When clients want to pay more for psychotherapy: ethical issues and implications

One ethical issue that commonly comes up in clinical practice is the negotiation of fees with clients. Although the APA Ethics Code provides standards regarding clients who are unable to or do not pay (Standard 6.04), little guidance is given pertaining to fee limits for clients who want to pay more. This issue is explored using a real case example, including the relevant ethical codes to be considered. The necessary “gray” areas of ethical decision-making are demonstrated through my own decision process. Implications for future scenarios are discussed.     

Impact of Ethical Information Resources on Independently Licensed Counselors

A random sample of 430 independently licensed counselors evaluated 4 ethical information interventions in the context of 16 boundary‐crossing scenarios. Results indicated that counselors have serious reservations about any form of boundary crossing. They reported mostly reviewing various codes of ethics, reviewing state laws and rules, consulting with others, working from gut instincts, and reflecting on personal experience when confronted with boundary‐crossing issues. Participants clearly preferred streamlined ethical information interventions.     

Response To Jason Springs

Jason Springs’s Healthy Conflict in Contemporary American Society is a masterful attempt to practice productive conflict and democratic dialogue in the face of static antagonisms and deep-seated divisions. In my response, I underscore Springs’s insistence on mediating between the moral imagination of Richard Rorty and the prophetic critique of Cornel West. For the author of Healthy Conflict, any hope in the survival of democracy relies on balancing critique of domination with constructive proposals for a more just and equitable world. On the one hand, Springs rejects any strong distinction between moral imagination and socio-political critique; in fact, he argues for their intertwinement, especially in the work of West. At the same time, there are moments when he suggests an opposition between expanding the moral imagination and engaging in the critical enterprise, especially as he identifies the limits in Foucault regarding normativity and democratic struggle. I respond to this slippage by arguing that Foucault, and critical theory more broadly, open up possibilities for rethinking ethics, politics, and our relationship to the violence that sustains the order of things.     

With crisis comes opportunity: Building ethical competencies in light of COVID-19

ABSTRACT

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has wide-ranging implications for the field of professional psychology. As clinical practice has rapidly adapted to ensure continuity of care, doctoral students have encountered unique opportunities for ethics-related competency development across practicum training settings. This article discusses the relevant American Psychological Association (APA) Ethics Code standards and additional ethical considerations facing trainees as they navigate their foundational clinical experiences and develop as professional psychologists in light of a pandemic.     

Comment by Arvind Sharma

Comments on:
JRE Focus on The 50th Anniversary of the Universal Declaration ofHuman Rights, Journal of Religious Ethics 26.2 (Fall 1998)
"Rethinking Human Rights: A Review Essay on Religion, Relativism, and Other Matters" by David Little, Journal of Religious Ethics 27.1 (Spring 1999)     

Covenants and Commands

Robert Adams’s account of divine command theory argues that moral obligations are idealized versions of everyday social requirements. One type of social requirement is the ordinary demand one person makes of one another. Its idealized version is the perfect command a perfect God makes of those he loves. This paper extends Adams’s account of moral obligation by considering another kind of social requirement: promises. It argues that we can understand a divine covenant as an idealized version of a promise. Promisers take on social requirements to promisees when they make promises. Analogously, God takes on obligations to humans when God makes covenants with them. Divine command theorists might fear that this makes God subject to moral rules not of his own choosing. This paper considers these fears and argues that they are unwarranted.     

Application of the APA ethics code for psychologists working in integrated care settings: Potential conflicts and resolutions

ABSTRACT

Increasingly, there is evidence of the potential benefits of an integrated care model. In fact, the American Psychological Association (APA) supports the role of psychologists in integrated healthcare given the positive outcomes for patients in primary care settings such as increased access to mental health services, reduced mental illness stigma, and improved health associated with recognizing the impact of psychosocial factors on physical wellbeing. Less attention has been paid, however, to ethical dilemmas that may arise for psychologists working in integrated healthcare. This paper explores considerations for resolving potential ethical conflicts that may arise for psychologists working in integrated care settings.     

The Innocuous Legacy of Christian Ethics in Comparative Religious Ethics

I argue that even if the influence of Christian ethics on comparative religious ethics (CRE) is inevitable, it need not be problematic. The legacy would only be worrisome if it stacked the deck in favor of Christian ethics or predisposed comparative ethicists to conform to the methods or thematic concerns of Christian ethics. Following Gadamer, I suggest that the ideal of presuppositionless objectivity is an illusion that applies to not only those who emerge from a Christian cultural context but in every global context. Given the specific historical and cultural contexts of the emergence of CRE, the residue of Christian ethics in CRE is understandable and expected. Thus, the legacy of Christian ethics in CRE will only be problematic to the extent that the potential dangers of Christian hegemony remain hidden, which does not seem to be the case in the contemporary academic context.     

Relational Complexity and Ethical Responsibility

Richard Miller uses the concepts of alterity and intimacy as touchstones for analyzing neglected aspects of our interpersonal and social relationships. He argues that, as persons in relation, we oscillate between experiences of alterity and intimacy, and it is with a greater awareness of this oscillation that we do best to consider our ethical responsibilities. This paper affirms the value of thinking about—and potentially reimagining—how we conceive and relate to various others. It also makes explicit that, as persons, each of us is separate, not only from some, but from all other persons, even as we are also one with them. Moreover, each of us is different from all other persons, even as we are also like them. The aspects of persons and relationships on which we focus, in a given situation, matter because they partly determine the choices that we make in another’s regard.     

Using targeted visceroception to improve interoceptive sensibility and emotion regulation

Focusing on one's body can improve the awareness and regulation of emotion. Interoception – sensing the physiological condition of the body, particularly of the viscera – appears to play an important role. While the majority of previous research studies have examined interoceptive sensitivity (i.e., detection of objectively measurable physiological changes), there has been relatively limited investigation of interoceptive sensibility (i.e., subjective awareness of those changes), and even fewer studies permitting causal conclusions. The current study is part of a randomised controlled trial on visceroception in the context of emotion regulation, using an 8-week intervention involving focused attention on either cardiac or gastrointestinal activity. Group differences in emotion regulation and reactivity were assessed using the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Difficulties in Emotion Regulation Scale, and the Emotion Reactivity Scale (ERS). The findings suggest that focussed attention on gastrointestinal activity (i.e., gastroception), in particular, improves interoceptive sensibility and emotion regulation, as evidenced by increases on the MAIA's Noticing, Body Listening, and Self-regulation subscales, and decreases on the Arousal subscale of the ERS. Gastroception may make distinct contributions to the benefits of body focus in a research context where the gut is often overlooked.