Values nonpaternalism—the ethical imperative to avoid imposing values onto clients—is implicit in most widely used ethical frameworks employed by psychotherapists. Although changes in client values may represent desired psychotherapeutic outcomes, some such changes may be ethically problematic. Interventions are characterized by values paternalism when they are intended to promote client welfare but are accompanied by impositions against client values. Providers and consumers of psychotherapy may routinely lack awareness of this consideration. Psychotherapists may have a duty to be informed about ethically (...) problematic value change accompanying psychotherapy and to inform clients about this phenomenon. (shrink)

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present article analyzes the subject of psychologists taking a public position on (...) controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present article examines ethical issues that (a) should be taken into account before psychologists take a public position on a controversial issue and (b) are in conflict with APA’s Ethics Code or current research. (shrink)

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists (...) to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients. (shrink)

The British Columbian members of the Canadian Guidance and Counselling Association were surveyed to explore their attitudes regarding dual relationships. Of 529 deliverable surveys, 206 usable returns yielded a response rate of 39%. Participants were asked to provide incidents of problematic dual relationships and to discuss the problematic aspect(s) of these dual relationships. Respondents provided a total of 110 useable incidents with 165 associated problematic aspects. Many respondents provided data not directly related to the original questions, which were also analyzed. (...) The results of this study draw attention to several issues: (a) counselors are dealing with a variety of problematic dual relationships, (b) counselors experience discomfort and negative effects on their personal/work life secondary to these dual relationships, and (c) counselors consider the unique context of each dual relationship to be important in their ethical decision-making processes. (shrink)

A qualitative study was conducted with 48 Chinese counselors and psychotherapists who were interviewed in 2006 and an independent sample of 50 participants who responded to a survey in 2014. This study aims to explore how the new emerging expansion of mental health practice is related to issues and challenges of dual role relationship and how the well-engrained values and social characteristics of Chinese culture influences perceptions and resolution of ethical dilemmas. The participants identified similar dual relationships in 2006 and (...) 2014: Incidental boundary crossings, a sexual or romantic relationship, a dual social relationship, and a professional dual relationship were the most frequently reported types of dual relationships encountered by Chinese practitioners, and the socioeconomic and cultural context and the development trajectory of counseling and psychotherapy in China play a significant role in shaping practitioners’ behaviors. The comparison of the data in 2006 and 2014 indicated that practitioners in psychotherapy and counseling have an improved awareness and understanding of ethical issues, evidenced by the decreasing cases of romantic and sexual relationships and increasing cases of social dual relationships influenced by the interrelatedness of traditional Chinese culture. (shrink)

Buddhist teachings and practices can be viewed as a journey of soteriological transformation, where language, as a tool for the analysis of views, occupies a place of special significance and importance. This article examines how the concept of non-duality, from the Madhyamaka perspective, has served as a powerful rhetorical device with the explicit aim of fostering soteriological transformation. Among the various expressions representative of the Madhyamaka perspective, two are particularly explored in this article for their facilitation of soteriological transformation: the (...) expression of ‘neither a dharma nor a not-dharma’ and the teaching that ‘one should let go even of dharmas, still more so not-dharmas’ . I argue that the Madhyamaka expression of ‘neither A nor not-A’ is hardly ever just about conforming to any linguistic conventions. It is about gaining liberation from linguistic conventions and unexamined remarks. (shrink)

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay (...) via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues. (shrink)

ABSTRACT Engaging in sexting, such as sending or receiving of sexual words, pictures, or videos via technology, is a common behavior in minors and a rising trend. This study aimed to understand the ethical dilemmas that clinicians face when working with minors that engage in sexting under current mandated reporting standards. For this study, 178 graduate students and licensed clinicians who work with minors in the state of California completed an online survey involving vignettes concerning issues of sexting behaviors in (...) adolescents. Participants were asked to read each vignette and answer a series of questions regarding their knowledge and attitudes related to the presented issue and whether or not they would breach confidentiality in each case. Results indicated that participants, who had undergone specific training in issues of social media and technology, were significantly more likely to have more declarative knowledge of mandated reporting requirements, however, their reporting behavior was not significantly different from those, who had not previously had any training. Younger clinicians tended to report less than older clinicians. This study highlights the discrepancy that exists between the knowledge of mandated reporting standards relevant to sexting behaviors and clinicians’ reporting practice. (shrink)

Intimate partner violence, a subcategory of domestic abuse, is a prevalent national health concern that many clinicians will face during their careers. It is important that clinicians become aware of the numerous ethical considerations that are relevant to this population. The existing literature has not yet examined the ethical issues faced by clinicians working with IPV clients through the lens of the most recent American Psychological Association ethics code. This article provides a brief overview of the historical context and the (...) current state of the literature pertaining to IPV. Then it examines the unique ethical challenges associated with the treatment of IPV clients through the American Psychological Association ethics code. Recommendations are provided throughout this article to help clinicians make ethical decisions, maximize the benefits their clients receive from therapy, and minimize violence risk. (shrink)

Any professional or scientific discipline has a responsibility to do what it can to ensure ethical behavior on the part of its members. In this context, this paper outlines and explores the criticism that to date the emphasis in ethics training in professional psychology, as with other disciplines, has been on the rational elements of ethical decision making, with insufficient attention to the role of emotions and other nonrational elements. After a brief outline of some of the historical background to (...) the development and understanding of ethical decision making, relevant theoretical and empirical literature on the influence of emotional and other nonrational factors on our ethical decisions is reviewed. The implications of this literature for ethics education and training are outlined, particularly with respect to the use of case studies. An integrative approach is proposed, and conclusions and recommendations are offered with respect to such an approach. (shrink)

The British Columbian Members of the Canadian Guidance and Counselling Association were surveyed to explore their attitudes regarding dual relationships. Of 529 deliverable surveys, 206 usable returns yielded a response rate of 39%. The survey instrument collected data regarding respondents' characteristics and ethicality ratings of 39 dual relationship activity items. An exploratory principal components analysis was performed on responses, resulting in a 4-factor equation, which accounted for 44% of the total variance. The results suggest that, although conceptual considerations of dual (...) relationship typology do underlay the resultant factors, the relative ethicality of each item is also influential. (shrink)

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared (...) to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed. (shrink)

Treatment of sexual minority youth presents psychologists with a number of challenging ethical considerations. The APA Ethics Code is a valuable resource for addressing these issues, but psychologists require additional guidance in order to provide ethical treatment. This article provides relevant background, an overview of the ethical considerations of treating sexual minority youth, and recommendations to improve upon the current state of awareness and available resources. Psychologists must continually strive to improve our understanding of ethical decisions around treatment, training, and (...) research that will serve to address this vulnerable population's unmet mental health needs. (shrink)

Educational gatekeeping functions in psychology serve to assess, remediate, and/or dismiss students and trainees with problematic professional competencies (STPPC). Recently, professional psychology graduate programs have increasingly focused on problems with professional competency, and they have begun to implement formal procedures to intervene with STPPC (Rubin et al., 2007). However, there has been considerably less literature addressing the ethics and ethical considerations of instituting these gatekeeping functions, especially in different stages of education and training in psychology. The American Psychological Association (APA; (...) 2002) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) offers faculty and supervisors ethical principles and obligatory standards that provide guidance about how to implement highly ethical gatekeeping practices. The purpose of this article is to highlight the major ethical issues and dilemmas that faculty and supervisors may face when intervening with STPPC and provide recommendations for ethical gatekeeping practices that are inspired by the APA Ethics Code. (shrink)

Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004; Pomerantz & Segrist, 2006) indicates that when psychologists consider a client with symptoms of depression or anxiety, payment method significantly influences diagnostic decisions. This study extends the scope of the previous research to consider clients with symptoms of social phobia and attention deficit hyperactivity disorder (ADHD). Psychologists in independent practice responded to vignettes of clients whose descriptions deliberately included subclinical impairment. Half of the participants were told that the clients would pay via (...) managed care; the other half were told that the clients would pay out-of-pocket. Confirming previous studies, payment method had a highly significant impact on diagnosis such that compared to out-of-pocket clients, managed care clients were much more likely to be assigned Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses. Ethical implications relate to informed consent, accuracy and truthfulness in diagnosis, and psychologists' integrity. (shrink)

A sample of 44 psychologists who practice in the Caribbean completed a web-based survey containing 73 behavioral items related to ethical issues in professional practice. The aim of this exploratory study was to learn about perceptions regarding ethical behaviors that create ethical dilemmas and the level of agreement to their responses and to identify how demographic variables influenced their perceptions of ethical behaviors. Findings suggest that there was approximately an equal level of agreement on behaviors such as being an advocate (...) for your client and being sexually involved with a current client rated as ethical and unethical, respectively. Several demographic variables and ethical behaviors such as level of degree and confidentiality issues were statistically significant. Finally, psychologists prefer the presence of a professional psychological association with an ethics committee. (shrink)

Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

Elder abuse presents difficult ethical considerations that the field of psychology has yet to sufficiently address. As demographics and sociocultural factors shift in the coming decade, this deficit in ethical competence may become an increasingly serious problem. Although legal definitions of elder abuse lack uniformity and clarity, there is much room for improvement in the field of psychology. Ethical considerations most relevant to professionals in psychology draw heavily on the principles of beneficence and nonmaleficence and respect for people's rights and (...) dignity. Professional standards of competence, discrimination, informed consent, privacy and confidentiality, and cooperation with other professionals are also critical in these considerations. A number of recommendations are made, centering around the needs for more education, frank discussion, and empirical examination of the complexities of elder abuse. (shrink)

The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but (...) primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights. (shrink)

Are psychotherapy clients who pay via health insurance more likely to receive Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) diagnoses than identical clients who pay out of pocket? Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004) indicates that when psychologists consider a mildly depressed or anxious client, payment method significantly influences diagnostic decisions. This study extends the scope of the previous study to include clients whose symptoms are even less severe. Independent practitioners responded (...) to vignettes of clients whose profiles deliberately included subclinical impairment and a high level of functioning. Half of the participants were told that the clients would pay via managed care; the other half were told that the clients would pay out of pocket. As in the earlier study, payment method had a highly significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to be assigned DSM-IV diagnoses. In addition, a noteworthy percentage of participants assigned diagnoses regardless of payment method. Ethical implications are discussed. (shrink)

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 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. (shrink)

The present study examined the ethical judgements of Turkish counselors using a translation of the Gibson and Pope ethical judgements survey. Items predominantly judged as ethical and unethical, and group differences regarding gender, taking ethics as a course, professional affiliation, and level of academic degree, were investigated. Chi-square analysis, Fishers’s exact test, and Fisher–Freeman–Halton tests were used in statistical analysis. Results revealed that participants predominantly judged breach of confidentiality in cases of child abuse and potential harm toward oneself or others (...) as ethical. Items concerning sexual dual relationships were predominantly perceived as unethical, and male participants were more likely to judge items regarding sexual and nonsexual dual relationships as ethical. Implications for future research and practice are discussed. (shrink)

Participants were given 3 ethical dilemmas, asked to generate their own solutions, and asked to make judgments about a number of provided alternatives. Students were asked either to make decisions after seeking consultation or to make decisions independently of consultation. There were few significant between-group differences along a number of dimensions including participants' ratings of acceptability of provided alternatives and levels of certainty, justification, and satisfaction with personally generated solutions. For one of the vignettes, individuals using consultation, when compared with (...) the control group, were significantly more likely to prefer their own solution to that of provided alternatives. The study was viewed as a needed first step in investigating a cherished assumption in clinical practice. (shrink)

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)