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The Case for 

Kink Clinical Practice Guidelines 

a working best practices development project 


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This is an all volunteer project, a donation of any size would help us continue to work on and disseminate this information

Why Mental Health Practice Guidelines are Crucial for Working with Kink, BDSM, & Fetish*

As helping professionals, mental health workers have an ethical and a professional responsibility to provide culturally humble care to our clients. This care is especially crucial for individuals who are underserved and misunderstood in society, such as those involved in kink and fetish. When some find their way to mental health professionals for help, they may be fortunate to find a therapist who is knowledgeable and experienced with kink and BDSM. Yet, many more may find clinicians unfamiliar with kink who have unaddressed biases or may pathologize them. Due to this care gap and high likelihood of negative experiences, people involved in kink often fear being stigmatized and can experience the negative effects of minority stress.


To change this, in the Spring of 2018, a team of highly experienced clinicians gathered to explore what constitutes clinical best practices in working with those who are interested and/or involved in kink, BDSM, and/or fetish eroticism. Since then we have been doing ongoing work to create these guidelines. Read on to find out where we are in the process!


Where We Are Now: March 2020

After several rounds of community input and feedback from professional colleagues over a two year period, we completed the Kink Clinical Practice Guidelines in December of 2019.  You may access a PDF of the Guidelines here.

We have submitted proposals to present at various professional conventions and meetings in 2020, and plan on providing some webinars to review and discuss the Guidelines.  Please come back here to keep updated or join our mailing list.

Kink Awareness is Growing

The past few years have seen more and more people finding their way into kink and BDSM. With this greater interest, there has been a growing demand for therapists and other healthcare providers who are sensitive to their interests, experiences, and relationships. Kink-involved clients are often tired of having to educate their clinicians, and are ill-served by the therapeutic community when judged or pathologized, especially when that results in clients being given actively harmful clinical information. It's time to take advantage of this momentum to start to articulate what competent care might include, in a careful, systematic way.  

Need for Development of Clinical Guidelines 


"We all deserve mental health support that is robust, respectful, and RELEVANT. Not only can these guidelines help clinicians, but they can also help clients better advocate for affirming care by showing they have a right to it."

— Aida Manduley, LCSW - Boston

Since the early 2000s, calls for clinical practice guidelines for working with BDSM clients have been published periodically. Recently, though, there has been an increase in the number of empirical studies and case presentations that address therapeutic concerns when working with kink-identified clients and patients. In addition, there has been an increase in the number of continuing education training workshops, online educational offerings, and conferences that address the need for kink competence in therapy. Given these changes, an appropriate next step in developing this area of competence is the creation of proposed clinical practice guidelines for therapists and counselors. 

*What We Mean With These Terms

We use BDSM (short for Bondage, Discipline &/or Dominance, Sadism &/or Submission, and Masochism) and kink as an umbrella term to cover a wide range of behaviors, practices and identities. These words encompass things such as intense sensation (including but not limited to “pain”), eroticizing power dynamics and differences, "unusual" sensual stimuli (“fetish”), role play or dramatization of erotic scenarios, and activities that induce shifts and changes in consciousness (called “headspace” in BDSM/kink subcultures).

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