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A psychologist has been suspended for "inappropriate" behaviour in his treatment of a woman who had been sexually abused as a child, once climbing in a window at her home when she did not keep an appointment.
The Auckland practitioner, who also gave the patient flowers and a birthday card, admitted a charge of professional misconduct at a hearing of the Health and Disability Practitioners Tribunal.
Expert evidence submitted to the hearing said such unprofessional behaviour would lead the vulnerable woman to be confused to the nature of the relationship.
The psychologist - who has interim name suppression - was suspended for 18 months and fined $10,000 for breaking boundaries and fostering dependency with the patient.
The tribunal heard that the woman had a history of sustained and severe childhood sexual, physical and psychological abuse from her father.
She was treated for Post Traumatic Stress Disorder (PTSD) and Dissociative Identity Disorder (DID) between 2000 and 2006.
However, the tribunal heard the defendant's treatment of the woman was "completely outside the bounds of normal, professional psychologist behaviour" and included:
Therapy sessions at his home while he wore a dressing gown and ate breakfast.
Taking the patient on errands to the bank and shops.
Giving up to three two-hour therapy sessions a week but only charging for one hour.
The decision reveals the psychologist also sent his patient text messages and emails and visited her at home.
The tribunal also heard of physical touching in the therapy sessions that was "irresponsible" - especially towards a woman who had suffered sexual abuse as a child.
As part of the therapy, the psychologist encouraged the patient to recall the abuse suffered at the hands of her father, allowing her to regress to a childlike state.
The patient would lie across his lap on a pillow supported by his arm and the "holding therapy" became regular treatment.
If she was distressed, he would rock her back and forward, which created a strong bond between the psychologist and the patient's child state.
Dr Janet Carter, a senior psychology lecturer at Canterbury University, gave expert evidence to the tribunal about the psychologist's behaviour.
The use of touch in psychotherapy was contentious and not used in mainstream practice she said - but was never appropriate for patients with PTSD and DID.
Touching a woman who was sexually abused as a child was "irresponsible", and in this case the touching was "extreme" in nature, intensity and frequency.
"It is more likely his behaviours would have contributed to ambiguity about the nature of their relationship," Dr Carter said.
The patient discussed dependency with the psychologist on many occasions.
In an email, she wrote: "I have a huge dependency problem and it feels to me like a problem created by a very intense desire to be accepted by you as a parent."
In later emails, the psychologist referred to himself as a "stand-in dad" and said he had learned a lot from working with her.
As his unprofessional attitude continued for years, the tribunal said there was an "ongoing risk to patient safety" if he returned to practise.
