This book explores the ethics around everything connected with setting up and running a therapy private practice. Offering a hands-on approach to realistic ethical dilemmas encountered by the private practitioner, the book examines the everyday management of practice, and the context of ethical issues in contemporary private practice. Chapters explore the fundamentals of some of the most common ethical considerations in private practice, providing space for the reader to think creatively about how they use their preferred ethical framework, and (...) how that may be translated into an individually tailored approach for each client, and for each private practice. The book provides exercises, examples, and vignettes, in addition to the author's own unique working model, to help the reader bring theoretical reflections into their own everyday practice. Relational Ethics in Psychotherapy and Counselling Private Practice will help private practitioners feel more confident and grounded in their private practice and up-to-date with developing thoughts. It will also appeal to training institutes, supervisors, and students. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They (...) can begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

The comprehensive guide to ethics "An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."--Dick Suinn, president-elect 1998, American Psychological Association "The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology."--Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of (...) psychology, University of South Florida The authors draw on their professional experience, empirical studies, and case examples to examine the ethical responsibilities that confront psychotherapists and counselors in their day-to-day practice. They offer insights into contending with the sometimes competing demands of clients' needs, formal ethical principles, personal values, and evolving legal standards in a range of areas--including fees, informed consent, sexual concerns, confidentiality, documentation, and supervision. (shrink)

The Healing Virtues explores the intersection of psychotherapy and virtue ethics - with an emphasis on the patient's role within a healing process. It considers how the common ground between the therapeutic process and the cultivation of virtues can inform the efforts of both therapist and patient. Within this book, the Duff R. Waring argues that there is a case for patient virtues that are crucially relevant to working through the problems in living that arise in psychotherapy, (...) e.g., honesty, courage, humility, perseverance. The central idea is that treatment may need to build virtues while it ameliorates problems. Hence, the patient's work in psychotherapy can both challenge character strengths and result in their further development. (shrink)

Perhaps no other population exposes the clinician to more moral and legal dilemmas than clients with an HIV-positive diagnosis. What does the therapist do about the HIV positive patient who is having sex with unnamed partners and refuses to stop? What should be said in end-of-life decisions? What of the adolescent who is HIV positive but whose guardian does not wish the youth to be informed of his status?

Following years of debate over the effectiveness of cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), public health bodies in the UK and beyond have determined that no psychotherapy is clinically proven for this patient group. In the field of ME/CFS and the wider arena of ‘medically unexplained symptoms’ (MUS), patient survey data and qualitative research capturing patient experiences and psychotherapist attitudes suggest that therapeutic practice may sometimes fall short of required ethical standards. This raises questions about how (...) psychotherapists can safely support, as opposed to treat, people with these debilitating conditions. We consider four ethical principles that feature throughout psychotherapists’ codes of practice, those of respect, competence, responsibility and integrity, and discuss examples of good and poor practice in this arena as evinced by recent empirical literature. Following this, we offer a variety of suggestions to help strengthen ethical psychotherapy practice with patients with ME/CFS and other MUS. In terms of practitioner education, we recommend greater emphasis on humility, reflexivity and disability-affirming practices, exploration of personal as well professional ethics, and integration of patient expertise-by-experience, accompanied with the latest evidence, into foundational and ongoing training. In terms of ongoing practice, we suggest consideration of formalised patient-focused feedback systems and greater transparency vis-à-vis patient access to clinical notes. Finally, we underline the importance of elevating patients from mere subjects to co-producers of psychotherapy research. (shrink)

Ethics and Values in Psychotherapy examines the ways in which the ethical convictions of both therapist and client contribute to the practical process of psychotherapy. Practitioners are increasingly focusing on the issue of their extensive--and often problematic--ethical influence on clients as they attempt to agree on guidelines and standards for professional practice. Alan C. Tjeltveit argues that any discussion of ethical practice in psychotherapy must be carried out in connection with traditional ethical theories. The author draws (...) on scientific, clinical, and philosophical approaches to address issues such as: the role of therapy in society; the goals and outcomes of psychotherapy; techniques and practices; the existence and operation of values; and the intellectual and social context in which therapy takes place. This comprehensive study is a significant contribution to the debate on the ethical character of psychotherapy. (shrink)

_ This scholarly article explores the critical role of professional ethics in the field of counseling and psychotherapy. Ethical considerations are fundamental to maintaining the integrity and trustworthiness of mental health professionals. The paper examines the core principles and ethical guidelines that govern the practice of counseling and psychotherapy, addressing the complexities and challenges that practitioners may encounter. Through an in-depth analysis, the article emphasizes the significance of ethical decision-making, confidentiality, cultural competence, and ongoing professional development in (...) fostering positive therapeutic outcomes. _. (shrink)

Cultivating trusting psychotherapy bonds is complex, challenging, and a critically important topic. In Trusting in Psychotherapy, the author posits that trusting cannot be understood apart from trustworthiness and that therapists should give equal attention to the task of becoming trustworthy to their patients. Blending developmental science and ethical thought, the author elucidates such topics as what it means to trust in the practice of psychotherapy; the many facets of trusting and trustworthiness; attachment relationships; the central role of (...) hope in trust; and the ethical-moral basis of trusting and trustworthiness. (shrink)

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from a cost (...) and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard. For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research. (shrink)

This study explores how therapists deal with ethical dilemmas in psychotherapy with older adults. Semi-structured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. Findings clustered around three themes: (i) respecting autonomy when interacting with family of vulnerable and dependent older patients; (ii) prioritizing respecting autonomy in risk situations and in suspected financial abuse without impaired judgment; and (iii) prioritizing protecting the patient in risk situations of patients with dementia and of suspected physical abuse or neglect. (...) These findings highlight several important issues regarding the management of ethical dilemmas in psychotherapy with vulnerable and dependent older adults. (shrink)

The work of every school of psychotherapy and every therapist is inevitably structured by a value system and requires codes of ethics and practice. This book addresses the conscious and unconscious aspects of the value system in which therapists are situated. Values and Ethics in the Practice of Psychotherapy and Counselling explores the central issues through the experience of the contributors, each of whom is well known in this field. Each chapter will raise questions for the (...) reader which will stimulate individual thinking about practice or can form a basis for discussion and debate for training or graduate groups. The book is firmly rooted in practice. Each chapter deals with a different aspect of the psychotherapist's work beginning with the general underlying principles, continuing through matters of technique and on to contextual issues. Finally the book moves to the outer world, politics and spirituality as ways of connecting inner and outer, social and individual. The arrangement of chapters allows for flexibility and creativity while providing a coherent structure. Values and Ethics in the Practice of Psychotherapy and Counselling is recommended reading for psychotherapists, psychoanalysts and counsellors in training and practice. (shrink)

Behandlungsfehler in der Psychotherapie sind bisher kaum erforscht. Eine empirisch gestützte Kategorisierung von Behandlungsfehlern stellt einen ersten Schritt dar, sich evidenzbasierten ethischen Empfehlungen zum Umgang mit solchen Fehlern zu nähern. Zielsetzung dieser Arbeit ist es, dafür erste Grundlagen zu erarbeiten, die auf Erfahrungen von Praktikern Bezug nehmen. Nach einer systematischen Literaturrecherche wurden 30 semistrukturierte Interviews mit approbierten Psychotherapeuten unterschiedlicher Ausrichtungen (Schulen) geführt und anhand der qualitativen Inhaltsanalyse nach Mayring ausgewertet. Die beschriebenen, alltäglich auftretenden Behandlungsfehler konnten in technische, normative, Einschätzungs- und (...) Systemfehler klassifiziert werden. Viele der technischen und Einschätzungsfehler wurden als reversibel angesehen; sie könnten sogar konstruktiv für die Behandlung nutzbar gemacht werden. Das Versäumnis, einen Fehler zu korrigieren, wurde als Hauptfehler betrachtet. Bei normativen Fehlern sei mit rechtlichen oder berufspolitischen Konsequenzen, aber auch mit Vertrauensverlust und Therapieabbruch zu rechnen. Für Systemfehler fühlten sich die befragten Therapeuten nicht verantwortlich; hier seien berufspolitische Änderungen nötig. Die Ergebnisse zeigen, dass die Befragten zu der Empfehlung tendieren, Psychotherapiepatienten in passender Form über Behandlungsfehler aufzuklären und in die entstehenden Konsequenzen einzubeziehen. Fazit: Psychotherapeuten äußern sich aufgeschlossen gegenüber einer transparenten, konstruktiven Fehlerkultur – eine wesentliche Voraussetzung für Fehlerprävention. Häufig resultiert erst durch die fehlende Korrektur eines (alltäglichen) Fehlers ein Behandlungsfehler, der Konsequenzen hat (z. B. Scheitern der Therapie). Um diesem entgegenzuwirken, zeichnet sich eine Befürwortung für eine passende Form der Patientenaufklärung über Fehler ab. (shrink)

Psychotherapy is an activity which takes many forms and which has many aims. The present paper argues that it can be viewed as a form of moral suasion. Kant's concepts of free will and ethics are described and these are then applied to the processes and outcome of psychotherapy. It is argued that his ideas, by linking rationality, free will and ethics into a single philosophical system, offer a valuable theoretical framework for thinking about aims and (...) ethical issues in psychotherapy. (shrink)

New and experienced psychotherapists alike can find themselves overwhelmed by an ethical quandary where there doesn't seem to be an easy solution. This book presents positive ethics as a means to overcome such ethical challenges. The positive approach focuses on not just avoiding negative consequences, but reaching the best possible outcomes for both the psychotherapist and the client. The authors outline a clear decision-making process that is based on three practical strategies: the ethics acculturation model to help therapists (...) incorporate personal ethics into their professional roles, the quality enhancement model for dealing with high-risk patients who are potentially harmful, and ethical choice-making strategies to make the most ethical decision in a situation where two ethical principles conflict. Throughout the decision-making process, psychotherapists are encouraged to follow four basic guidelines: Focus on overarching ethical principles Consider intuitive, emotional, and other nonrational factors Accept that some problems have elusive solutions Solicit input from colleagues and consultation groups Numerous vignettes illustrate how to apply positive ethics to many different ethical challenges that psychotherapists will likely encounter in practice. (shrink)

Presents a comprehensive set of basic ethical principles for the professional practice of psychotherapy. Defines unethical practices; refers to relevant portions of existing professional codes; and provides guidelines for behavior not covered by current codes. Also discusses legal matters that may arise in the practice of psychotherapy, noting the distinction between what is legal and what is ethical.

This up-to-date and comprehensive handbook guides the reader, step-by-step, through all aspects of complaints and grievance management. It includes useful addresses, current codes of ethics from the major organizations, protocols and sample letters.

Although racism has always been present in the therapy room, the recent political climate and flood of news stories highlighting racist narratives and behaviors have made race and racism more salient in our society. For white therapists who align with antiracism in their self-identity and practice, this may present a difficult ethical dilemma when race and racism enter the therapy office. Therapists have a duty to protect client autonomy and self-determination as much as possible. However, therapists also have a responsibility (...) to the communities in which they work and to not willingly condone activities of others that hold prejudice, both of which are threatened with unacknowledged racism. This article addresses the issue of whether to work with racism as a clinical and ethical concern with white clients who hold racist ideas and narratives, and then offers a concise clinical model for therapists to help guide their practice. (shrink)

BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should be (...) communicated to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists’ age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.ConclusionsThe present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective. (shrink)

The moral status of professional boundaries and the ethical nature of dual and multiple overlapping human relationships in contemporary clinical practice remain enduring problems in all health care disciplines. In this paper I explore the ethics of dual or multiple overlapping relationship and apply a virtue ethics framework to the case of psychotherapy.After clarifying the context and meaning of commonly used terminology, and considering what some of the key Australian codes of ethics relevant to psychotherapy (...) advise about dual relationships, I identify some commonly occurring situations where overlapping relationships are unavoidable. A case study from a rural context where size, isolation, and community expectations profoundly impact on the capacity of a psychotherapist to maintain clearly defined professional therapeutic relationship boundaries is analysed. The rural example is pertinent. A virtue ethics approach goes some way toward alleviating perceptions about the nature of dual relationships that contribute to an enduring reticence amongst psychotherapists (and other professionals) to practice in rural settings.Clearly, if a dual relationship involves exploitation then that relationship is a boundary crossing that should rightly be categorised as a boundary violation. Boundary violations are exploitative and unethical. However, some dual relationships may involve boundary crossings that are not necessarily boundary violations. Despite their general prohibition by Australian (and many other countries’) codes of ethics relevant to psychotherapy, I argue that in certain situations, if a psychotherapist (who crosses a professional relationship boundary) acts with professional integrity from the distinct professional role-related virtues and/or regulative ideals that ensure the goals of psychotherapy (to increase autonomy and psychological wellbeing) are met, then a dual or multiple overlapping relationship in psychotherapy will be ethical. (shrink)

Although touch frequently occurs in psychotherapy with children, there is little written on the ethical considerations of therapeutic touch. Because physical contact does occur, therapists must consider if, how, and when it is used, for both their clients' safety and their own. In this review, I further develop the issues suggested by Aquino and Lee (2000) in the use of nurturing touch in therapy by considering many types of touch that occur in psychotherapy with children; the possible positive (...) role of touch; clients' perception of touch in therapy; considerations related to the therapist, the child's safety, and any history of abuse in the child's and family's background; and other practical considerations. I list guidelines. (shrink)

Wilkinson's (1) critique of psychoanalysis and psychoanalytically oriented psychotherapy is weakened by inconsistent use of crucial terms, a systematically biased selectivity in reviewing empirical evidence and prior debates, and a failure to address issues crucial for a scientific understanding of psychotherapy.

Malpractice issues in psychotherapy and psychological treatments refer to the unethical behavior of a psychologist or psychotherapist toward the patient. The current study reviewed complaints directed at psychologists and psychotherapists in Sweden with regard to possible incidents of malpractice. Eligible cases were retrieved from a database managed by the Health and Social Care Inspectorate [Inspektionen för vård och omsorg (IVO)], an administrative authority responsible for the safety and quality of healthcare and social services delivery. These cases were analyzed using (...) thematic analysis. In total, 33 complaints matched the keywords proposed by IVO, and were scrutinized in detail. The cases primarily involved psychiatric care by a psychologist in outpatient settings, although many cases comprised multiple healthcare providers responsible for the patient’s care, or targeted the healthcare unit as a whole. The results demonstrated that different forms of malpractice occur, and can be classified in two general themes, Incorrect administration and implementation and Attitude and behavior, which involve organizational aspects as well as examples of malpractice and unethical behavior. Implications for clinical practice and future research include further training in ethics and malpractice, video recording or auditing sessions, routine outcome monitoring, and providing patients with information on how to file complaints. (shrink)

Preface : how and why the stories came to be -- Introduction : self-deception and red flags -- Sammy meets the wolf : meet the characters who will decide the cases -- I'm not your monkey : loss of control with a difficult client -- Junk yard therapy : self-delusion and exploitation -- Rats! : warring colleagues -- The John : a predator at work and play -- The raid on Hollywood Boulevard : the professional role vs. the right to (...) a private life -- Kill the boss : when clients threaten physical harm -- Broken : Bartering gone bad -- Baby steps off a cliff : the slippery slope to sexual exploitation -- Car crash : a simple disclosure with unforeseen consequences -- Mad FAX : what not to do when clients don't pay -- The star catcher : the undoing of a troubled psychotherapist -- Vampire : Countertransference exploding -- Epilogue : a transformed Dr. Halsey goes home. (shrink)

The purpose of this paper is to establish ethical guidelines for the use of paradoxical interventions in psychotherapy. These are defined as interventions which are counterintuitive, coercive, and which require non-observance by the client. Arguments are developed to show that such interventions are associated with a psychology that understands individuals solely in terms of their relationship: a 'strong interactionist' position. Ethical principles consistent with such a position are considered, and from these it is derived that: paradox is an ethical (...) technique with resistive patients; it requires consent; its content should be consistent with general ethical principles, especially those of beneficence and non-maleficence; non-paradoxical techniques should be preferred when possible; and it should not be used as an assessment procedure. It is concluded that research is needed to explore the effect of such ethical guidelines of effectiveness, though preliminary impressions are encouraging. (shrink)

In the present contribution, we argue that all health care professionals and particularly psychotherapists should provide a plausible rationale for their treatment including an etiological model and a model of unique and common change mechanisms. The provision of a plausible rationale has two goals: (1) meet the ethical challenge of informed consent, and (2) to improve treatment outcome by fostering the meaning response. In the course of the ethical and a legal obligation of psychotherapists to obtain patients’ informed consent before (...) initiating psychotherapy, patients have the right to receive maximally comprehensive information for providing their consent, which - among other information about the treatment (such as general psychotherapeutic approach, setting, and procedures) – should include a plausible treatment rationale. A useful concept in conceptualizing and communicating a treatment rationale as part of the informed consent procedure is Moerman’s general notion of the meaning response as the physiological or psychological effects of meaning in the course and treatment of an illness. The more compelling the rational explanation of the targeted treatment effects, the stronger the meaning response is expected to be. As the mechanisms of change in psychotherapy are known to be quite abstract and considered common to all approaches to a large extent, it seems especially important to provide a convincing treatment rationale to strengthen trust in the therapist and potentially foster positive expectations of process and outcome. To that extent, strengthening a patient`s meaning response to information provided at the beginning of psychotherapy may be central to activating common therapeutic factors. (shrink)

Ethics is defined as the realm of the 'ought', the realm of conscience which postulates that Man has the freedom to carry out what he judges to be morally right. By such acts he realizes his freedom of making himself into a truer, more authentic person than he was before. A libertarian psychotherapy, based on this ethic, is outlined. Medical science (as all science) belongs to the realm of the 'is' and postulates that the phenomena which it studies (...) follow a necessary course. It is therefore deterministic. In psychiatry, allowance is made for a neurological determinism in cases in which personal freedom has been diminished or abolished by mental illness, but the determinisms of behaviour therapy and of psycho-analysis are rejected by the author. (shrink)

Mental health professionals face many complex questions in the course of their work with clients and patients. Among the most difficult are dilemmas that involve ethical issues. This book presents a forthright exploration of these dilemmas and the ethical considerations they raise. Drawing on extensive interviews, the author identifies common ethical problems that practitioners encounter. What happens, for example, when personal interests intrude into therapy? How can the therapist make an accurate assessment of his or her appropriateness as a care (...) provider for a particular patient? What about confidentiality? How are problematic financial arrangements best addressed? The author goes on to show how these dilemmas may be intensified by the unique assumptions of different therapeutic orientations--individual, group, family, marital, and organizational--and how professionals can learn from such experiences to better understand and apply their particular approach. This analysis--and the words of the therapists themselves--provide both a guide to practice and a unique store of experience for the growing number of researchers and students concerned with ethical problems in psychotherapy. (shrink)

A dual relationship in psychotherapy occurs when the therapist engages in another, significantly different relationship with the patient. The two relationships may be concurrent or sequential. For both sexual and nonsexual dual relationships, men are typically the perpetrators and women are typically the victims. This article presents examples of dual relationships, notes the attention that licensing boards and other agencies devote to this topic, reviews the meager research concerning nonsexual dual relationships, and discusses common strategies that promote both sexual (...) and nonsexual dual relationships. (shrink)

Annotation Examines how contemporary psychotherapy often fails to recognize the distinction between ultimacy and triviality.

Conversational artificial intelligence (CAI) presents many opportunities in the psychotherapeutic landscape—such as therapeutic support for people with mental health problems and without access to care. The adoption of CAI poses many risks that need in-depth ethical scrutiny. The objective of this paper is to complement current research on the ethics of AI for mental health by proposing a holistic, ethical, and epistemic analysis of CAI adoption. First, we focus on the question of whether CAI is rather a tool or (...) an agent. This question serves as a framework for the subsequent ethical analysis of CAI focusing on topics of (self-) knowledge, (self-)understanding, and relationships. Second, we propose further conceptual and ethical analysis regarding human-AI interaction and argue that CAI cannot be considered as an equal partner in a conversation as is the case with a human therapist. Instead, CAI’s role in a conversation should be restricted to specific functions. (shrink)

In this article, I discuss two principles that can be viewed as universally applicable in psychotherapy and counseling: respect for clients' welfare and respect for their self-determination. Consideration of the practical application of these principles leads to the formulation of a set of guidelines to aid therapists and counselors in making choices about instrumental and end goals. These guidelines are intended to be applicable regardless of the particular personal and cultural values of the therapist and client.

Ever since Thomas Szasz announced that mental illness was a myth and that psychiatric disorders were in fact moral dilemmas hiding beneath the shirt-tails of medicalisation, psychiatric ethics has been hotly debated, a debate given poignancy in the 1970s by the revelations of the abuse of psychiatry in Soviet Russia. However, discussion of ethical aspects of psychotherapy has lagged behind its psychiatric cousin, and it is mainly the emergence in the past decade or so of psychotherapy as (...) a profession in its own right—and with it the need to develop professional codes of ethics—that has stimulated practitioners and their critics to take psychotherapeutic ethics seriously. This book is one of the few devoted exclusively to the subject, and …. (shrink)

“Jane” is a mother of two, who was referred for psychotherapy. However, Jane had misgivings about engaging in the offered psychotherapy because of threats made by her domestically violent partner. The therapy sessions are audio recorded for the purpose of professional supervision and clinician reflective practices. Jane’s partner had threatened to subpoena the therapy recordings to legally separate Jane from her children. This article focuses on how three different parts of Jane’s multidisciplinary care exhibit different competing ethical priorities. (...) Psychotherapeutic clinicians private use of audio recordings of the therapy enhances patient care and their own professional development but with the risk of concealing possible unethical behaviour by either party. Medico-legal access to the therapy recordings preserves potentially relevant evidence in the pursuit of justice but risks the interpretation of the psychotherapeutic information outside of the therapeutic context. Policies advocating the inclusion of the therapy recordings in the medical record improves clinician accountability but risks harming the vulnerable patient due to threats to patient-therapist confidentiality. (shrink)

This edited volume comprehensively examines the critical ethical challenges that arise in the practice of counselling and psychotherapy. It translates philosophical positions and professional ethical guidelines in a way that can be applied to practice. The various chapters focus on specific ethical issues that emerge in working with a range of different client groups; for example, children, couples and families. While some ethical imperatives are common across the board, others could be more closely associated with certain client groups. Practitioners (...) might experience uncertainty in working with vulnerable client groups; for example, lesbian/gay/transgender/intersex (LGBT) clients, or persons who report intimate partner violence. Several chapters raise questions, provide information and additional resources to enhance ethically informed practice. Chapter contributions also highlight the ethical dilemmas that might be unique to certain contexts; for example, private practice, schools and consultation-liaison settings. This volume also addresses contemporary and relatively less understood playing fields like 'digital ethics' related to therapist-client interface in the internet space and the navigation of ethical dilemmas in the newly emerging field of employee assistance programmes which address mental health needs in the corporate sector. Written by experienced practitioners of psychotherapy, and culturally contextualized, this is a valuable resource for academics and practitioners interested in psychotherapy and counselling. (shrink)

Psychotherapy helps one enact ideas about a good life, and therapists practice orientations rooted in their chosen approach. A 'good life' can therefore mean different things depending on the therapy. Building on the philosophy of Charles Taylor, Smith examines the link between therapy, ethics and the root of therapeutic views in comparison to modern, Western ideas about 'living well'. This is one of two complementary volumes. This volume builds on the last to explore what it means to engage (...) the different ethics of different therapies by offering a deeper explication of therapeutic ethics. Utilizing Taylor's work on practical reasoning, Smith explores topics like the nature of the ethical argument, the role of ethical intuitions and the value of framing ethical debate as ongoing dialogue. He applies this to therapeutics ethics to show how vital it is to consider the ethical proposals that are present in current theories and practices in order to understand the psychotherapies. A key text for upper level undergraduate, postgraduate students and professionals in the field of psychotherapy, psychoanalysis, theoretical psychology and philosophy of the mind. (shrink)

Introduction to ethical issues and decision-making in counseling and psychotherapy -- The mental health professions and counseling specialties -- Value issues in counseling and psychotherapy -- Ethical decision-making processes -- Introduction to ethical principles in counseling and psychotherapy -- Introduction to ethical standards in counseling and psychotherapy -- Privacy, confidentiality, and privileged communication -- Informed consent -- Roles and relationships with clients -- Professional responsibility -- Counselor competency -- Ethical climate -- Office and administrative practices -- (...) Technology in the practice of counseling and psychotherapy / David B. Peterson, R. Rocco Cottone -- The ethical professional counselor and psychotherapist. (shrink)

This article questions a number of widely held views of the role of values in psychotherapy. It begins with a discussion of the now largely discredited view that psychotherapy can be value free. It also broadens this challenge to question the popular idea that values form an inescapable part of the therapeutic encounter. While this view is correct in outline, it is necessary to reject the underlying conception of values as largely arbitrary preferences that the client and the (...) therapist bring to the encounter, as this fails to do justice to the inherently ethical nature of psychotherapy. It argues that we should recover the Greek notion of therapy as essentially concerned with the character of a person. In other words, the goal of therapy is virtue. (shrink)

This article defines the nature of paternalistic interventions in psychotherapy and discusses reasons why the client's right to consent to treatment is important. We describe a reasoning process developed by Culver and Gert (1982) that can be used to determine when paternalistic actions are and are not ethically justifiable in mental health practice. We demonstrate how this procedure may be applied to psychotherapy by using a number of case illustrations.

Since the emergence of psychology, its relation with religion has been inconsistent. Their different sources and methodologies but common aims made them close or distanced. Today these disciplines acknowledged and learned to benefit from each other. The affect of religion/spirituality on human’s lives raised the attention of psychology and required the integration of these into psychotherapy. In order to approach the psychology-religion relation via the traces of religion within psychotherapy the paper deals with the necessity, the knowledge needed, (...) the principles when integrating religious/spiritual principles and practices into psychotherapy; finally the religious traces in psychotherapy. The paper comprises few Turkish examples together with the huge body of theoretical and practical examples on the topic. These theories and practices should be important examples for Turkey. By addressing the religious traces in psychotherapy the aim of the paper is to show that the cliff between psychology and religion is in fact not that deep.SummaryIt can be argued that psychology and religion have common interests relating the well-being of individuals. There is a huge body of research that emphasizes the implementation and necessity of cultural, religious, spiritual principles in professional psychology. The proprium of these models is to integrate the client’s religious/spiritual sources into therapy. Especially religious clients benefit from therapies that define their treatment goals around their religious views. However, it must be considered that if the disorder has a biological dimension and/or is severe psychopathologic pure religious interventions will not be sufficient. This paper traces the religious/spiritual principles within psychotherapies and shows that the cliff between religion and psychology is not that deep.At different places in the world therapy is done according to western standards. However, determining mental health or disorders according to western criteria might be problematic. In societies in which religious/spiritual life is an essential part of culture, religion plays a crucial role in people’s perception of disease and treatment. In mental health, spirituality is an important and primary source for coping. Empirical studies reveal the positive outcomes of religious practices such as personal prayer, repentance, meditation, and dhikir on mental and physical health. In light of this data it becomes clear that psychotherapies should be revised socio-culturally and culturally sensitive psychotherapies that cover belief and religious practices should be developed. Another need for the integration of religion, belief, and spirituality with psychotherapy is the significant effect of these experiences on individual’s lives. With regard to the broad impact of religion, psychological interventions solely might not be sufficient to fulfill human psychological needs. As studies show, religious clients expect religious practices in treatment as well as a therapist who is open and respectful to religious principles, ready to talk about own religious beliefs, willing to integrate religious matters into therapy. To fulfill these expectations therapists, need to be trained and educated in religious/spiritual matters. Additionally, the therapist must acknowledge and be conscious about her/his own worldview, religious commitment, and spiritual life. However, the therapist needs not to be religious him/herself or share the same religion as the client. It is sufficient that the therapist is open and receptive to the client’s beliefs so that these can be used as effective sources in therapy. Spiritual psychotherapy considers spirituality as one of the main sources of clients. Thus, it might be critical when the therapist has poor knowledge about religion when the client considers it as significant. This source might be helpful for the client in coping with his/her problems and limitations. Having knowledge about the client’s religion and culture might also be important to acknowledge his/her perceptions and beliefs. Because individuals’ understanding of disease, their beliefs about reasons for mental disorders, their expectations from the health system are important factors in seeking help and choosing therapy.Therapists who decide to integrate spiritual/religious principles into psychotherapy have to adhere to some ethical principles. The source and the degree of the psychological disorder are important, too. Even though the efficacy of religious rituals and spiritual interventions are extensive in each case it has to be investigated whether religiosity/spirituality is part of the problem or the solution. Certain aspects will guide the therapist in deciding whether to integrate religiosity/spirituality into the therapy process or not. Additionally, he/she has to gather information about the client’s religious/spiritual life (spiritual anamneses) in order to choose the most appropriate religious method and intervention. Today psychotherapy deals with coping, questions about the meaning, purpose, and way of life. Actually, these are issues with which religious traditions has dealt and proposed solutions for thousands of years ago. For example, ethical principles for mental health professionals correspond to those of religious teachings. The attitudes and the type of relationship recommended by the client-centered approach are also commended by religious teachings for all human relations. Beginning with the 1960’s an increasing interest in Buddhist teachings is observable among psychotherapists. Mental exercises (especially meditation) cause transformations in the self-perception and lead to enduring changes in consciousness. Religions such as Islam, Judaism, and Buddhism recommend meditation technics like contemplation, dhikr, and yoga. Confession in the Catholic Church has similarities with psychotherapeutic catharsis. Many cultures own one kind of forgiveness rituals of confessions. As studies report people benefit from these rituals. Forgiveness is a multifaceted issue with psychological and spiritual dimensions and involves cognitive, emotional, relational, and spiritual processes. Research indicates the religious and psychological functions of forgiveness. Many subjects such as personal prayer, hope, empathy, love, and tolerance are common issues of both, psychotherapy and religion/spirituality. Different psychotherapeutic approaches and especially positive psychology integrate these values that are valued by religion/spirituality into their theories and practices.In conclusion, the cliff between psychology and religion/spirituality is not that deep at it seems at first sight. They have many subjects in common. Individuals turn to religion and spirituality in times of crises. This makes it inevitable to include religion and spirituality into the therapeutic process. Because religions provide ways of coping, hope, and meaning in difficult times. This fact is recognized and accepted abroad and lead to the religious/spiritual psychotherapy movement, which will hopefully an inspiration for Turkish psychology as well. (shrink)

The aim of this paper is to advance the understanding of psychotherapy as ethical care, a mode of healing practiced in societies rich in the phenomenaconcerning the operations of collective life. By contemplating and establishing the four concepts: situated negativity, therapeutic locale, bodily experience(insituated negativity), and speech as action, the author is able to delineate the modes of therapeutic interactions right at the locale between the therapist andthe patient in order to disclose the structure of interpersonal thwartedness and connectedness (...) within psychotherapy. Viewed in this perspective, psychologicalsuffering is always the suffering of situated negativity. Healing, however, is not to cancel this negativity but to let it become a source of new ways of existence.This reverse of attitude toward negativity involves ways of “talking” into bodily experience in psychotherapy. The meaning of ethical care thus can be describedas: what the therapist aims to approach through speech is not positive normative ethics, the socially recognized “should-be,” but the situated negativity whichdenotes an expelled position from normative interpersonal ordering and which is to be experienced as nameless and full of forces. Situated negativity is not thatwhich to be eliminated but the source to be appreciated by both the therapist and the patient. (shrink)

This paper describes the nature of aesthetic judgments and the justifications that underpin these, with a particular focus on the theory of aesthetics set out by Kant in the Critique of Judgment. It argues that judgments of self often take the form of aesthetic judgments, that such judgments are prevalent in the psychotherapeutic discourse, and that this has major implications for the type of dialogue that is required in therapy. Such a dialogue shares many of the characteristics of art criticism, (...) but may be supported by scientific empiricism. Recent research on the interaction between emotion and cognition is reviewed and implications for therapeutic change are discussed. The paper concludes that aesthetic philosophy provides a common ground for emotion, cognition, ethics, and a sense of the meaningfulness of life. (shrink)

Part of the development of ontological or “strong” relationality has been the exploration of its more applied aspects. My focus for this article is a therapeutic boarding school, which L. Jay Mitchell and I cofounded in West Virginia. I describe how our intention to base this school exclusively on strong relationality led us to employ Aristotle's virtue ethics. 2012 APA, all rights reserved).

Are dual relationships always detrimental? Speaking the Unspeakable provides an in-depth exploration of client-practitioner dual relationships, offering critical discussion and sustained narrative on thinking about and being in dual relationships. Lynne Gabriel draws on the experiences of both practitioners and clients to provide a clear summary of the complex and multidimensional nature of dual relationships. The beneficial as well as detrimental potential of such relationships is discussed and illustrated with personal accounts. Subjects covered include: · Roles and boundaries in dual (...) and multiple role relationships · Client experiences and perceptions of being in dual and multiple role relationships · Developing a relational ethic for complex relationships This book offers an insightful and challenging portrayal of dual relationships that will be welcomed by therapists, trainers, trainees and supervisors. (shrink)

Psychotherapists and counsellors confront several ethical dilemmas as they tend to provide effective services. There has been much debate among psychotherapists and counsellors alike around the utility of therapeutic contracts. Some view contracts as being restrictive to the therapeutic process and often hindering the work done in sessions. In contrast, many counsellors and psychotherapists use those agreements to revisit specific therapeutic topics and establish the guidelines necessary for this professional arrangement. No matter the opinion or preference of contracts, the development (...) of written and/or verbal consent of specific topics in psychotherapy remains essential. This remains one of the formal features of the arrangement and starting relationship in current counselling and psychotherapy practice. This paper aims to discuss the necessity and ethical demand of therapeutic contract in counselling and psychotherapy practice. (shrink)