Understanding Sexual Abuse

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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 your 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 that describe how physiotherapists are expected to behave in order to show that they are acting in the best interests of their patients. Please read the Boundaries and Sexual Abuse Rule.

    To access these rules, 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.
    • 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 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. 

    Learn more about making a complaint here

    Bill 87, Protecting Patients Act, 2017: Learn More

    Community Resources for Victims of Sexual Abuse

    The Ontario Network of Sexual Assault / Domestic Violence

    Treatment Centres: A network of 35 hospital-based centres throughout Ontario

    Locate a Centre

    Women’s Shelters

    A list of women’s shelters across Ontario  eMentalHealth.ca: View List

    A map and list of Ontario women’s shelters Sheltersafe.ca: View List and Map

    Women’s Sexual Assault Networks

    Anonymous and confidential 24/7 telephone and crisis line
    GTA: 416-863-0511 or Toll Free: 1-866-863-0511
    www.awhl.org

    24/7 hotline for francophone women living in Ontario
    1-877-336-2433

    www.femaide.ca


    Contact information for several 24-hour helplines & information about legal steps
    Get Support

    Specific Populations

    Available to call 24/7 and has the contact information of centres all around Ontario (includes helpline for children and  Aboriginal women)
    Look for Support Near You

    Available to call 24/7 with information on services around Ontario (Children, Elder Abuse, Men, First Nations)
    Abuse Hurts.ca

    Distress Centres

    24/7 support in Toronto (includes suicide prevention)
    416-408-4357

    Get Support

    Funding for Sexual Abuse

    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.

    Learn more about funding for therapy and counselling related to sexual abuse

    Spouses are Not Exempted from Sexual Abuse

    Learn More

     

    Boundaries and Sexual Abuse Standard

    Read the Standard Now

    Contact the Physiotherapy Information Advisor

    You are NOT Alone. The College is Here to Help

    If you or anyone you know has been a victim of sexual abuse, the College is here to help. Please contact the Physiotherapy Information Advisor to explore your options and get help. Contact practiceadvice@collegept.org or 647-484-8800 or 1-800-583-5885.

    Email the Physiotherapy Information Advisor

    Make a Complaint

    Contact the College: Investigations

    Contact us if you think that you or someone you know has been sexually abused by a physiotherapist. Email investigations@collegept.org or call 416-591-3828 ext. 227 or 1-800-583-5885 ext. 227

    Make A Complaint