Sexual Contact Between Psychologists and Patients

Summary

This article discusses sexualized dual relationships between psychologists and patients, including both sexual contacts while treatment is in progress and after its termination. The reported prevalences of sexual contact between psychologists and patients and between psychologists and former patients are discussed as well as practitioners attitudes towards these two types of relationships. The profiles of both psychologists and patients likely to be involved are outlined as are the clinical and professional consequences of these behaviours. Finally, the APA Ethics Code (2002) is examined to determine whether its inclusions in these areas are adequate and to shed more light on clinicians' continued roles and responsibilities even after treatments have concluded.     

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.     

Book Review: Managing Mental Health in the Community: Chaos and Containment

Abstract

The British Association of Counselling first introduced a Code of Ethics and Practice for Counsellors in 1984. It has subse-quendy been revised three times. The codes have to be sufficiently broad to be accepted by the membership of BAC, who come from a wide range of theoretical backgrounds. Inevitably this means that the codes do not satisfy everyone nor do they resolve all ethical dilemmas. This paper focuses on sections of the codes which are unsatisfactory, or inadequate for psychodynamic counsellors. It also looks at the influence of psychodynamic counsellors in changes to the clauses on sexual exploitation. Finally the absence of any mention of dual and multiple relationships is discussed.     

Adolescents' use of affiliative and aggressive strategies during conflict with romantic partners and best-friends

Objective: Developmental theory suggests romantic relationships present unique demands when adolescents transition from the interaction patterns of same-sex friendships to cross-gender interactions. A possible response is to incorporate behaviours of the other gender: girls adopting aggressive strategies and boys adopting affiliative ones. The goal of this study is to explore this hypothesis by comparing conflict resolution among romantic couples and same-sex best friends. Method: Observational methods were employed with 37 female best friends, 22 male best friends and 37 romantic couples. Of the romantic couples, 35 also were observed with a best friend. Affiliative and aggressive behaviours were tabulated during two conflict tasks. Results: Female best friends were more affiliative than male best friends and romantic partners; these latter dyads were more aggressive than the female best friends. Within group comparisons indicated that boys and girls decreased their affiliative behaviours, especially verbal humour, and increased their aggressive behaviours, especially teasing, when observed with the romantic partner compared to the best friend. Decomposing the romantic dyad, girlfriends displayed relatively more aggressive behaviours than their boyfriends, and boyfriends exhibited more affiliative behaviours. Conclusions: Findings shed light on gendered shifts in patterns of interaction as adolescents transition from same-sex friendships to romantic relationships.     

Ethical Challenges for Military Psychologists: When Worlds Collide

Despite the mental health needs in the military and improved access to military psychologists, many in need do not seek psychological services. The military policies, culture, and environment pose considerable barriers to help seeking. In turn, military practices often conflict with the psychologist’s professional ethics, leading to a range of ethical dilemmas including multiple relationships, multiple agencies, and limited confidentiality. To address ethical concerns and encourage service members to seek mental health services, this article proposes maintaining an understanding of military rules, law, and professional ethics; identifying multiple relationships and establishing boundaries up front; and collaborating with the patient in disclosures of information.     

Modifications des relations intrafamiliales dans les familles françaises de jeunes enfants pendant le premier confinement lié à la COVID-19

IntroductionIn the context of the COVID-19 pandemic, the French state implemented containment measures requiring parents to stay at home with their children, while ensuring, in addition to daily tasks and work, their schooling.ObjectiveThe objective of this publication is to present the modifications of parent-child and spousal relationships during this period and their main sources according to the parents.MethodAn online questionnaire from 28 April 2020 to 29 May 2020 collected data from 490 French families with at least one child from birth to six years old. A content analysis of the discursive corpus was carried out with NVivo software (version 10). Quantitative statistical processing (using STATA software, version 16.1) tested the relationships between socio-demographic variables, as well as those relating to the parents’ experiences, and “strained” and “strengthened” intrafamily relationships.ResultsWhile for 33.3% of the respondents, family relationships did not change, they became stronger for 42.5% and tense for almost a quarter (24.3%).ConclusionUnderstanding the sources of tension experienced by families of young children during lockdown, as well as what enabled other families to better cope with this situation, may enable measures to be implemented to deal with the consequences of the discomfort generated by the lockdown and to avoid further psychological problems during possible future ones.     

Authority in Relationships

Abstract

Authority consists in having standing to make a claim on another person’s actions. Authority comes in degrees: persons have the authority to make moral demands on each other, but if they participate in close relationships, such as friendships or love relationships, their authority over each other is greater, compared to the authority of strangers to make demands, as participants in personal relationships can demand more from each other than can strangers. This paper discusses the phenomenon of a relationship-dependent greater authority on a conceptual level. It thereby fills a gap in the literature on the proper theory of authority: while being a common part of our moral practice, relationship-dependent authority has mostly been neglected in this context. It is even doubtful whether the most influential contemporary accounts of authority can accommodate it. As will be argued, neither Joseph Raz’s service conception nor Stephen Darwall’s second-personal conception of authority are able to. The triggering-reasons account of authority, as recently developed by David Enoch, is better suited in this regard: according to this conception, relationship-dependent authority stems from special conditional reasons that are implied by relationships and that can be triggered by the authoritative demands of their participants.     

Managing Nonsexual Multiple Relationships in University Counseling Centers: Recommendations for Graduate Assistants and Practicum Students

Graduate students typically serve in a wide variety of positions throughout their course of study in an academic setting. Because of the large number of roles assumed, graduate students may encounter several ethical dilemmas unique to the academic setting, particularly dilemmas regarding nonsexual multiple relationships. Although the topic of multiple relationships and psychologists has been extensively discussed in the literature, fewer articles have focused on the potential for nonsexual multiple relationships between graduate assistants, practicum students, and undergraduate students. This article focuses on the unique ethical dilemmas and challenges experienced by graduate assistants completing their practica at University Counseling Centers and provides recommendations for evaluating and managing nonsexual multiple relationships with undergraduate students.     

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues (e.g., Americans with Disabilities Act) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

Dyadic coping in coach-athlete relationships: A grounded theory

ObjectivesThe purpose of this study was to make an original contribution to sport psychology literature by offering a substantive grounded theory of dyadic coping in coach-athlete relationships. Specifically, this study aimed to capture the development and manifestation of dyadic coping for coaches and athletes operating in individual sports.DesignUsing constructionist grounded theory methodology as a guide, a theory of dyadic coping was constructed by the authors, 13 coaches, 15 athletes, and five sport and exercise psychology practitioners.MethodTheoretical sampling procedures ensured that data collection was directed by the developing theoretical concepts, rather than a set of predefined criteria. We conducted individual interviews (n = 16) with coaches and athletes, and one 90-min workshop with coaches, athletes, and sport and exercise psychology practitioners. Methodological rigor was enhanced by focusing on credibility, originality, resonance, and usefulness.ResultsThe theory proposes that when coaches and athletes appraise a stressor communicated in their dyad as significant and meaningful, they use dyadic coping to protect themselves and their coach-athlete relationships. This process is moderated by a number of personal (e.g., personality), relationship (e.g., length), and organizational (e.g., leadership behaviors) characteristics.ConclusionThe theory presented here represents a notable shift in thinking away from coping as an individual process and toward coping as an important interpersonal phenomenon. This type of coping can have long-term effects on coaches’ and athletes’ relationship functioning, well-being, and performance.     

“I love you as both and I love you as neither”: Romantic partners’ affirmations of nonbinary trans individuals

Abstract

Background: Transgender microaffirmations are subtle endorsements of a person’s gender identity through both verbal acknowledgements and behavioral gestures. Microaffirmations positively impact individuals who identify as transgender by acknowledging their gender identity and by communicating a sense of support and validation.

Aims: This study focuses on microaffirmations specifically directed toward nonbinary transgender individuals within romantic relationships.

Methods: Participants included 161 adults who identified as nonbinary: 85 who identified as gender nonconforming and 76 who identified as agender. These participants were either currently in a romantic relationship or had been in a romantic relationship within the past 5 years. Participants completed an online survey and provided examples of the microaffirmations they experienced from their romantic partners.

Results: Responses were analyzed via thematic analysis, resulting in four overarching themes: (1) Identity Validations, acknowledgement and acceptance of nonbinary identity; (2) Identity Endorsements, active endorsements of nonbinary through language or behavior; (3) Active Learning, self-education about nonbinary identities; and (4) Active Defense, interruptions of others’ negative actions directed at nonbinary partners.

Discussion: Discussion of the results focuses on understanding how microaffirmations operate to complicate binary notions of gender/sex and positively influence nonbinary transgender individuals in interpersonal relationships.     

School Psychology: Training Individuals for One of the Best Kept Secrets in Professional Psychology

Abstract

School psychology training at the doctoral level is discussed. Given the increasing diversity in the schools as well as the varied education and mental health needs of the population, school psychology training is necessarily broad, involving traditional skills such as assessment, intervention, consultation, and counseling, all of which are taught within a context of a changing school population with changing needs. Because there is compulsory education, school psychologists’ interface with a broad cross-section of individual children, their parents, and their teachers. Moreover, school psychological practice is not limited to schools, as doctoral school psychologists are health service providers; many of these individuals work in other settings for which they are trained to provide services. The complexities and challenges of training school psychologists within this broad agenda effectively across domains are discussed.     

Boundary Issues and Multiple Relationships in Genetic Counseling Supervision: Supervisor,Non-supervisor,and Student Perspectives

Boundary issues and multiple relationships potentially affect all supervision interactions. Boundary crossings are departures from the strictest professional role and may or may not benefit supervisees. Boundary violations are outside common practice and may place supervisees at significant risk. Multiple relationships occur when supervisors concurrently or consecutively hold two or more roles with supervisees. Studies in other fields indicate supervisors and supervisees may be uncertain about professional conduct regarding these issues. In this study, genetic counselor supervisors (n?=?126), non-supervisors (n?=?72), and genetic counseling students (n?=?129) completed an anonymous survey investigating four major questions: 1) Are various boundary issues and multiple relationships perceived as differentially appropriate? 2) Do supervisor, non-supervisor, and student perceptions differ? 3) What challenging situations have respondents experienced? and 4) What management strategies did they use? There was general agreement among groups in their appropriateness ratings of 56 hypothetical supervisor behaviors, although supervisor ratings tended to reflect stricter boundaries regarding the appropriateness of interactions than student ratings. A majority rated unavoidable boundary crossings and supervisor multiple relationships involving an academic relationship as most appropriate, and romantic/sexual multiple relationships and/or boundary violations as least appropriate. Analysis of respondents’ actual challenging situations revealed many involved boundary violations, placed students at risk of harm, and often resulted in student compliance.     

Supporting dual career in Spain: Elite athletes' barriers to study

ObjectiveThe aim of this study was to analyze whether a Career Assistance Program (PROAD) facilitates the dual career.Design and methodA cross-sectional, prospective and quantitative design was used. A questionnaire was sent to all of Spain's elite athletes from Olympic sports. Of the 2378 elite athletes, 575 (332 men and 243 women) completed the 29-item questionnaire. The overall response rate was 24.2%.ResultsMost of the athletes perceived the dual career as difficult. Their most significant barriers are related to time management. The PROAD athletes and the non-PROAD athletes encountered the same barriers to studying. In general, the PROAD program seemed to have a positive effect on the academic level an athlete achieves. The athletes enrolled in the PROAD were more informed than the non-enrolled athletes. PROAD athletes were more proactive in demanding help and they had a closer relationship with the Spanish Sport Council than the non-PROAD athletes.ConclusionsStudent-athletes have several problems with the normalized educational system. Sport psychologists should reinforce the athlete's strengths, and they should seek the opportunities the sport context provides to athletes. The barriers could be minimized by adopting certain strategies. The PROAD program seems to be useful in terms of providing information, in ensuring elite athletes work or study before the end of their sports career, in making them responsible and autonomous, and in being more active.     

Treatment of Male Homosexuals in Groups

Abstract

The healing power of psychodynamically oriented therapy and training groups rests, to a large degree, upon the quality of the here and now interactions. For the work to be effective, the basic principles of analytic group work need to be followed, including the observance of no extra–group contact. Simply said, nothing leaves the room. This principle has both ethical and clinical implications. It is my premise that while some forms of outside contact between members are relatively benign, other types are not. Outside contact that is built into the fabric and context of the group may pose a risk, as may be the case where dual relationships exist between members. The impact of dual relationships between group members in the particular instance of analytic training institutes is the focus of this article. What happens to the transference in this context when members reveal too much of their personal lives to each other through dual relationships is explored. It is suggested that extra–group contact can disrupt the balance between reality and transference distortion in group interactions in at least three ways: (a) “The Emperor’s New Clothes” effect, (b) looping, and (c) gaslighting. Vignettes are presented to illustrate these phenomena and suggestions for reform are offered.     

The Constructive Use of Power and the Philosophy of the Self in the Training of Family Therapists

Abstract

This article presents findings from an exploratory qualitative study, which used individual interviews and a focus group to investigate how women in Black-White interracial heterosexual partner relationships retrospectively described their racial identity development and the influence of gender identity development on this process. Social consrructionist, feminist, and racial identity development theories guided the grounded theory methodology. Participants described both constraining and empowering racial identities. Salient constraining racial identities were being a “sell-out” or “traitor,” being a “rule-breaker,” having a masked reference group orientation, needing to prove reference group orientation, and having minority family status. Empowering racial identities included refusing to take sides, being “not racial,” being neutral, identifying by respect rather than by race, having a multiple reference group orientation, being strong, and being an educator and mediator.

Gender identity themes of strength and resiliency emerged as significant influences in racial identity development. Suggested questions for use within a narrative therapy context provide a clinical application of findings from the study.     

A School Psychologist's Self-Study Guide to Sport Psychology

SUMMARY

School psychologists may find the field of sport psychology beneficial to them in extending their skills and effectiveness. As trained psychologists, they are likely to already have some of the knowledge and skills necessary for working in the area of sport psychology. However, without additional training, this may not be sufficient for ethical and effective practice. This article enumerates the necessary knowledge and skills for working in sport psychology according to APA's recent proficiency standards. It then details a plethora of available resources and methods for entering into the domain of sport psychology. The article emphasizes self-study while continuing to practice ethically within the ‘boundaries of one's competence.’     

Selective Social Belief Revision in Young Children

ABSTRACT

Recent research has shown that from early in development, children selectively form new beliefs in response to information supplied by others. However, little is known about the development of selective revision of existing beliefs in response to socially conveyed information. Such selective social belief revision has been extensively studied by social psychologists in the context of advice-taking. Here, we adapted the methods of this research tradition for studying selective advice-taking in young children and adults. Participants solved a perceptual judgment task, received advice, and subsequently made final decisions. The informational access (perceptual quality) of participants and advisor were experimentally manipulated. Adults revised their judgments systematically as a function of both their own and the advisor’s informational access whereas children based their adjustments only on their own informational access. Two follow-up experiments suggest, however, that this pattern of results in children reflected performance rather than competence limitations: In suitably modified tasks, children did proficiently consider both their own informational situation and that of the advisor in their selective social belief revision.     

Your Cheatin' Heart

SUMMARY

This work challenges therapists to look at themselves and their beliefs regarding affairs. The work also examines common illogical beliefs in regards to extradyadic involvement. The reader is challenged to examine the underlying dynamic of extradyadic relationships and how their own biases affect how they view clients and work with the dyad.