Sexually inappropriate behaviors in clinical settings are relatively common occurrences that may negatively affect the therapeutic process. For example, more than half of female psychologists have reported at least 1 incident in which a client responded in a sexually inappropriate manner. Thus, it is important for clinicians to understand inappropriate behaviors and respond in a manner that is both personally satisfying and helpful to the client. A framework for conceptualizing these behaviors is proposed, as well as components for, and examples of, therapeutic responses. Recommendations are provided for preventive measures to decrease the likelihood of inappropriate behaviors and for systemic approaches to benefit professional training in regards to these issues. Our aim is to stimulate further discussion of sexually inappropriate behaviors specifically by facilitating psychotherapists' ability to address clients' within-session sexual behavior, facilitating speculation of the antecedents of and motivations behind such behaviors, and facilitating discussion of such behaviors within supervision and, more broadly, within training programs.

Lung tissue obtained from eight consecutive patients with systemic lupus erythematosus complicated by severe, acute pulmonary disease was studied by both light and immunofluorescence microscopy. Light microscopic examination disclosed interstitial pneumonia in four cases, cytomegalovirus pneumonitis in one case, bronchiolitis and peribronchiolitis in one case, pulmonary infarction in one case and focal atelectasis in the remaining case. Direct immunofluorescence examination revealed focally bound immunoglobulins or complement (C3) within pleural and/or pneumocyte nuclei in each specimen. Immunohistologic studies in these cases may thus suggest a diagnosis of systemic lupus erythematosus with acute pulmonary complications, despite the lack of specificity of the pathologic changes seen by light microscopy.

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