RESPONSIBILITY TO SOCIETY

ASTO members, both registered sex therapists and associate members, are knowledgeable, sex positive, ethical, and culturally competent sex therapists. They consult when necessary, monitor their practices, and participate in continuing education. They contribute to the discipline of sex therapy as well as laws and regulations pertaining to sex therapy. They promote the development of a sex positive and just society.

ASTO Sex Therapists:

Are also members in good standing of regulated health colleges and participate in self-regulation in the public interest.
Strive to be culturally competent when working with diverse populations.
Engage in ethical practice and monitor their practices to ensure the continuation of ethical practice.
Collaborate with and support colleagues and other health professionals in the best interest of clients.
Participate in continuing education in order to maintain the highest level of competence.
Devote a portion of their services for which there is little or no financial return.
Supervise responsibly in order to promote the continuation of the profession, assist in developing future competent and ethical ASTO sex therapists, and in the public interest.
Are engaged in developing laws and regulations pertaining to sex therapy that serve the public interest, and advocate for change when relevant laws and regulations are not in the public interest.
Engaged in contributing knowledge to the practice of sex therapy that serves the public interest.
Uphold provincial regulations and act according to ASTO policies when it is brought to their attention the unethical, illegal, or incompetent practice of another ASTO member.
Strive to use their power and privilege in ways that serve the promotion of a sex positive society.
Promote the development of an equitable and inclusive society in the interest of all individuals.
Do not provide services in a manner that discredits the profession or diminishes the public's trust in the profession.

SEX POSITIVE

ASTO Sex Therapists:

Are sex-positive, that is, we embrace mutuality and consensual and pleasurable sexual choices from an affirmative position of joy (Mazur & Libby, 1977 cited in Libby, Fisher & Nass, 1980).
Affirm that sexual well-being is an important aspect of personal well-being and health.
Reject any particular template of sexual “normalcy” in favour of the plurality of sexualities, sexual and intimate relationships that are consensual, mutually respectful, pleasureful and equitable (Reiss, 1990).
Aim towards a state of physical, emotional, mental, spiritual and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality, sexual desires and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence (In keeping with the objectives set forth by the World Health Organization ).
Support clients/patients in exploring the spectrum of sexual and erotic desires, behaviour and relationship styles.
Honour sexual, erotic, gender and relationship diversity. They strive for cultural competence and value inclusivity in dealing with sexual and gender fluidity.
Value and honour the capacity and right to sexual desires and pleasure in individuals from early childhood to old age, notwithstanding individual differences in health and abilities.
Affirm the right to the highest attainable standard of sexual well-being, with the possibility of pleasurable, satisfying, and safe sexual experiences. Everyone has the right to the highest attainable level of health and wellbeing in relation to sexuality, including the possibility of pleasurable, satisfying, and safe sexual experiences. This requires the availability, accessibility, acceptability of high quality health services and access to the conditions that influence and determine health including sexual health (WAS, 2014). Legal limitations will follow later in this document.
Above and beyond the right of clients/patients to confidentiality in sex counselling and therapy, ASTO sex therapists affirm that everyone has the right to privacy related to sexuality, sexual life, and choices regarding one’s own body and consensual sexual relations and practices without arbitrary interference and intrusion (WAS, 2014).
Support comprehensive sexuality education, including the skills of respectful sexual communication and negotiation.
Support our clients’ rights and capacities for sexual and reproductive autonomy and self-determination.
Support clients in exploring their own sexual values and making choices which honour their own integrity.
Affirm that each person has the right to control and decide freely on matters related to sexuality and their body. This includes the choice of sexual and reproductive behaviours, practices, partners and relationships with due regard to the rights of others. Free and informed decision making requires free and informed consent prior to, and throughout, any sexually-related testing, interventions, therapies, surgeries, or research (WAS, 2014).
Recognize that the right to pursue a healthy and happy sexual life applies to all individuals, and not just to those who conform to a particular body type, physical condition, or mental status. ASTO sex therapists believe that individuals with special needs or challenges, as well as with significant medical conditions, should be offered special support, and opportunity for sexual expression appropriate to their situation and circumstances.
Believe in the right of all individuals to be free to access erotic art, erotic performances, and to be free to utilize sexual accessories and media in their pursuit of a healthy sexual life.
Support the right of young people to access sexual information and pleasure.
Do not support sexual material that exploits young people. As outline in the criminal code: Criminal Code (R.S.C., 1985, c. C-46) http://laws-lois.justice.gc.ca/eng/acts/C-46/section-163.1.html

References

Mazur, R. (1980). Toward a sex-positive society. In R. Libby, M. P. Fisher and G. Nass. Sexual Choices. Belmont, CA: Wadsworth.

Reiss, I. (1990). An end to shame: Shaping our next sexual revolution. Buffalo, NY: Prometheus Books.

World Association for Sexual Health (2014). Declaration of Sexual Rights (revised). WAS Advisory Council.

CONFIDENTIALITY AND INFORMED CONSENT

ASTO sex therapists are compliant with the Personal Health Information Protection Act (PHIPA) of Ontario and have informed consent, privacy and confidentiality policies. These guidelines are also enforced by the regulatory bodies of each ASTO sex therapist. To learn more about PHIPA guidelines please visit the PHIPA Information and Privacy Commission website at www.ipc.on.ca.

ASTO Sex Therapists:

Have unique confidentiality concerns, as the “client” in the therapeutic relationship is often more than one person. Client confidences will not be disclosed without consent by each client in the therapeutic relationship. Exceptions are as permitted and/ or mandated by law (see # 4 for description of limitations*).
Shall inform clients and obtain client consent for audio and visual taping, third party observation and when team consultation is used as part of the therapeutic treatment. Consent must be obtained by the ASTO sex therapist if tapes are to be used for teaching, writing, research and public presentations purposes. ASTO sex therapists shall clearly document that consent has been obtained. A client can withdraw his/her consent at any time. ASTO sex therapists will follow PHIPA Regulations in securing digital files.
Shall maintain all records and reports must be in a manner that assures security for the time determined by ASTO sex therapists’ individual professional colleges. All records will be disposed of in a manner that maintains confidentiality.
Shall discuss the course of therapy, fees, informed consent and confidentiality with clients at the beginning of the therapeutic relationship. Specific to confidentiality, ASTO sex therapists shall disclose at this time to clients, the limits to privacy as governed by the law and their individual professional colleges. Such limitations include the ASTO sex therapist‘s duty to report a child in need of protection, a serious misconduct by a registered health professional, a client presenting as a risk to self or others and when client information is ordered released by the court. As governed by federal and provincial legislation and the requirements of our respective professional Colleges.

COMPETENCY IN PROFESSIONAL PRACTICE

ASTO sex therapists uphold the highest standards of professional practice and are defined by their dedication to professional excellence.

ASTO Sex Therapists:

Engage in ongoing professional development regarding new developments and best practices in the field of sexuality.
Maintain current knowledge regarding relevant legislation.
Do not provide service outside their competencies.
Take steps to ensure that clients are protected from possible harm when practicing new skills or in new specialty areas. ASTO sex therapists seek appropriate consultation where needed.
Make appropriate referrals if a client requests service that is outside the therapist’s scope of practice or competent practice.
Seek appropriate assistance for personal issues that may impair their work or clinical judgment.

INTEGRITY IN PROFESSIONAL PRACTICE

Moral, Ethical and Legal Standards

ASTO sex therapists shall act in accordance with the standards and guidelines for the protection of consumers promulgated by other professional associations to which the ASTO sex therapist is a member in good standing and the laws of the jurisdiction in which the ASTO sex therapist provides professional services to clients, students, supervisees and others.
ASTO sex therapists will act in accordance with ASTO ethics, standards and guidelines related to education, counselling, therapy, supervision and research.
ASTO sex therapists are aware of their influential positions with regard to clients, students and supervisees. ASTO sex therapists endeavour to avoid conflicts of interest and make every reasonable effort to avoid engaging in dual relationships that might impair professional judgement or cause harm to clients, students, or supervisees. Dual relationships include, but are not limited to, business or personal relationships with a client or a member of their immediate family, a student, or supervisee. ASTO sex therapists are obligated not only to declare a potential conflict of interest but to seek consultation from peers and supervisors to determine ways to avoid/minimize potential harm to clients, students, supervisees or colleagues.
ASTO sex therapists do not abandon their clients without making reasonable arrangements for the continuation of their treatment.
ASTO sex therapists shall be aware of and monitor the fact that their personal needs may influence judgements and actions in the therapeutic relationship and shall, regardless of experience or training, have a qualified review source such as a supervisor available to assist in safeguarding against unwise or inappropriate judgements and acts. Helpful reference: “Feminist Therapy Institute Code of Ethics”. In H. Lermann and N Porter (Eds) Feminist Ethics in Psychotherapy. New York: Springer Publishing, 1990.
ASTO sex therapists recognize that the right to pursue a healthy and happy sexual life applies to all persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, sexual orientation, gender identity, or relationship status. Individuals with special needs or challenges should be offered special support and the opportunity for sexual expression appropriate to their situation and circumstances.

Welfare of the Client

ASTO sex therapists shall also be held to a higher standard by our organization due to the particularly vulnerable position our clients, supervisees and students are in when accessing services and education related to sexuality.
ASTO sex therapists shall also be held to a higher standard by our organization due to the particularly vulnerable position our clients, supervisees and students are in when accessing services and education related to sexuality.
ASTO sex therapists recognize boundary concerns and power differentials in counselling and therapy relationships. As professionals, we reserve the right to our own sexual ethics, acknowledge where we differ from others and do not impose our values upon our clients/patients.
ASTO sex therapists shall be transparent about:
1. The nature of professional services available to the client with an explanation of mutual roles and duties.
2. Any financial issues, especially payment obligations of the client.
ASTO sex therapists shall not engage, attempt to engage or offer to engage a potential, current or former client or spouse/partner of that person in sexual behaviour whether the client consents to that behaviour or not. Sexual behaviour includes, but is not limited to kissing; sexual intercourse and/or touching by either the ASTO sex therapist or the client of the other’s breasts or genitals; sexual solicitation, physical advances, or verbal or non-verbal conduct that is sexual in nature, that occurs in the context of the ASTO sex therapist’s activities as an educator, counsellor or therapist. This includes such behaviours or actions that are experienced or seen by the client as either unwelcome, offensive, or creating a hostile workplace or educational environment and could be experienced by a reasonable person in a similar context as severe or intense.
ASTO sex therapists shall be aware that the ethical duty of the therapist prevails when the therapeutic relationship becomes sexualized and that their influence in the therapeutic relationship remains long after termination. Sexual involvement with a client or former client or their spouse/partner is likely to be harmful and is prohibited for two years after the termination of therapy and strongly discouraged thereafter. ASTO sex therapists need to consider whether or not this relationship has the potential to exploit or harm the client. The practitioner’s ability to be objective and unbiased in determining what is in the best interest of a former client and their spouse or partner is likely to be compromised. If a ASTO sex therapist engages in sexual intimacy with a former client or their spouse or partner more than two years after their last professional contact, the burden shifts to the therapist to demonstrate that there has been no exploitation, nor injury to the former client, their spouse or partner. The ASTO sex therapist shall consult with another ASTO sex therapist to explore the potential impact on the client. The ASTO sex therapist also has to be cognizant of the risk to the field/profession.

Welfare of Students, Supervisees, and Others

ASTO sex therapists shall, from the onset of professional contact with supervisees or students clarify the Registered member’s professional qualifications and competencies, the responsibilities and duties of all concerned as well as any financial obligations.
ASTO supervisors shall maintain in confidence personal information regarding a student or a supervisee. The provision of confidentiality does not preclude fulfilling a professional responsibility or duty to ASTO, consumers, educational or training institutions or programs, professional associations or governmental/regulatory or legal source.
Supervisees are advised that Supervisors, the Documentation Committee and possibly the Executive Committee will share concerns regarding their practice.
ASTO sex therapists shall maintain high standards of scholarship and present information that is accurate, relevant and timely in all administrative, educational and supervisory duties. Any conflicts of interest shall be disclosed to clients.
ASTO sex therapists shall keep meaningful records of all administrative, educational and supervisory activities.
ASTO sex therapists shall remain cognizant of the power differential that exists between themselves and a supervisee and will not harass in any manner a student or supervisee. An ASTO sex therapist should demonstrate zero tolerance for harassment of any associate ,registered member or client.

Advertising

ASTO sex therapists and associates accurately represent their education, training and experience in their advertising: business cards, websites, consent forms, public presentations, phone listings, etc.
Associate members must provide the appropriate disclaimer: I am currently under ASTO supervision, working towards becoming a Registered ASTO sex therapist. Participation in this process does not guarantee my becoming a Registered sex therapist.
Associate members can indicate they are sex therapists on their cards but cannot indicate that they are ASTO Associate Members on their cards.

Research

ASTO members act with integrity when constructing their research and in dealing with research participants. Reference: Tri- Council Policy Statement: Ethical Conduct for Research Involving Humans. Canada, 2014