The State of California puts out an informational brochure for clients and therapists.
Shortly after founding Minnesota's Walk-In Counseling Center in 1969, Schoener and his colleagues noted frequent visits from patients who reported bad experiences with previous therapists.
Patients came to him in their darkest hours, going through divorce, struggling with substance abuse, perhaps grieving over the loss of a loved one. But while some call Albemarle County social worker Howard Vidaver a therapist of rare talent and insight, court documents suggest he has been betraying one of the bedrock rules of his profession by engaging in sexual contact with patients. If true, the allegations suggest that he violated therapist/patient trust– and that it happened after he had already been disciplined by the state licensing board for similar behavior.
In a divorce complaint filed last November in Albemarle County Circuit Court, Vidaver's wife, Laurie Vidaver, alleges her husband "engaged in acts of adultery and sodomy" with multiple female patients at various locations, including in his Charlottesville office, for more than 15 years.
"It's devastating," says Laurie Vidaver, reached by phone. "Several families have been torn apart by this."
According to experts, it's a serious problem. A 1991 study of 958 patients who had been sexually involved with a therapist found that about 90 percent of those patients were harmed by the experience– with about 11 percent requiring hospitalization, 14 percent attempting suicide, and one percent committing suicide.
Of those harmed, only 17 percent fully recovered, according to the study by Kenneth Pope and Valerie Vetter.
Currently, 23 states make sexual contact between patient and therapist an imprisonable criminal offense. Virginia is not one of them.
Since 1980, Howard S. Vidaver has been licensed to practice social work in Virginia. But that's not to say he's always been in good standing with the Virginia Department of Health Professions, which oversees the various counseling professions.
In April 2007, according to public disciplinary records, Vidaver was placed on supervised probation by the Board after he admitted to having sex with someone listed only as "Client A" over a period of three years, from 1999 to 2002. The acts allegedly occurred in his office.
The state responded by prohibiting Vidaver from treating individual female clients for a period of two years, although he was permitted to continue seeing couples. As part of his rehabilitation in the profession, he was required to meet with an approved supervisor once a month with an emphasis on some of the most challenging aspects of therapist/client relationships, including boundary issues and the topic of "transference."
Transferring the feeling
While many modern practioners eschew some of the teachings of the famed Austrian psychoanalysis pioneer Sigmund Freud, one of his concepts still widely embraced is "transference," a process by which a patient redirects personal feelings onto the therapist. While those feelings can include anger or jealousy, often they're feelings of being in love– and a therapist must be vigilant, says local clinical psychologist Sherry Kraft.
"There is a vulnerability that is always a potential in these relationships," says Kraft, citing in particular the risk to patients who may already be feeling lonely or isolated. The therapist, she explains, is "a person whom you see regularly, who devotes their entire attention to you, who knows things about you that you have not been comfortable sharing with the outside world and sometimes even with family members."
Such close feelings, however, must not be mistaken for a personal relationship.
"The intimacy there is somewhat artificial," says Kraft. "It's a professional relationship."
Or should be.
Problems can arise, Kraft says, if the therapist fails to recognize and appropriately deal with the feelings. Ethics codes of organizations such as the American Psychological Association require a therapist to immediately refer the patient to another practitioner if they recognize their own version of those feelings: "countertransference."
Trouble can begin when a therapist fails to recognize countertransference, and the private nature of the therapist/patient interaction, Kraft says, increases the risk of unethical behavior.
"When you go to a doctor's office, there's a nurse there to protect the doctor against some of these issues," explains Kraft. "In therapy, there's no one else there."
When a transgression is reported and verified in Virginia, the professional sanction is often "supervised probation." But that supervision comes in the form of private meetings between the therapist and someone appointed by the licensing agency. The therapist can continue to see his patients alone, an opportunity to continue the behavior.
And that, according to Laurie Vidaver's November 10 divorce complaint, seems to be what happened with her husband.
Back in practice
When the Virginia Board of Social Work reinstated Vidaver's full unrestricted license in June 2009, a letter attested that he had complied with the terms of his two-year probation and closed with kind words.
"The board wishes you well in your future endeavors," wrote Patricia Larimer, deputy executive director of the Board.
According to the divorce filing, however, at least some of his future endeavors remained problematic. The "adultery/sodomy" that his wife alleges in her complaint began in 1995 and "continues to this day."
While patient records are confidential, the divorce filing takes the unusual step of naming one female client with whom Vidaver allegedly has had repeated sexual contact.
Laurie Vidaver and her attorney, Chris Smith, declined to say how they learned so much about the alleged conduct, but Hook legal analyst David Heilberg says he believes they must have evidence to back up the claim made in their legal complaint.
"I wouldn't put that out there unless I was quite certain," says Heilberg.
Reached for comment, the client– whom the Hook is not naming in keeping with its policy regarding victims of alleged sexual assault or abuse– confirmed that an investigation is under way but declined further comment. Vidaver did not return a reporter's call.
And Vidaver's attorney, Ron Tweel, noting that the social worker would not be commenting, declines to add anything. But in his court-filed response to the allegations, Vidaver pleads the Fifth Amendment, the part of the Bill of Rights that protects individuals from testifying against themselves.
A reporter was able, however, to make contact with two of Vidaver's former clients (the reporter, who saw him, quite uneventfully, for just a single session about two years ago, is also a former client).
"He was the third therapist we saw, and he was insightful in a way that the other therapists were not," says one former patient. Requesting anonymity, she says she met with Vidaver for treatment over several years both in individual and in couple's counseling. "He made a real difference in our lives," she adds.
Another former patient, calling Vidaver "gifted," says they worked out a variety of personal problems over several years prior to 2007. Learning of the latest allegations, however, she says she believes there were times he pushed ethical boundaries.
"He cried on a couple of occasions," she recalls, describing an emotional involvement which felt "almost like I had a relationship with him, like he was a player in my life." During another session, she says, Vidaver asked if she'd chosen her outfit specifically for him. "He didn't maintain the professional distance I would have expected," she says.
As for Larimer, the Board member who wished Vidaver well upon closing the state's disciplinary case, she says she can't comment, asserting that any investigation cannot be discussed until it's complete.
The policy, while protecting therapists who may have been falsely accused, can leave current and prospective patients unaware that the therapist they're seeing may have engaged in unethical behavior.
And that worries Jan Wohlberg, founder of TELL, the Therapy Exploitation Link Line, a website that supports victims of therapy abuse. Noting the 15-year span of the new allegations and the November filing of the divorce complaint, Wohlberg says that patient safety demands a prompt response.
"I think 90 days is enough to complete an investigation," she says.
While noting the right of accused therapists to due process, Wohlberg is one activist eager to help victims with a problem that's more widespread than some realize.
A 1995 paper published in the Journal of Contemporary Health Law and Policy claims that while patient/therapist sexual contact is already considered a punishable ethical breach by all major oversight organizations, seven to 10 percent of male therapists and one to three percent of female therapists have engaged in it.
"We get about 41,000 individual visitors to our website each year," says Wohlberg, "and our website is not even that easy to find."
A former professor at Boston University, Wohlberg has dedicated much of the last three decades to helping victims, and she says the effects of such behavior can be "horrendous."
She has reason to know.
In 1972, at the age of 31 and with two young children, she lost her husband to a workplace murder. Soon after, she began grief and depression treatment with a psychiatrist she had previously consulted.
"He manipulated me," she says, and the two ended up having sex in his office during her scheduled sessions.
"He was charging my insurance, and I was paying him," notes Wohlberg, pointing out the potential insurance fraud (although he was never charged with a criminal offense).
She reported the errant therapist, but she says the ensuing investigation took more than two years. And after the Massachusetts medical board stripped him of his license to practice in that state and ordered him to reimburse her, Wohlberg says, the man moved to California and set up shop.
In the mid-1980s, Wohlberg shared her story with a similarly abused friend and, along with several other victims of alleged therapy abuse, they founded TELL in an effort to provide information and support.
The main message that she and TELL's dozen volunteers from around the world impart: "Sex is not a part of therapy," she says. "You could be a prostitute, naked and begging for sex, and it's still the therapist's responsibility to set boundaries."
Illegal or just unethical?
Even if it's widely accepted that therapists shouldn't have sexual contact with their patients, should it be illegal? Clinical psychologist Gary Schoener says yes.
"It's criminal sexual conduct," says Schoener, a nationally renowned expert in therapy sexual abuse who notes that 23 states already have laws on the books, and 22 make it a felony.
"It's rape, and the reason is the nature of the relationship," says Schoener. "The ability to manipulate is extraordinary. They know your secrets."
He says the emotional intimacy is way too deep and the power differential way too lopsided to portray it as two consenting adults.
"You can't have valid consent," says Schoener, "because of the distortion in the mind of the client through transference."
As for any notion that only "weak" people can be manipulated, Schoener recalls a case in which the legal counsel for a Fortune 500 company was frequently excusing himself from important meetings to call his female therapist, with whom he was having sex.
"He got to the point where he was getting advice from her about what to tell the company's executives," says Schoener, who says he has also assisted corporate bosses and judges who've been victimized.
"These are people who are high-powered in the rest of their lives," he says, "but that doesn't mean that in that relationship you can't be controlled."
If Schoener is firmly in favor of criminalization, TELL's Wohlberg says she's less eager to jail offenders.
"My number-one concern is for victims," she says. "People who've been victimized are often very confused about their feelings towards the perpetrator. I worry, given the ambivalence that most victims have, that criminalizing will drive it further underground."
"The prosecutor can't bring a criminal case without a victim's cooperation," Schoener responds, adding that "offering victims more options is always beneficial."
Could therapist/client sexual contact be criminalized in Virginia? Delegate David Toscano did not return a reporter's call, and Delegate Rob Bell says no one has approached him.
"I'd be willing to consider it," says Bell, posing various questions about how a criminal offense might be defined.
Would it refer only to intercourse? Would it apply to all counselors, even those who aren't licensed? How long after treatment terminates would sexual contact between the therapist and former patient be criminalized? And, Bell asks, is it even necessary– could existing laws protect patients?
Schoener says that states that criminalize such conduct limit it to intercourse between a therapist and any patient and generally define it as occurring within two years of termination of the treatment. He says that other criminal laws can't protect therapy clients– unless they're minors or mentally incompetent.
"There was one case," says Schoener, "where the therapist terminated therapy, and then the two of them immediately drove to a hotel."
While Schoener favors felony charges and permanent loss of their license for many therapist offenders, especially repeat offenders, he says each case deserves individual scrutiny. There are times, he says, when the therapist should be rehabilitated– such as one he saw suffering through a personal crisis and depression.
"His life was caving in," says Schoener, "and he became enamored of a client. In one session with her, he kissed her, hugged her, touched her breast, then pulled himself off, terminated treatment, and reported himself." (The therapist received treatment, abided by his sanctions, and was able to return to practice, Schoener says, in a healthier frame of mind.)
Unfortunately, he says, such one-time offenders aren't as frequent as the serial predators– and even in serial cases, the severity of the offenses can range widely.
For decades, Northern Virginia psychiatrist Martin Stein abused his patients, sexually and by overprescribing medications, and also engaged in bizarre and unapproved treatments that resulted in false recollections of past sexual abuse by family members. As detailed in several reports in the Washington Post (and noted in the Hook's October 16, 2003, cover story), one patient died of a prescription drug overdose, and others suffered brain damage from the dozen or more medications Stein had pushed.
Most cases of therapist abuse, however, are far less dramatic even as they devastate lives.
Moving past abuse
If a person has been victimized by a therapist, the last thing they may want is to find another therapist. But according to TELL's Wohlberg, that's exactly what must happen.
"It's critical to find an ethical therapist who can help you recover," she says, noting that the majority of licensed professionals have not transgressed. Understanding that it is never the patient's fault is also critical not only for the victim's recovery, but also for anyone else who may have been harmed– such as a patient's spouse.
Schoener says he explained to one man devastated by his wife's sexual involvement with her therapist: "It's not an affair; your wife is the victim of a felony."
Even in states like Virginia, which don't criminalize the practice, the damage to victims and their families can be severe.
"We have people who've killed themselves," says Schoener.
Laurie Vidaver says she understands those consequences and says she too struggled after her husband's earlier transgression with Client A– something she believed had been a one-time thing.
"I was hoping for the best," she says,"trying to keep my family together."
Faced with evidence that her husband's behavior continued, she says she felt she had no choice but to file for divorce.
"It's totally unethical," she says. "It's victimizing people and taking advantage of vulnerable people who see him for help."
As for the former patient who recalled Vidaver shedding tears during appointments, she says she finds the allegations against her former therapist "revolting," but she notes that they reinforce at least one of the important lessons he imparted during couples counseling sessions for her and her now ex-husband.
"He taught us about 'duality,'" she says. "It's the idea that two things can be true about a person."
The latest allegations against Vidaver, she says, suggest "duality" is in play in his own life.
"He can be a brilliant therapist," she says, "and also be a deeply flawed individual."