When Jo Adams was referred to the counsellor at her GP’s surgery, she expected to be given help for her severe depression. But that was not all she received. During the six sessions, her counsellor paid her a number of suggestive compliments. In her desperately ill state, they gave her a boost. “They put me on a false high, even though I’m happily married,” says the 35-year-old, who works in sales. “He made me laugh when I was suicidal. I felt I couldn’t do without him and if he went out of my life I would go back to the hell of depression I had known.”

When the sessions ended, she wrote to him to express her gratitude for helping her. For several months the pair exchanged letters. The counsellor, who was 20 years her senior, poured out his troubled personal life. One day he turned up at her doorstep and they embarked on a four-month relationship. As they kissed and cuddled, he would try to pressurise her into having sex, though she always refused. “It was all very manipulative,” she says. “He kept saying it was OK, but I knew it wasn’t. I felt powerless. I was very vulnerable. I was so ill, and saw this man as a way out of my depression. I thought I loved him.”

Ms Adams had a breakdown and told her husband. It was the first time in 20 years that she had seen him cry. She told the counsellor it had to stop, and a month later, following another mental collapse, she told a doctor at her surgery what had happened. “I was even more depressed than when I had gone to see [the counsellor],” says Ms Adams. “I was suicidal again and had to have someone with me for 24 hours a day for nine months. I blamed myself for a long time. I had a lot of self-hatred. It put my recovery back at least three years.” Two years later, she is still on medication.

The charity Witness, which supports people who have been abused by health and care workers, believes the problem of sexual abuse by counsellors to be so serious that earlier this spring it held a conference on the subject, called Broken Boundaries: Sexual and Non-Sexual Boundary Violations in the Psychological Therapies.

“There is a lack of awareness and attention to the issue on the part of practitioners and professional bodies,” says the charity’s chief executive, Jonathan Coe.

“If a therapist is struck off they are legally still allowed to practice. So for even the worst offences there is currently no enforceable sanction. At the moment anyone can set up as a therapist, even without training or experience.”

The only UK study of therapist-patient sexual conduct found that 3.5 per cent of therapists admitted sexual contact with patients. However, Birmingham psychologists Drs Tanya Garrett and John Davis, who conducted the survey of 581 clinical psychologists, think the true figure may well be higher. Almost a quarter of the respondents reported having treated a patient who had been sexually involved with previous therapists. And nearly two-fifths knew of other clinical psychologists who had had sex with patients. “We know that it’s likely that reported levels of abuse by professionals are lower than the actual levels,” says Dr Garrett, who estimates the real figure to more likely be 6 or 7 per cent.

Most perpetrators are men and their victims female. There have been incidents of same-sex pairings, as well as adults sexually abusing child patients. The Birmingham psychologists found that therapists who had themselves undergone therapy were more likely to have sex with patients, and that single or divorced therapists were more likely to start a sexual relationship than married ones.

Research has also found that victims often suffer from borderline personality disorder. Typically they have been sexually abused, and may be over-demanding and have intense relationships because they fear being abandoned.

The impact on patients can be devastating. Some are so traumatised they attempt suicide. Often they are re-hospitalised. Research also suggests they can be vulnerable to being abused again by another mental health professional.

Even if a counsellor belongs to a therapeutic association, has a fancy address and is endorsed by celebrities there is no guarantee he or she will behave honourably. Last year therapist Beechy Colclough, whose clients have included Elton John, Michael Jackson, Robbie Williams and Kate Moss, was exposed for having affairs with women patients in his Harley Street consulting room. One of his victims, Janet Bell, started seeing him in private practice in 1999 for binge drinking. After six months he offered to massage her shoulders when she complained of a bad back. The massages became more intimate. After about a year of therapy they had sex for the first time. “I was lying naked on the floor on big square cushions and he was massaging me,” she says. “He just did it, and I didn’t try and stop him. I should have ended it there and then, but, bizarrely, his wanting to have sex with me made me feel special. I was so in need of affection at the time, I think I would have taken anything.”

They had sex during most sessions until the end of 2002, when she texted him to say she was not coming back. She never heard from him again. She filed a complaint with the British Association for Counselling and Psychotherapy (BACP). He is no longer a member. “What he did is little better than abuse or rape,” she says.

Doctors can be struck off for having a sexual relationship with a patient. Last October the rules were tightened further when the General Medical Council issued revised guidelines stating that having an affair with a former patient would almost always be viewed as inappropriate, no matter how much time has elapsed since treatment ended. But it is anticipated that counselling and psychotherapy will not be subject to statutory regulation until 2008. In the meantime, while a therapist’s membership of a professional body may be terminated, there is nothing to stop them nailing a new plaque to their front door the following day.

The Council for Healthcare Regulatory Excellence (CHRE) is currently running a one-year project, funded by the Department of Health, to find strategies to minimise abuse of patients by healthcare practitioners. “Professionals will throw back the claim that ‘the patient came onto me’. The theme that runs through all of the sets of guidance is that it’s absolutely and always the professional’s responsibility to set and maintain the boundaries,” says Professor Julie Stone, who heads the CHRE project.

With support from Witness, which has been calling for statutory regulation for over 15 years, Jo Adams reported her counsellor to his governing body, the British Association for Sexual and Relationship Therapy. He is no longer a member. Ms Adams has also started legal proceeding against him in the civil courts. “I know there are lot of people who are suffering in silence. There is help out there,” she says.

Some names have been changed

When healers do harm

* Psychologist Dr Steven Manley, who had sex with a patient claiming it was therapy, was suspended from the British Psychological Society for three years in 2005. He met the woman, known as Mrs W, in a car park. She said he “brainwashed” her into thinking it would help her and charged her £35 for the sessions.

* Colin McLean-Manning was jailed for a year in 2004 for indecently assaulting 12 patients. The mental health nurse got a sexual thrill from brushing their hair and rubbing himself against them. He has since been struck off the nursing register.

* In December 2006 the British Psychological Society suspended Gemma Bouwman for three years after she confessed to a sexual relationship with a former client, Mr JG, who was said to have problems relating to physical and sexual abuse he suffered as a child.

During one of their sessions, he told the psychologist he wanted to have an affair with her. She eventually discharged him so they could see each other non-professionally. She was sacked by the NHS following an internal investigation.

To contact Witness call 08454 500300