feel no peace. Exploited by a psychiatrist |
LIST OF APPENDICES |
Appendices may be obtained by contacting
Alethea Brooks, Secretary
201 West Preston Street, Room 504
Baltimore, MD 21201
Tele