Within the field of psychiatry there is a broad consensus that sexual contact of any kind with a patient is unacceptable under any circumstances. We know from ethics committees and indurance trusts that sexual misconduct is a significant but under-reported problem. On this workshop we will discuss the modus operandi of offender-professionals and the dynamics of the interaction between victims, offenders and institutions. Their ‘silence’ triggers the ‘slippery slope’ toward boundary violations. The understanding of the path of abuse is the basis of effective intervention strategies.