Understanding Sexual Abuse

What is sexual abuse?

For health care providers in Ontario, the Regulated Health Professions Act (RHPA) defines sexual abuse not only as sexual intercourse with a patient, but also touching or remarks of a sexual nature directed towards a patient.
What does this mean?

It means a physiotherapist is not allowed to:
  • have sex of any form with a patient
  • touch a patient in a sexual way
  • make comments of a sexual nature or behave in a sexual way towards a patient
Please note that this does not apply to touching, behaviours or comments that are of a clinical nature and are appropriate to the care provided.

The College of Physiotherapists of Ontario exists to protect the interests of the public and sees any form of sexual abuse or sexual boundary crossing as unacceptable. Sexual abuse must never be tolerated.  

What can a patient do if they are feeling uneasy during a therapy session? 

  1. Tell the physiotherapist to stop. 
  2. Ask the physiotherapist to explain what he or she is doing and why he or she is doing it. 
  3. Refuse to continue with the therapy if feeling uneasy.

If you think that you or someone you know has been sexually abused by a physiotherapist, please contact investigations@collegept.org or call 416-591-3828 ext. 227 or 1-800-583-5885 ext. 227.

What is appropriate touching?

Physiotherapists use their hands to touch various parts of the body to assess and provide treatment to patients. When touching occurs as part of your therapy you can expect that:

  • the physiotherapist will tell you what he or she is going to do before touching you
  • the physiotherapist will ask your permission to touch you
  • you will be allowed to ask questions or express any concerns
  • you will feel respected
  • the touching will be needed for your treatment
  • you can ask that an activity be stopped at any time if you are feeling uneasy
  • you can withdraw your consent or change you mind about the activity at any time 

Understanding the relationship between patient and physiotherapist/physical therapist—the therapeutic relationship

The relationship between a patient and a physiotherapist is a professional one that is all about a patient getting the needed care or therapy from a professional. This is called a therapeutic relationship. 

Patients trust their care to a physical therapist because of their unique knowledge and skills. Patients should expect that the physiotherapist will respect their needs and act in a caring and professional manner.

A therapeutic relationship is very different than an intimate personal relationship. If a therapeutic relationship exists, physiotherapists are not allowed to have an intimate personal relationship with a patient. This does not mean that the physiotherapist will not be friendly and interested in you as a person, but it does mean that the physiotherapist should not develop an intimate personal relationship with you in or out of the clinic or practice setting, while you are a patient. In fact, to do so could be defined as sexual abuse, even if you consent to the relationship. The physiotherapist is the one responsible for maintaining an appropriate relationship with patients. 

The College has rules called standards that describe how physiotherapists are expected to behave in order to show that they are acting in the best interests of their patients. 

To access these standards, visit the Standards or contact the College's Practice Advisor at: 416-591-3828 ext. 241 or 1-800-583-5885 ext. 241 or at practiceadvice@collegept.org

How to recognize sexual abuse

Because of the way that sexual abuse of a patient is defined in the law, it is difficult to describe exactly the kinds of actions that might be considered to be sexual abuse of a patient by a physiotherapist. Many times it depends on the situation. What one person finds friendly and kind, may seem too casual or intimate and make another person uncomfortable. Each person's level of comfort with physical contact and informal ways of speaking can be different.

The list below includes some examples of actions or behaviours that are likely inappropriate on the part of the physiotherapist. These behaviours can be obvious or subtle and words can be as damaging as actions. Contact the College if you experience any of the following with your physiotherapist:  

  • Any unwanted sexual attention or behaviour, for example kissing or hugging in a sexual way.
  • Sexual touching, for example touching your buttocks, breasts, genitals or any other areas in a way that is not needed for therapy.
  • Sexually suggestive or seductive  remarks, for example, comments about your sexual relationships or sexual orientation or inappropriate sexual remarks or questions about your appearance or clothing. 
  • Sexually insulting or offensive comments or jokes.
  • Asking to meet you outside the clinic or practice setting or to have an intimate, personal relationship with you—for example, dating.
  • Not asking for permission before touching you.
  • Anything that makes you feel uneasy. 

What should you do if you suspect sexual abuse by a physiotherapist?

If you suspect that you or someone else is being sexually abused, contact the Professional Conduct:

investigations@collegept.org
416-591-3828 ext. 227 or 1-800-583-5885 ext. 227

Don't assume that someone else will report the physiotherapist and don't worry if you are mistaken. It is important that College investigates these situations. 

Please know that it is not your fault. The physiotherapist is responsible for understanding and maintaining an appropriate, therapeutic relationship. Tell someone you trust, for example, another health care provider, a family member, or someone at the College. 

The College Practice Advisor can talk to you about what is expected of a physiotherapist. You can reach the Practice Advisor at 416-591-3828 ext. 241 or 1-800-583-5885 ext. 241 or practiceadvisor@collegept.org.  

A member of the Professional Conduct team can assist you in understanding what action can be taken and can accept a complaint made about a physiotherapist. Contact investigations@collegept.org or  416-591-3828 ext. 227 or 1-800-583-5885 ext. 227.

Complaints and accusations can be uncomfortable but it is important that the physiotherapist be held accountable for his or her actions and the impact on patients. It can also assist with learning and protects others from harm. 

Green arrow boxLearn more about making a complaint here. 

If you have been sexually abused by a physiotherapist you may be eligible for funding for any therapy or counselling that is needed as a result.

Green arrow boxLearn more about funding for therapy and counselling related to sexual abuse.