Clinical Practice Guidelines for Working with People with Kink Interests Published!

by Richard Sprott, Ph.D.

For many years, therapists and counselors who worked closely with the BDSM/kink communities
—on the front lines of helping people who are kink-identified or practicing BDSM—have often served in relative isolation. They have honed their clinical judgments and approaches, figuring out what works and what is harmful when working with kink-involved clients, often with little feedback or support.  There have been a few important publications of these insights and calls for further work in this area have come from various corners of the mental health field.

However, the past few years have seen significant changes in the public awareness of kink and BDSM in Western English-speaking countries and in the field of mental health. There are more and more people finding their way into kink and BDSM.  There may even be a decline in the power of the stigma attached to these sexualities. There is also more demand and more opportunities for specialized training in working with kink/BDSM involved clients and patients in the field of mental health.  The kink/BDSM communities are significantly underserved and face similar health disparities that affect other sexual minority communities.

As these changes unfold, though, there are new challenges, and new opportunities. One challenge is being able to assess whether or not a counselor or therapist has the knowledge, skills and attitudes that embody affirmative care for kink-identified clients.   One opportunity is that we have enough critical mass and momentum, in terms of clinical experience and in terms of research, to start to articulate what competent care might include.

The Kink Practice Guidelines Project started in the spring of 2018 and has had the goal of producing clinical practice guidelines for mental healthcare providers working with kink/BDSM involved patients and clients.  We wanted these guidelines to reflect the best clinical judgment and experience, and the most up-to-date empirical research that we can gather.

By creating these guidelines, we hope to move the entire field of mental health further towards providing competent care to these people we care so much about.

Practice guidelines are aspirational.  They are meant to articulate goals and standards that professionals can strive for, to guide their own professional development and to increase the quality of services they offer.   

We are conscious of the struggles around language, culture and diversity.   We want it to be clear that any practice guidelines we create are going to be limited by our particular cultural positions, and  will miss  some important issues. The guidelines may not apply easily, or sometimes at all, to some portions of the kink / BDSM communities or populations around the planet.

Still, we feel this is a good  time to start  that  journey,  to make  space for those larger conversations, by first putting  together and  articulating to the best of our abilities a statement about compassionate, caring  and  competent therapy for kink-identified or BDSM-practicing people. We look forward to your feedback and engagement in this important area of clinical practice.

If you would like to learn more about this document and what is means for your practice, KPACT will be rescheduling the KPACT education event on Friday, April 17, for a KPACT educational event Intro to the 2020 Clinical Guidelines for Clients with Kink Interests. We do look forward to finding a new date for this important event later in the year as the COVID19 crisis eases. FOR MORE INFO. Please check the KPACT website for updates.


Richard Sprott received his Ph.D. in Developmental Psychology from UC Berkeley in 1994. As a researcher he has examined in detail the relationship between professional identity development and the development of professional ethics in medical doctors, ministers and teachers, and professional identity development in emerging fields of work.  He is currently directing research projects focused on identity development and health/well-being in people who express alternative sexualities and non-traditional relationships, with a special emphasis on kink/BDSM sexuality, and polyamory or consensual non-monogamy.  He is also co-chair of the Children, Youth and Families Committee of the Society for the Psychology of Sexual Orientation and Gender Diversity (APA Division 44).   Richard currently teaches courses in the Department of Human Development and Women’s Studies at California State University, East Bay and graduate level courses at various universities in the Bay Area, including UC Berkeley and Holy Names University.

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