When it comes to projecting a public image, the social work profession has had an ugly year.

State licensing regulators have taken action against five social workers for having sexual relationships with patients and against another for physically abusing clients under his care."I don't know quite how to account for it all," says Dr. Eugene Gibbons, chairman of the state's Board of Social Work Examiners, which hears licensing violations brought against social workers by the state Division of Occupational and Professional Licensing.

But Gibbons believes part of the reason for the number of cases is a heightened awareness by the profession and the public about unprofessional conduct and its consequences.

"They are not going to get ripped off anymore or abused," Gibbons said of consumers demanding quality mental health therapy.

Licensing Director David E. Robinson agrees, adding that media exposure of malpractice cases has helped. "We are told that people have not known where to report problems, and publicity has identified us as the agency dealing with this type of thing."

Sexual involvement with a patient is the most common charge of unprofessional conduct brought against social workers. And when it happens, it most likely involves not just one but two troubled people, Gibbons explained.

On one hand, there are patients seeking help for their problems. When they receive that assistance it can sometimes be misinterpreted as more than professional help and taken instead as a gesture of love and romantic attraction.

On the other hand, therapists not seeking help for their own personal problems take advantage of a vulnerable patient.

Sex between a mental health therapist and a patient can cause serious damage to both parties, Gibbons said.

For counselors, it could cost them their careers, as regulators apply sanctions against their professional license to practice. For patients, it prolongs the problems they sought help for in the first place as they must now also overcome distrust for the professionals trying to help them.

The seriousness of the problem is not lost on the social work profession. Gibbons credits the increasing number of cases in part to an increasing number of practitioners willing to turn in a colleague for stepping out of line with a patient.

"In the past there was an unspoken agreement that you would personally help a colleague with a problem," he said. "Now, there is a group quick to call licensing" authorities to notify them of a possible problem.

It's difficult to pinpoint any certain group of social workers - young or old, certified or clinical - responsible for the growth in unethical patient relationships.

Robinson acknowledged that unqualified or unlicensed practitioners setting themselves up as counselors do more to harm than help.

Gibbons said older, more experienced counselors have been the ones alerting regulators to unethical conduct by younger practitioners. At the same time, today's graduating social workers should be more aware of unethical relationships because they are required to take ethics courses.

Next year, students may have to become familiar with an entirely new code governing the social work profession. Current law doesn't clearly differentiate between certified and clinical social work.

Among the changes being considered is making it a felony for a certified social worker to engage in psychotherapy without a clinical social work license.