Additional Information

• • Target audience

    • This course is intended for psychologists, counselors, social workers, marriage and family therapists, and other mental health and related professionals. 

  • Instruction level - Intermediate

    • It is expected that participants will have basic knowledge of the topic. Less than 25% of the presentation will review knowledge provided in an introductory workshop in this topic area. The remaining time will focus on advanced topics such as new research, specialty topics not typically covered in graduate education, or specific clinical applications. 

  • Recommended Prior Course 

    • Consent as Foundation - Understanding Sexual, Gender & Relationship Diversity

      • This course serves as a foundation for all the courses in this series on GSRD. 

    • If you have taken a course with Dr. Kieran from at any time, you may have most of the basics already.    

  • Full description

This intermediate-level clinical workshop offers a deep-dive examination of consent, coercion, and power as they operate across the full landscape of human relationships—with particular attention to the grey areas that defy easy clinical categorization. This is not a workshop on intimate partner violence (IPV). Although IPV frameworks provide essential context, the central focus of this program is the harder clinical territory that exists on either side of the clear cases: the places where power, care, structural pressure, attachment fear, and genuine desire become entangled in ways that challenge even experienced clinicians to assess accurately.

Building on earlier workshops in the StorieTree Professional Education series—particularly Foundations 3 (Kink is Not a Diagnosis) and Foundations 2 (Defining the Relationship)—this program assumes familiarity with the basics of kink, BDSM, and consensual non-monogamy. Participants bring that foundation into direct clinical application, developing skills for navigating situations where healthy and harmful are not cleanly opposed, consent is complicated, and the clinician’s own assumptions are part of the clinical picture.

The program begins with a foundational reframe: consent is not primarily a sexual concept. It operates across all domains of human activity and relational life—who does the household labor, who manages the emotional work of a relationship, what roles people occupy, and how those roles were chosen (or simply accumulated). The workshop examines how cultural expectations, gender socialization, economic inequality, and—critically—fear of attachment loss can constrain a person’s perceived and actual freedom to negotiate, decline, or revise agreements. Participants explore how these forces operate in all relationships, not only those organized around explicit power exchange, and how they can render consent genuinely ambiguous even in the absence of overt coercion or explicit threat.

From this broad foundation, the workshop narrows to examine the specific challenges that arise in clinical work with clients in kink, BDSM, and power exchange relationships. The program presents evidence-based frameworks for differentiating consensual power exchange from IPV—including Michael Johnson’s typology of intimate terrorism versus situational couple violence, DSM-5 and ICD-11 criteria for paraphilic disorders, and current APA practice guidelines—while centering the dual clinical risk this population presents. Clinicians working with power exchange relationships face two failure modes, not one: the risk of pathologizing consensual practice as abusive (driven by kink-phobia, vanilla-normativity, or simple unfamiliarity), and the risk of missing genuine coercion or harm within a kink or CNM relational context. Both failures harm clients. This workshop develops the clinical capacity to hold both risks simultaneously.

The program’s central section examines genuine grey areas in depth. This includes cases where BDSM and IPV coexist within the same relationship; situations of “polyamory under duress” or “kink under duress,” in which structural or relational power differentials produce what appears on the surface to be consensual agreement; clinical presentations where one partner’s interests significantly constrain the other’s authentic participation; and cases where fear of losing the relationship—rooted in attachment history, economic dependency, social isolation, or cultural expectation—functions as a form of consent impairment that appears across relationship types regardless of structure or erotic content. Equally, participants examine how harm can be hidden in ostensibly conventional or “normal” relationship structures, and how clinicians’ comfort with familiar configurations can create blind spots.

Clinical skills content includes:

• Assessing consent across all domains of relational life—not only sexual activity—including household roles, financial arrangements, and division of emotional labor

• Identifying how attachment fear and fear of relational loss function as consent constraints, and exploring these with clients in a non-pathologizing way

• Differentiating IPV occurring within kink relationships from consensual kink itself, using structured assessment that examines each element of a dynamic separately

• Applying the A-B-C-D-E framework for ethical decision-making in ambiguous or complex presentations

• Using question frameworks that assess power, safety, and harm without assuming pathology in power exchange relationships or overlooking harm in conventional ones

• Navigating mandatory reporting obligations, duty-to-protect concerns, and documentation in grey-area cases

• Managing clinician discomfort, bias, and uncertainty without either abandoning clinical responsibility or imposing values on the client

By the end of the workshop, participants are equipped to assess consent and power dynamics with greater accuracy and clinical confidence across diverse relationship structures, to recognize how their own assumptions shape the assessment process, and to navigate genuine ethical complexity without defaulting to either reflexive pathologizing or uncritical affirmation.

• • Presenter 

    • Dr. Rachel Anne Kieran (Psy.D.) is a psychologist, writer, and educator, and the founder of StorieBrook Therapy & Consulting, LLC, an affirming therapy practice rooted in justice, community, and cultural humility. Her clinical work focuses on sexual, gender, and relational diversity (including kink and consensual non-monogamy), neurodiversity, fat and disability justice, and clients from non-majority spiritual and pagan paths.

Dr. Kieran’s practice model emphasizes accessible, bespoke collaboration with clients, including sliding-scale options and a community space designed to be welcoming, trauma-aware, and identity-affirming. Through StorieTree Professional Education, she creates continuing education programs for mental health and allied professionals that center ethics, intersectionality, and dismantling systemic barriers to care.

Her current writing projects include a book on finding and crafting mental healthcare for diverse spiritualities, and related work on “rainbow sheep” identities—those who never fully fit either mainstream or countercultural norms. Across her roles as therapist, educator, and author, Dr. Kieran is committed to the belief that affirming care is a right, not a privilege.

• • Learning objectives

    • After completing this workshop, participants will be able to:

      • Describe the consent spectrum—from enthusiastic informed consent through compliance, pressure, coercion, and force—and explain how cultural expectations, gender socialization, economic inequality, and fear of attachment loss can constrain consent across all domains of relational life, including household labor, role expectations, and emotional labor, not only sexual activity.

      • Articulate evidence-based frameworks for distinguishing consensual BDSM from intimate partner violence, including Johnson’s typology of IPV, DSM-5 and ICD-11 criteria for paraphilic disorders, and how intent, subjective experience, and long-term outcomes function as differentiating factors.

      • Identify the dual clinical risk in working with power exchange and relationship-diverse clients—pathologizing consensual practice through kink-phobia or vanilla-normativity on one side, and missing genuine coercion or harm on the other—and apply the A-B-C-D-E model and structured consultation to navigate presentations that fall in the grey area between these risks.

      • Recognize how attachment fear and structural power differentials function as consent constraints across all relationship types—including kinky, CNM, and ostensibly conventional relationships—and use non-pathologizing clinical language to explore these dynamics with clients.

      • Apply structured, non-judgmental question frameworks to assess consent, power, and safety across all relational domains, and articulate the ethical and legal obligations—including mandatory reporting and documentation—that apply when harm is suspected in any relationship context.  
        
        

  • Agenda / structure

    • Introduction and Framing – 20 minutes

      • What this workshop is—and what it is not

      • Working assumptions, positionality, and a note on discomfort

      • The dual clinical risk: kink-phobia and harm-blindness

    • Consent Across Human Activity – 35 minutes

      • Consent is not primarily a sexual concept: mapping the full range of relational domains

      • Household labor, relational roles, financial decisions, social participation

      • The consent spectrum: Consent → Compliance → Pressure → Coercion → Force

      • Cultural expectations, gender socialization, and structural power as consent constraints

      • Fear of attachment loss: how relational need shapes what feels like a free choice

      • Parallel process: consent in the therapy room

    • BDSM and IPV: Differentiation and Where It Gets Complicated – 35 minutes

      • What the research shows: BDSM practitioners and psychological well-being

      • Johnson’s typology: intimate terrorism vs. situational couple violence

      • Differentiating by intent, subjective experience, and long-term outcomes

      • DSM-5 and ICD-11: the role of consent and distress in paraphilic disorder criteria

      • APA 2021 guidelines: clinical and ethical obligations

      • Kink-phobia and vanilla-normativity as assessment distortions

    • The Grey Areas – 45 minutes

      • When BDSM and IPV coexist: assessing each element of a dynamic separately

      • “Polyamory under duress” and “kink under duress”: structural coercion without explicit threat

      • Fear of attachment loss as consent impairment across all relationship types

      • Mismatched desire: when one partner’s kink significantly shapes the other’s participation

      • High-risk practices: harm reduction, physical safety, and clinical obligations

      • The conventional relationship that hides harm: avoiding the assumption that familiar equals safe

      • Case examples and small group discussion

    • Clinical Assessment Skills – 30 minutes

      • Structured assessment: the A-B-C-D-E framework

      •  Question frameworks that assess consent without assuming pathology or health

      • Talking about power, safety, and harm without blame, disgust, or leading language

      • Mandatory reporting, duty-to-protect, and documentation in grey-area cases

      • When and how to refer; building a competent referral network

    •  Questions and Wrap-Up – 15 minutes

      • Key takeaways

      • Participant questions

      • Resources and next steps  
        
        

  • CE information

    • • This program has been approved for CE by the Georgia Psychological Association.  

        • Acceptance of continuing education credit is determined by individual licensing boards. 

          • The Georgia State Board of Examiners of Psychologists accepts GPA-approved CEs for license renewal under Area III for renewal of their licensees. For information on the board requirements in other states, please consult your state licensing rules.

          • The Georgia Board of Professional Counselors, Social Workers, and Marriage & Family Therapists accepts GPA-approved CEs for license renewal as related hours for renewal of their licensees (Rule 135-9-.01(2)(f)(1)).  For information on the board requirements in other states, please consult your state licensing rules. 
            
            

  • Pricing & accessibility notes

    • Standard Price - $90 just $75!

    • For more information on equity pricing for accessibility, please read the StorieTree Pricing & Equity Policy

    • For more information on StorieTree's ongoing accessibility efforts, please visit our Accessibility page.  

  • Cancellation/refunds - please see the StorieTree Attendance, Participation & Refunds Policy

  • Disclosures - please read the StorieTree Disclosure Policies for more information