Ethical issues regarding perpetrator involvement in the systemic treatment of incest

Using a systemic perspective to treat survivors of incest elicits the controversial question of whether to involve the perpetrator in the therapy process. Ethically, the therapist has a responsibility to ensure that the therapeutic process will do no harm to the client; therefore, involving the perpetrator may be contraindicated in some circumstances. Therapists may feel torn between determining what the most ethical practice is. This determination is affected by a wide variety of factors, and requires clinical judgment once these factors are understood. The article proposes the Incest-Perpetrator Involvement Checklist to guide therapists through the relevant issues that should be addressed prior to approving the perpetrator's inclusion in conjoint therapy with the survivor.