A Whatcom County mental health counselor accused of having intimate and personal relationships with clients that were inappropriate has surrendered her license, the state Department of Health announced.

In doing so, Alana Ruth Karsch can never practice as a mental health counselor in Washington state again.

She reached a resolution with the state in September. Health officials announced it this week.

Karsch neither admitted nor denied the accusations against her, according to a document that she signed and the state department posted online. But she acknowledged that there was sufficient evidence for the health law judge to rule with the state should the matter go to a hearing.

The state department’s Mental Health Counselor Program said in a news release that Karsch “failed to maintain appropriate client-practitioner boundaries” and changed treatment records after she was terminated from her job and an investigation was launched.

Additional details of the state health department allegations, as laid out in case documents, include:

She used pet names and terms of endearment for someone identified only as client A, whom she treated from about April to October 2017.

Karsch reportedly sent emails to the client in which she used “love” and “hugs,” contacted the client outside of counseling at least once, and “interacted with and touched client A in ways that client A reasonably interpreted as romantic, seductive or sexual.”

She accepted gifts and money from a person identified only as client B, whom she provided counseling and/or “coaching” services to from about February 2016 to October 2018.

Karsch wrote “I love you” in communications with the client and had personal and intimate communications with the client, and participated in a “mutual fantasy” with the client in which she became pregnant and gave birth to their “imaginary child.”

The state said Karsch didn’t maintain appropriate boundaries with the client while she was counseling the client and after she stopped doing so.

Karsch also reportedly had an inappropriate relationship with client B’s husband that included “exchanging email and text communications that (the) husband reasonably interpreted as romantic, seductive or sexual.”

In January, the state announced it had suspended Karsch and barred her from practicing as a mental health counselor until the accusations against her were resolved.

Kie Relyea has been a reporter at The Bellingham Herald since 1997 and currently writes about social services and recreation in Whatcom County. She started her career in 1991 as a reporter and editor in Northern California.