Ethical Considerations for Cognitive-Behavioral Therapists in Psychotherapy Research Trials

Psychotherapy research studies, which balance the pursuit of knowledge with the provision of treatment, can place unique demands on clinicians, patients, and research staff. However, the literature on ethical considerations in psychotherapy trials is minimal. The current paper depicts CBT community standards of practice in the context of two NIMH-funded treatment trials of major depression, both involving CBT and medication. We describe issues that arose; discuss the ethical considerations involved; and describe our course of action, along with our rationale.     

When Psychotherapy Is Not Working: Ethical Considerations

Evidence-based practice (EBP) models have been developed, in part, to enhance the likelihood that the outcome of health care treatment, including psychotherapy, leads to positive improvement. However, two additional outcomes can occur: no change and poor outcome (e.g., harm, worsening of symptoms). What does the clinician do when psychotherapy is not working? When faced with various treatment decisions, such as this, the EBP model posits that therapists should apply their clinical expertise in considering the “best available research” within the context of various patient characteristics. In part because of various limitations of this approach, I suggest that another important set of principles are important to consider in tandem when faced with this clinical dilemma—that is, ethical concerns. Borrowing from the American Psychological Association’s (2017a) Ethics Code, I discuss how the following issues exist when clinicians wrestle with this question: avoidance of harm, competence, conflicts of interest, and informed consent. I conclude this paper with a list of suggestions that can potentially foster the application of ethical principles when making treatment decisions.     

Ethical and Legal Considerations for Internet-Based Psychotherapy

The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.     

Inpatient Group Psychotherapy: Practical Considerations and Special Problems

A comparison is made between group-analytic and group focal conflict theory in terms of the conceptualization of the group as a whole; the emergence of group-level phenomena from the interaction of individuals; the associative flow as the material for therapy; facilitative and nonfacilitative group conditions; the therapist's aims on behalf of the persons in the group and perceived routes toward therapeutic gain; general factors contributing to therapeutic gain; specific factors contributing to therapeutic gain; and the therapist's role. Differences in terminology are examined to determine whether and how they reflect differences in substance. Many similarities and some differences in emphasis can be shown to exist. Both approaches generate respect for the power and potential of the group to support significant reexperiencing, with attendant opportunities for personal benefit and change.     

Ethical Issues in Research on Psychotherapy

A number of ethical issues that researchers in the area of psychotherapy have to consider are reviewed and some possible solutions considered.     

Ethical Considerations in Family Therapy Research

In this article, significant ethical issues that arise in the conduct of family therapy research are considered and four major areas are emphasized: (a) the researcher's responsibility to protect the rights of research participants, (b) confidentiality and informed consent, (c) the researcher's values, and (d) methodology. In each area, parallels are drawn between the ethical issues facing family clinicians and those facing family researchers.     

Comparison of Dreams in Individual and Group Psychotherapy

This article gives specific reasons and evidence why group psychotherapy is the treatment of choice for addictions. Utilizing object relations theory and the self-psychology of Kohut, the authors present a model of group psychotherapy that combines these perspectives with those of Yalom's interactional group psychotherapy. Agreeing with Kohut and other object relation theorists, the authors view addiction as a condition that is the result of a person's misguided attempts at self-repair because of deficits in psychic structure. Vulnerability of self is the consequence of developmental failures and deprivation. Substance abuse only exacerbates this condition leading to exaggerated difficulty in regulation of affect, self-care, and characterological pathology. Abstinence is usually required as the first step in arresting this process and establishing a treatment regimen that will allow the vulnerabilities of the self to be altered and restored. This article suggests that this recovery and treatment process is best accomplished in a group therapy setting that is conducted within the guidelines of the principles of object relations theory and a modified version of Yalom's interactional group therapy format.     

Assent and Dissent: Ethical Considerations in Research With Toddlers

In accordance with ethical principles and standards, researchers conducting studies with children are expected to seek assent and respect their dissent from participation. Little attention has been given to assent and dissent in research with toddlers, who have limited cognitive and emotional capabilities. We discuss research with toddlers in the context of assent and dissent and propose guidelines to ensure that research with toddlers still adheres to ethical principles. These guidelines include designing engaging studies, monitoring refusal and distress, and partnering with parents. Research with toddlers requires flexibility and creativity to respect toddlers in the context of their developmental capabilities.     

句法歧义解决研究的新进展——歧义解决的限制一满足模型

句法歧义(syntactic ambiguity)及其解决是一种重要的语言现象。一直以来，句法歧义解决的研究受Chomsky的生成语法理论影响，强调句法及句子意义的建构性特征，而忽视了词汇所携带信息及语境对句子加工的作用。自20世纪70年代兴起的认知的神经网络观使人们认识到句法歧义解决的限制满足性质，导致句法歧义研究出现了新的进展。     

Group Psychotherapy in France

This article discusses group therapy as part of a multidisciplinary approach to the management of the various psychological and physical rehabilitation concerns posed by kidney and liver transplant candidates and recipients at Howard University Hospital in Washington, DC. The group's history, format, intervention foci, and roles of clinicians and patients attending the group are described and evaluated. Given the relative paucity of research literature in this area, the authors offer recommendations for empirical evaluation of the benefits of multidisciplinary group psychotherapy in ameliorating physical and emotional suffering and prolonging life among transplant patients.     

Ethical Issues in Counselling and Psychotherapy: The Background

Ethical issues have their roots in the belief systems of individuals and society. Codes of ethics are seen as attempts to ensure that behaviour accords with these belief systems. An outline model is presented which highlights some aspects of beliefs, feelings and conscious and unconscious processes, and their effects upon the conscious behaviours of the individual. Aspects of social change and context are briefly considered, together with the subsequent effects upon beliefs and ethics, and issues of responsibility.     

Using Art in Counseling: Ethical Considerations

Various mental health professionals use, on occasion, drawings and other types of art in therapy, but relatively little has been written on the ethics surrounding this technique. The authors take the position that artwork should be viewed as equivalent to verbal communication. Such equivalency gives rise to a variety of ethical issues that encompass confidentiality, documentation, ownership, research, publication, and display of artwork.     

The Group Psychotherapy Literature: 1976

This paper reviews and critiques the literature on countertransference (CT) in group psychotherapy. The literature review is organized within a framework that calls attention to the origins, triggers, manifestations, and effects of CT in groups, as well as CT management factors. An overriding critique is that the present literature lacks a research foundation of any kind. An argument is made for beginning research in this domain, and guidelines for doing so are presented.     

Group Psychotherapy: A Behavioral Approach

Abstract

This clinical report highlights some of the processes arising in a therapy group of persons with persistent and chronic psychiatric illnesses as they cope with the stress of their long–standing therapist’s impending retirement. Members were initially disbelieving that the therapist would leave and were also concerned about their future care, particularly in terms of medications. Gradually they were more able to experience their feelings of loss and their genuine caring for the therapist and the group, using higher level defenses and increasing their ability to tolerate strong affects. They became increasingly able to demonstrate empathy, notably in their ability to consider the therapist’s emotions. The clinical material also illustrates the therapist’s personal involvement, countertransferences and expressions of concern.     

Ethical Considerations in Psychotherapeutic Systems

Theoretical Medicine and Bioethics - In the process of individual psychotherapy, the client and the therapist work together towards clarifying the client's problems, unlocking vicious circles,...