From the Burlington Free Press
When Jill Davis began therapy with psychologist Monica Descamps, she wanted help dealing with mild anxiety and stress.
Instead, the Norwich therapist, in violation of codes of medical ethics and sacrosanct tenets of the doctor-patient relationship, initiated a nine-month affair that left Davis severely depressed, hospitalized and suicidal, according to a series of formal allegations against Descamps.
The accusations have prompted a million-dollar lawsuit against the psychologist in federal court in Burlington, a complaint and critical finding by the Vermont Board of Psychological Examiners, a six-month suspension of Descamps' license, and strict conditions on her reopened practice.
"Descamps breached her continuing duty as a psychologist," reads a section of Davis' lawsuit, "by violating professional boundaries that should have properly existed."
Davis, a New Hampshire woman in her 40s, is seeking a jury trial and "fair, just and adequate" compensation: the $1 million limit of Descamps' insurance policy, according to the lawsuit and other court papers. The case is proceeding in federal court in Burlington because the dispute involves residents of two states.
Such conduct, which is prohibited by major associations of medical and mental-health professionals, occurs rarely but can be serious and detrimental, experts said.
"The power is entirely in the hands of the clinicians, and even more so in psychiatry, because they're probing into such intimate areas," said Robert Macauley, medical director of clinical ethics at Fletcher Allen Health Care in Burlington. "The potential for harm for the patient and even the therapist is so great. This is violating a really core principle."
Descamps has admitted her improper conduct -- she turned herself in to state regulators -- but is contesting the amount of money her former patient and lover is seeking. Descamps disputes the characterization that her actions were as detrimental as Davis claims, said her attorney, Eric Poehlmann of Burlington law firm Downs Rachlin Martin.
"Yes, that did happen, and obviously it was improper, but she stepped up to the plate at the end," Poehlmann said. "She cut off the relationship. She self-reported to the professional conduct board."
Lawyers met with a judge this month in U.S. District Court in Burlington for a hearing about a dispute involving settlement negotiations. Davis' attorney has accused Descamps' insurance company of negotiating in bad faith. The firm, Ace American Insurance Co. of Philadelphia, is arguing that Descamps' policy offers no coverage for "licentious, immoral, amoral, or other behavior which led to or culminated in any sexual act," company lawyers wrote in their own court papers.
A hearing on that issue is scheduled for early May, but the question of whether Ace must pay a potential verdict against Descamps is unlikely to affect the underlying case. "That will be litigated at some point in the future," said Davis' attorney, John Maley of Burlington firm Sylvester & Maley.
A trial could begin as early as June.
Ethical prohibitions
Affairs between doctors and current patients violate codes of conduct from the American Medical Association, the American Psychological Association and the American Psychiatric Association. The Medical and Psychological associations also discourage sexual relationships between doctors and former patients and require two-year "waiting periods." The Psychiatric Association prohibits such contact at any time.
"The necessary intensity of the treatment relationship may tend to activate sexual and other needs and fantasies on the part of both patient and psychiatrist, while weakening the objectivity necessary for control," reads a passage of the Psychiatric Association's policy. "Additionally, the inherent inequality in the doctor-patient relationship may lead to exploitation of the patient. Sexual activity with a current or former patient is unethical."
A 1995 study published in the journal Canadian Psychology found that male mental-health practitioners violated those rules nearly five times more often than their female counterparts. The study said 1.7 percent of female and 8.3 percent of male psychologists and psychiatrists reported having sexual contact with a client.
Macauley, the Fletcher Allen medical ethicist, said the Descamps case is the first Vermont incident he's heard of involving sexual contact between a therapist and a former patient. Macauley, who also teaches at the University of Vermont and advises his students "never ever ever" to have a relationship even with a former patient, said doctors hold more power in relationships with patients, and people who seek counseling can transfer their feelings for someone else in their lives to the therapist.
"It raises the question of: Could the relationship be consensual, because is the person the patient is in love with the psychiatrist or the other person?" Macauley said.
The allegations
In Davis' case, according to her lawsuit, she sought counseling with Descamps in February 2003 for treatment of "low-level anxiety resulting from starting osteopathic school and her long-time partner's illness."
The partner, whom the lawsuit does not identify, died that November. Davis, depressed over the death, continued therapy with Descamps until February 2004, when the psychologist ended counseling and initiated a romantic relationship that lasted nine months, according to the lawsuit and findings from the professional conduct board.
During therapy, Descamps failed to manage the transference of Davis' feelings, and also her own "counter-transference," according to the lawsuit, which was filed in May 2006. Descamps also shared with Davis details of the lives and troubles of some of her other patients, violating their right to privacy, the professional board determined.
As a result of the relationship, the complaint contends, Davis suffered post-traumatic stress disorder, major anxiety attacks, sleeping problems, depression and thoughts of suicide. Davis requires ongoing hospitalizations, medication and extensive psychiatric care, according to the lawsuit.
Poehlmann, Descamps' attorney, said the scope of Davis' injuries will be a central issue at trial. For instance, the defense argues Davis already was enduring PTSD when the relationship began.
"A lot of her complaints are the exact same thing she had been suffering before," Poehlmann said. "It's hard to tell how much of that is the result of Dr. Descamps' conduct. Essentially, we're saying, 'You had it before, and how much worse did Dr. Descamps make it?'"
Descamps, a 1989 University of Vermont graduate who is in her 40s, declined to comment. Maley, Davis' attorney, declined to say how his client is doing or to comment on the substance of the allegations.
The Board of Psychological Examiners took up the case in September 2005 and issued an opinion signed Feb. 1, 2006, concluding Descamps engaged in unprofessional conduct. The board suspended the psychologist's license for two years but stayed all but six months of the term. The suspension began in July, and her license was reinstated Jan. 1, according to information from the Secretary of State's Office.
As part of the board's decision, Descamps also was required to enroll in three graduate-level courses: one about professional boundaries, another on ethics, and a third on client confidentiality.
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