Boundaries and the Use and Misuse of Power and Authority: Ethical Complexities for Clergy Psychotherapists

Acknowledging their power and authority and establishing and maintaining clear and safe professional boundaries tend to be complex issues for clergy psychotherapists. The legacy of dual training, insufficient attention to professional ethics, as well as differing role expectations and professional socializations as clergy and counselor make it imperative for clergy psychotherapists to be particularly thoughtful about boundary issues in counseling. This article discusses the vulnerabilities and complexities clergy psychotherapists encounter, particularly matters of multiple relationships, confidentiality, and practice policies. It also proposes preventive actions to raise awareness and safeguard ethical conduct.     

Validation and predictive utility of the Sociocultural Attitudes Toward Appearance Questionnaire for Eating Disorders (SATAQ-ED): internalization of sociocultural ideals predicts weight gain

A widely used measure of societal influences on body image and eating disturbances—the Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ) was validated in women with eating disorders. The original SATAQ and measures of convergence and divergence were administered to 165 eating disordered inpatients. Factor analyses were conducted to determine the underlying structure of the SATAQ. Convergent validity, diagnostic category norms and the predictive utility of the revised SATAQ were examined. Factor analyses indicated three factors: Internalization, Awareness, and Success. Internalization significantly predicted treatment success after controlling for admission BMI and drive for thinness. The revised SATAQ-ED measures multiple aspects of societal influence, predicts short-term outcome, and can be a useful tool for evaluating potential outcome and treatment efficacy.     

Existential themes in the treatment of people at suicide risk. Understandings and practices of specialist healthcare professionals

ABSTRACT

This qualitative study focuses on the ways in which existential themes were understood and addressed in therapeutic relationships with patients who had attempted suicide. Health care professionals (HCP) from Norway specialist healthcare participated in focus groups. The interviews were transcribed and analysed by systematic text-condensation through a four-step procedure. We found that the HCPs emphasised the context-specific functions of their departments. They considered these conversations essential but demanding. They indicated existential themes of hope/hopelessness, loneliness, meaning, life/death, shame, religion and suicide. The HCPs’ understandings of themes deemed to be existential and how they should be addressed were primarily based on clinical experience. This appeared to exacerbate the pressure on their personal involvement, leading to the question of whether patients’ existential needs are tackled or instead disappear into a conversational vacuum. The study suggests that HCPs' professional competence of existential themes pertaining to patients at suicide risk needs to be strengthened.     

Silencing,Psychological Conflict,and the Distinction Between Virtue and Self-Control

According to many virtue ethicists, one of Aristotle’s important achievements was drawing a clear, qualitative distinction between the character traits of temperance (sophrosyne) and self-control (enkrateia). In an influential series of papers, John McDowell has argued that a clear distinction between temperance (or virtue, in general) and self-control can be maintained only if one claims that, for the virtuous individual (but not for the self-controlled), considerations in favor of actions that are contrary to virtue are “silenced.” Some virtue ethicists reject McDowell’s silencing view as offering an implausible or inappropriate picture of human virtue, but they argue that (contra McDowell) virtue can still be clearly distinguished from self-control by the absence of motivational conflict alone. In this paper, I argue that this criticism of McDowell is at most half right. If the silencing view is false, so that virtue can have a cost and the virtuous person can justifiably feel negative emotions in response to that cost, there is no principled reason why the virtuous person cannot also have motivational conflict. So, if one rejects the silencing view, then one must allow that the distinction between virtue and self-control is at most a matter of degree.

     

Emotional stressors among volunteers operating a diaconal suicide-prevention crisis line in Norway: a qualitative study

ABSTRACT

Despite the worldwide proliferation of suicide-prevention crisis-line networks, there is limited in-depth knowledge of how the volunteer call responders experience and manage emotional stressors. The study’s purpose was to explore emotional stressors related to operating a diaconal suicide-prevention crisis line, and how these are managed in daily operations. In this qualitative study, 27 volunteers were interviewed in four focus groups. The material was analysed using systematic text condensation. The participants experienced emotional stressors related to being unable to actively intervene, encountering traumatised callers and feeling uncertain about representing the Church. They used a combination of personal coping strategies and organisational support factors. Implications for training and practice are further discussed.