Ethical issues in record keeping in group psychotherapy

This article discusses numerous ethical issues regarding the keeping of records in group psychotherapy, those activities that have to do with the creating, retaining, storing, releasing, and disposing of them. A central dilemma for the group therapist is whether to keep records separately for each individual group member or to keep one record for the group as a whole. Confidentiality of records, patient access, and release of information tend to be more complex issues for group psychotherapists than for individual psychotherapists. Although notes written about the entire group may capture important themes, such notes can compromise the privacy and confidentiality of individual group members. An individual record for each patient is recommended.     

Ethical and malpractice issues in hospital practice

Ethical and malpractice issues arising in hospital practice are reviewed. Topics include (a) preparation and authorization to carry out clinical responsibilities, (b) personnel procedures, (c) financial and political forces influencing hospital policies, (d) billing procedures, (e) clinical procedures for responding to patients' needs, (f) confidentiality, (g) discrimination, (h) internship and training issues, (i) sexual abuse of patients, and (j) staff conflicts influencing patient care.     

Outcome of psychodynamic child psychotherapy in routine practice

The aim of the present naturalistic study was to explore the effectiveness of psychodynamic child psychotherapy in routine practice. The sample comprised 207 psychotherapies with children 4–12?years of age with a broad range of mental health problems. Data on two measures, children’s global assessment scale (CGAS) and strength and difficulties questionnaire (SDQ), were collected pre-post therapy. Within-group changes were analysed using repeated measures mixed-models ANOVA. Individual changes were examined by means of clinical significance. The analyses revealed improvement in general functioning, decrease in problem severity and problem impact on the child’s everyday life, as well as an increase in prosocial behaviour. For CGAS, an interaction effect was discovered suggesting a larger improvement for younger children (4–6?years) than for older children (10–12?years). After therapy, 38% (n 76) achieved clinically significant improvement. Time-limited psychotherapy proved favourable for children assigned to that particular treatment modality. The study generated similar results as previous well-controlled trials, revealing statistically significant results in a large sample and in spite the use of non-specific outcome measures. The study provides everyday evidence to the effectiveness of child psychodynamic treatment with parallel parental work for a broad range of child mental health problems.     

The relevance of current clinical practice in child psychotherapy to child psychiatry

SUMMARY

The role of child psychiatrists is evolving. Economic and psychosocial factors such as marital breakdown, inner city decline, unemployment, plus increased awareness of conditions such as Substance Abuse and all forms of Child Abuse have led to stress for children and their caretakers. There is also increasing recognition that with help many troubled children and their families can emerge better able to function. Child psychiatrists occupy a pivotal position in the child mental health team and need to be familiar with all the treatment options available to ensure their effective use. This paper presents examples of current work being undertaken by child psychotherapists and discusses the implications of this for the training of child psychiatrists as well as for clinical work.     

Ethical practice: foundations and emerging issues

Ethical practice in counseling should mean more than remedying past mistakes. Counselors must look to the future and develop ways to stay in contact with the realities of a changing world. They must give certain philosophical and procedural questions constant attention to check on the validity for the present of long held ideas. In this way emerging issues can be identified before impossible situations are created.     

Ethical issues in the research and practice of applied developmental psychology

Within the last decade, applied developmental psychology (ADP) has emerged as a new subspecialization within traditional graduate programs in developmental psychology. Current definitions of ADP range from a primarily research-oriented discipline to a superordinate discipline under which clinical, educational, and school psychology organize applications of the developmental data base. This work draws upon several common themes to arrive at a broad definition of ADP. We outline reasons for developmental psychology's entrance into the “decade of applied research,” the broad spectrum of activities currently characterizing ADP, and training programs proposed to prepare students for these activities. The extension of developmental psychology into applied areas requires attention to the ethical issues encountered across the full spectrum of ADP activities. We present a perspective of ethical issues whose framework is predominantly applied developmental psychology. Our approach focuses on ethical concerns associated with both knowledge generation and knowledge application. In so doing, we raise issues concerning the need for applied developmentalists to address questions concerning the impact of planned methods on development in normal and atypical populations, consultation to institutions and public policy makers, competencies required to conduct developmental education programs, and utilization of developmental assessment techniques.     

Ethical issues for psychologists in hospital-based research and practice

Psychologists are increasingly viewing hospital-based practice with problems of physical health and illness as an area of both needed and appropriate involvement. Indeed, a wide array of research findings underscores the importance of psychological factors in maintaining physical health and preventing illness. However, the increasing involvement of psychologists, and broader acceptance of the practice contributions they can make, may lead to their experiencing ethical dilemmas in research and in practice. This article considers some ethical issues of confidentiality and informed consent in areas of research and practice with hospital-based patients.     

Accountability and dignity: Ethical issues in forensic and correctional practice

Our aim in the special issue is to address some of the more abstract and fundamental ethical problems evident in the criminal justice system and to inquire into their significance for those individuals who assess and deliver rehabilitation programs to offenders. In order to provide an appropriate theoretical framework for an investigation of ethical concerns in the forensic and correctional practice domains, we first outline an ethical framework that is intended to help practitioners reflect systematically on their practice [Ward, T., & Syversen, K., (2009). Vulnerable agency and human dignity: An ethical framework for forensic practice. Aggression and Violent Behavior, 14, 94–105]. Second, we explicitly examine the relationship between two normative frameworks evident within the criminal justice system, punishment and rehabilitation, and inquire into their relationship. Finally, we briefly describe each of the papers comprising the special issue.     

Religious issues in psychotherapy

Religious belief is important to a large proportion of our population. It has been found to be a potent neutralizer of death anxiety. Religion and psychotherapy shave values relating to self-actualization. It is the responsibility of psychotherapists to be aware of their own ambivalences and biases; to assess the significance of religious belief in the lives of their clients; to clarify conflicting views and values of client and therapist; to treat the client's psychodynamic problems; and respectfully to refer spiritual problems outside the domain of psychotherapy to the client's minister. An illustrative example from the author's practice is included.Based in part on a paper presented at the annual meeting of the California State Psychological Association, San Francisco, California, February 4, 1983. Dr. Sacks is Associate Dean Emeritus California School of Professional Psychology, Fresno. He has been in the private practice of psychotherapy for more than 30 years.     

Ethical issues in diagnosis

The ways in which ethical issues arise in making clinical judgments are briefly discussed. By showing the topography of the role of value judgments in medical diagnostics it is suggested why clinical medicine remains inextricably a value-infected science.     

Ethical issues in genetics

The first section of the Notes on Moral Theology reviews ethical issues in genetics through the lenses of privacy-confidentiality; risk-benefit analysis in relation to prenatal diagnosis and gene therapy; and freedom-determinism/human dignity in the context of cloning. The author provides an overview of developments in genetics and highlights thematic issues common to these developments.     

Developmental issues in psychotherapy research

Research on psychosocial interventions with children requires attention to developmental principles such as age-specific competence, maturational shifts, increasing cone of relevant contacts, and socioeconomic context of biological stages. Research strategies that include such variables should lead to ecologically sound investigations and the correct selection of outcome variables. A consideration of the specificity of treatment and controlled design alone are not sufficient to guide the study of the psychological treatment of developing organisms and persons.     

Existential issues in group psychotherapy

Existential issues in group psychotherapy derive from existential thought both as a philosophy and as a value system. Its origins derive from the weakening of traditional values and the growing alienation of man from himself. The unique features of existentialism can be applied to all forms of therapy. These features are universal to humankind. They are finiteness, aloneness, guilt, responsibility, and freedom. In including existential concerns as part of group psychotherapy, therapist and patients move more closely to bilateral relationships and subjective interactions.