The Ethics of Mandatory Personal Psychotherapy for Trainee Psychotherapists

Although the psychotherapist's personal psychotherapy has received considerable research attention in recent years, little systematic investigation of the ethical issues involved has been published. This article provides a rigorous interrogation of mandatory personal psychotherapy (MPP) as a training requirement for mental health professionals, a topic that remains ethically contentious. The article begins with a discussion of why MPP is an explicitly ethical issue, before debating the ethics of MPP under six questions, each worded to capture a salient ethical issue relevant to the appropriateness of making personal treatment a mandatory training requirement. Using principle, virtue, and care ethics perspectives, the arguments for and against MPP are critically investigated. The article concludes with an ethical position statement.     

Ethical Considerations for Psychologists Providing Treatment to Arab Americans

Given the recent increase in hate crimes against Arab Americans, there are growing concerns over the mental health needs of Arab Americans and a pressing need for psychologists’ competence in treating this group. Although there are several clinical guidelines for other health care professions, there remains a paucity of information on the ethical issues that may arise for psychologists treating this Arab Americans. This article briefly provides background information on Arab Americans, highlights elements of Arab culture that might influence psychological treatment, discusses ethical issues that might arise when psychologists provide services to Arab Americans, and provides recommendations to address these issues.     

When Does a Professional Relationship with a Psychologist Begin? An Empirical Investigation

Research on multiple relationships by practicing psychologists has typically presumed the presence of a professional relationship and focused on the ethicality of subsequent, nonprofessional relationships. Instead, this study focused on the question of what, exactly, constitutes the professional relationship in the first place. Practicing psychologists and undergraduates responded to vignettes portraying various early stages of interaction between a therapist and a prospective client. Participants' responses indicated that determinations of professional relationship establishment, and the ethicality of subsequent nonprofessional relationships, depended upon the degree of engagement. Some differences emerged between perceptions by professionals and nonprofessionals. Ethical and professional implications are discussed.     

后现代心理治疗及其伦理问题思考

文章通过论述后现代对现代认识论和思维模式的质疑与超越,分析了后现代语境下心理治疗与现代心理治疗的差异,并关注在后现代这一新的思维模式下,心理治疗领域可能产生的伦理问题。作者指出,后现代心理治疗的不确定性、价值干预和文化介入,使心理治疗的伦理挑战被进一步复杂化,对治疗师也提出了更高要求。     

Ethical Considerations for the Treatment of Youth in Foster Care

Mental health clinicians treating youth in foster care face several ethical challenges, such as competence for treating youth in foster care, understanding who can provide informed consent, and confidentiality. However, few articles have addressed these ethical concerns or provided recommendations for clinicians on how to navigate these issues. This article presents a brief summary of the foster care system, an overview of the major ethical challenges clinicians may encounter when treating youth in foster care, areas of the American Psychological Association’s Ethics Code, Code of Ethics of the National Association of Social Workers, and American Counseling Association Code of Ethics most germane to the treatment of youth in foster care, and general recommendations for clinicians treating this population.     

Ethical and Legal Issues Addressing the Use of Mobile Health (mHealth) as an Adjunct to Psychotherapy

mHealth refers to the rapidly evolving use of mobile devices for health care treatment purposes, particularly the use of apps and texting as adjuncts to psychotherapy. Although there is currently an extensive literature on issues related to telehealth, to date little guidance has been developed to help professionals function ethically in the rapidly emerging area of mHealth. This article identifies the major ethical considerations that need attention and proposes several recommendations to address mHealth use as an adjunct to psychotherapy, including the pressing need for relevant American Psychological Association practice guidelines to assist mental health providers in the ethical implementation of mHealth.     

‘All the Rest is Dance’: another look at Levinas

This paper begins by tracing the growing influence of Levinas’s thought in the humanities. Psychotherapy in particular has drawn on Levinas’s original contribution to ethics and is often inscribed within an existing dialogical frame of symmetry. The article discusses facets of Levinasian thought which have been neglected in psychotherapy, namely the notion of separation, in turn linked to the notions of asymmetry and of the traumatic subject, all at variance with dialogical therapy. A second, equally overlooked aspect of Levinas’s philosophy examined here concerns his politics. Some of the implications highlighted here are controversial: these relate to Levinas ‘naive Zionism’ and a prejudiced position in relation to Arab culture. Others are enlightening even if undeveloped: these relate to Levinas’s decolonial thinking of the 1970s. The paper reflects tangentially on the author’s clinical work, and calls for a more nuanced appreciation of Levinas’s philosophy which does not shy away from critique.     

Feminist Pioneer: Annette Brodsky Paving the Way

ABSTRACT

Even when the culture imposed stringent limitations on women’s roles, Dr. Annette Brodsky refused to succumb to these restrictions. As one of only a few women in her graduate school cohort, she broke new ground during her pre-doctoral internship, her post-internship military placement, and in her faculty position at the University of Alabama. Her renowned work advocating for and studying the effect of consciousness-raising groups engendered critical scholarship that revealed the harm of therapists’ sexual abuse and facilitated improved ethics and guidelines for psychologists in their work with clients. Dr. Brodsky has served as a pioneering feminist psychologist for several generations of women.     

Financial and Ethical Considerations for Professionals in Psychology

The profession of psychology is one of many entities affected by the current economic recession. The question of what to do when clients cannot pay agreed-upon charges will need to be answered. Ethical issues related to setting the fee for psychotherapy, insurance coverage, abandonment, pro bono psychotherapy, and lack of resources are addressed in light of the 2002 American Psychological Association's Ethical Principles of Psychologists and Code of Conduct and other relevant literature. The impact of the Mental Health Parity Act on the financial complexities that professionals in psychology now face is also discussed. Several recommendations are made for psychologists, calling them to be proactive in their communities, to be advocates for their clients, and to critically evaluate their financial practices.     

A challenge to ‘self’ centred ‘psycho’: Therapy as an introduction to an ‘inter-relational therapy’

This paper focuses on ‘psychotherapy’, particularly exploring the emphasis on the ‘psyche’. The term ‘psyche’ is described as potentially having different interpretations depending on the underlying ontological assumptions that influence its understanding and these, it is suggested, will have considerable implications for the therapy that identifies with the label ‘psychotherapy’. Two very different ontological perspectives are highlighted in this paper in order to illustrate the different conception of the term ‘psyche’; firstly, Freud’s interpretation of what is meant by ‘psyche’, which is then contrasted with a phenomenological perspective, with reference to the philosophy of Husserl and Heidegger. Both the Freudian and phenomenological approaches are then criticised for focusing on, what is described here as, an egocentric perspective and it is suggested that the term ‘psycho-therapy’ will inevitably lead to a preoccupation with putting the ‘self’ first as a basis for relating to the external world. An alternative term, ‘Inter-relational therapy’, is presented based on the ideas of Levinas and MacMurray, both of who are critical of a cultural preoccupation with focusing on the ‘self’ and suggest a need to acknowledge relationships with the external world, including the other people that populate it, prior to a ‘self’ reflective process.     

The culture of psychotherapy supervision

Psychotherapists in training and beyond are expected to receive regular clinical supervision. In Britain many practitioners are required to have life long supervision. This paper draws on recent research into supervision, and highlights a number of areas that have been identified as problematic, including: power and control, spirituality, touch, ethical issues and secrecy. It is suggested that a professional culture of supervision has been constructed that may not reflect the best interests of either clients or practitioners. The implications of this perspective are explored.     

Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals With Serious Mental Illness

Mental health professionals frequently work with family caregivers in the provision of psychotherapy services to individuals with serious mental illness. To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. When working with family caregivers, practitioners utilize the American Psychological Association’s Ethics Code (2010), legal codes, and a complex decision-making plan; identify and communicate ethical obligations to family caregivers; consider the unmet needs of this population; avoid harm resulting from multiple relationships; and balance ethical duties of beneficence and respect for autonomy.     

Informed consent as a prescription calling for debate between analysts and researchers(1)

This article is a review of the international scientific literature on informed consent and its use in some of the constituent organizations of the International Psychoanalytical Association (IPA). Because psychoanalysis comprises a theory based on practice, the dearth of clinical material for study, training and research purposes is a serious problem for analysts. Supervisions, presentations at scientific societies and congresses, publications and teaching material involve patients to an extent that goes beyond the work done in their sessions. Should consent be requested in these cases? This contribution addresses controversial and long‐standing issues such as informed consent and confidentiality, audio recording of treatments, knowledge production, the ambivalence of participating subjects over time and the perspective of analysts and patients respectively. The authors consider the various alternative approaches available for the handling of these ethical dilemmas without losing sight of the patient’s dignity and personal rights, while also taking account of the position of the analyst.     

Special Series Introduction: Confronting the Challenge of Clinical Decision Making in Evidence-Based Practice

This special series addresses the often ignored problem that many clients seen by practicing clinicians do not benefit from empirically-based practices as neatly as research may suggest. The authors in this series have considered the process of decision making in evidence-based practice, looking from differing viewpoints, and considering treatment setting and ethical issues. They present suggestions for clinicians to adapt treatment to the needs of clients while adhering to the robust research on psychotherapy processes and cognitive behavioral therapy.     

Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas,Ethical Issues,and a Proposed Decision-Making Process

Religion and spirituality are important aspects of the lives of most psychotherapy clients. Unfortunately, many psychotherapists lack the training to effectively and ethically address these issues with their clients. At times, religious or spiritual concerns may be relevant to the reasons clients seek treatment, either as areas of conflict or distress for clients or as sources of strength and support that the psychotherapist may access to enhance the benefit of psychotherapy. This article reviews persistent ethical issues and dilemmas relevant to providing psychotherapy to clients for whom issues of religion and spirituality are clinically relevant. Ethical considerations include assessment, advertising and public statements, informed consent, competence, boundary issues and multiple relationships, cooperation with other professionals, and how to effectively integrate religious and spiritual interventions into ongoing psychotherapy. A decision-making process is presented to guide psychotherapists in their clinical work with clients for whom religious and spiritual issues are salient or clearly linked to their presenting problems.     

National Survey of Client's Perceptions of Chinese Psychotherapist Practices

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients.     

Ethical Issues and Potential Solutions Surrounding the Use of Spoken Language Interpreters in Psychology

The need for psychological services to limited English proficient clients is increasing. Psychologists who provide clinical services to limited English proficient clients are frequently required to use the services of spoken language interpreters. Research has shown that the quality and consistency of interpretation services are often in question. Interpreters are generally not required to hold any certifications or to meet training requirements prior to providing interpretation services. This lack of oversight leaves the psychologist responsible for the quality of the interpretation when adhering to the American Psychological Association’s (APA) 2010 Ethical Principles of Psychologists and Code of Conduct. This article includes a discussion of the ethical and clinical issues inherent in providing psychological services through an interpreter, how those issues affect a psychologist’s adherence to the APA Ethics Code, and recommendations for meeting the ethical standards while providing sound clinical services through the use of spoken language interpreters.     

Therapy at the Cultural Interface: Implications of African Cosmology for Traumatic Stress Intervention

The topic of intercultural or multicultural therapy continues to stimulate much debate in the field of psychotherapy. Intercultural counseling training emphasizes respect for cultural beliefs as a core dimension of appropriate intervention. This paper addresses the limitations of this perspective in guiding therapists when faced with a clinical situation in which the non-challenging of cultural belief systems seems counter-therapeutic. The discussion is focused around critical observations of circumstances in which conventional African wisdom, as understood by clients presenting for trauma counseling, appeared to be counterproductive for their recovery in terms of western intervention principles. In psychotherapy for traumatic stress and traumatic bereavement, such tensions appear to arise particularly strongly because of the inevitable search for meaning in the face of extraordinary life events. Focusing on meaning making, cognitive intervention, schema realignment and reframing within trauma therapy, the paper explores ethical considerations and areas of potential conflict with reference to theory and clinical case material. Some strategies for therapeutic engagement are proposed.     

Ethical Care for Vulnerable Populations Receiving Psychotropic Treatment

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations (e.g., older adults, people currently low in social status, immigrants, and racial/ethnic minorities) face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and overmedication. Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy.