Case library / Sexual boundaries
Eight years, one client, and four sessions on MDMA
In short
License surrendered
$7,826Trainee to intern to licensed private practice, with the same client throughout. License surrendered.
The controlled-substance provision has no clinical-context exception, which matters to every therapist working anywhere near psychedelic-assisted practice.
What happened
He treated the same client continuously from 2011, when he was a trainee, through his internship, to licensure and private practice in 2019.
Physical contact escalated over years: from hugs, to lying together on the couch with him holding her from behind in what the record calls a bear hug. On several of those occasions she was aware he had an erection.
Four sessions between 2014 and 2016 involved MDMA taken by both the therapist and the client, along with alcohol. During one, he removed her shirt, touched her breasts and kissed her.
Outside sessions he socialised with her, sought emotional support from her about his own life, and sent emails and text messages signed “Love, T.”
What it was charged as
Two separate counts — sexual contact with an intimate part, and improper physical contact.
Gross negligence.
Recklessly causing emotional harm.
Administering a controlled substance in a manner dangerous to another person. §4982(c) requires denial or revocation for anyone who uses or offers drugs in the course of performing MFT services.
The outcome
License surrendered.
$7,826ordered in cost recovery under B&P §125.3What the rule actually says
§4982(c) is the subdivision therapists working in psychedelic-adjacent settings should read most carefully. Its second sentence is mandatory: the Board shall deny or revoke for a licensee who uses or offers a controlled substance in the course of performing marriage and family therapy services. There is no clinical-context exception in the text.
Discussion
Analysis, not part of the decision
Eight years, one client, and a continuous therapeutic relationship that crossed a trainee registration, an internship and a license. There is no point in this timeline at which a new relationship begins; the decision treats it as one relationship, and every stage of it is inside the Board's reach.
The provision to read closely is §4982(c). Its second sentence is mandatory rather than discretionary: the Board shall deny or revoke where a licensee uses or offers a controlled substance in the course of performing marriage and family therapy services. There is no clinical-context exception in the text, no research carve-out, and no exemption for a substance the client asked for. Anyone practicing in or adjacent to psychedelic-assisted therapy should be able to recite that sentence.
The escalation is also a study in how physical boundaries erode without a decision ever being made. Hugs, then lying together on a couch, then contact the client could not mistake. No single step in that sequence looks like the step that ends a career, which is precisely why the sequence works.
Where insurance reaches, and where it does not
Nothing reaches this. Beyond the sexual misconduct exclusion, every therapist policy excludes criminal acts, and the administration of a Schedule I substance in session is one. A therapist practicing legally in a ketamine-assisted or state-licensed psilocybin context needs to confirm in writing that the policy names that modality — several exclude practice outside the profession named on the declarations page.
What would have changed it
- Eight years with one client through three levels of licensure is a structural risk, not a clinical one. Nobody with authority over the work ever saw it, because the supervisor changed each time the license did.
- Escalation cases almost never have a first bad act. Look for the first unusual act instead — the first hug, the first message signed with love — and treat that as the point where consultation was owed.
Questions
For a law and ethics seminar, or for yourself
- Read §4982(c) and identify every element the Board must establish. Which of them is contested in a case like this one?
- The relationship spanned trainee, intern and licensed status. What would each of those three supervisors or employers have needed to see to interrupt it?
- Is there any legal route in California by which a therapist could administer a controlled substance in session? What does your answer imply for a clinician recruited into a ketamine or psilocybin practice?
Source. This write-up is drawn from the signed public decision in the case number above. Names, cities and employers have been removed — why. To pull the original, open the Board's quarterly newsletter archive, find the issue covering October 24, 2024, and match the case number in the Formal Disciplinary Actions section. Not legal advice.
