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Navigating the Ethical Landscape: Critical Issues in Practice and Training

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Ethical Issues in Counselling and Psychotherapy Practice
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Abstract

Counsellors and therapists must provide a safe space and walk the ethical line during their psychotherapeutic interactions with vulnerable clients. Ethical practice is informed by several philosophical positions; deontological, utilitarian, the widely used principle-based framework, feminist care ethics and other post-modern perspectives. Expanded frameworks of ethics encompass context, culture, and personal values and embrace the complexity of ethical dilemmas encountered in the therapy room. Research has identified common ethical dilemmas; confidentiality and its limits, boundary violations, therapist self-disclosure, but this has also raised questions about the intersections of culture and ethics. Various professional bodies have delineated ethical codes and guidelines but there are inevitable gaps in their translation to the arena of therapeutic practice. The application of ethical principles may be influenced by a range of client, setting, therapy (theoretical orientation or therapy modality), and organisational variables as well by extant legal frameworks and socio-political contexts. Training in ethics for mental health professionals is inconsistent and often inadequate. A critical evaluation of ethical codes, innovative training methodologies, the need for training in ethical decision-making models, and the value of therapist self-reflection are discussed, with a special focus on the Indian context.

A man without ethics is a wild beast loosed upon the world.

—Albert Camus.

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References

  • Ahuja, N. (2006). A short textbook of psychiatry (6th ed.). New Delhi: Jaypee Brothers Publishers.

    Book  Google Scholar 

  • American Counseling Association. (2005). ACA code of ethics. Retrieved December 13, 2013 from http://www.counseling.org/Resources/aca-code-of-ethics.pdf

  • American Psychiatric Association. (2013). The principles of medical ethics. Retrieved May 15, 2016 from https://www.psychiatry.org/psychiatrists/practice/ethics

  • American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Retrieved December 15, 2013 from http://www.apa.org/ethics/code/principles.pdf.

  • American Psychological Association. (2011). Resolution on marriage equality for same-sex couples. Washington, DC: Author. Retrieved December 15, 2013 from http://www.apa.org/about/policy/same-sex.pdf

  • Anton, B. S. (2010). Proceedings of the American Psychological Association for the legislative year 2009: Minutes of the annual meeting of the Council of Representatives and minutes of the meetings of the Board of Directors. American Psychologist, 65, 385–475.

    Article  Google Scholar 

  • Avasthi, A., & Grover, S. (2009). Ethical and legal issues in psychotherapy. Retrieved December 15, 2013 from www.indianjpsychiatry.org/cpg/cpg2009/article11.pdf

  • Barnett, J. E., Behnke, S. H., Rosenthal, S. L., & Koocher, G. P. (2007). In case of ethical dilemma, break glass: Commentary on ethical decision making in practice. Professional Psychology: Research and Practice, 38, 7–12.

    Article  Google Scholar 

  • Beauchamp, T. L. (2001). Philosophical ethics: An introduction to moral philosophy. McGraw-Hill.

    Google Scholar 

  • Beauchamp, T. L. & Childress, J. F. (2001). Principles of biomedical ethics. 5th Edn. Oxford University Press.

    Google Scholar 

  • Bergin, A. E., Reed Payne, I., & Scott Richards, P. (1996). Values in psychotherapy. In E. P. Shafranske (Ed.), Religion and the clinical practice of psychology (pp. 297–325). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Bernard, J. M., & Goodyear, R. K. (2004). Fundamentals of clinical supervision. Boston, MA: Pearson.

    Google Scholar 

  • Bersoff, D. N., & Koeppl, P. M. (1993). The relation between ethical codes and moral principles. Ethics and Behavior, 3(3 & 4), 345–357.

    Article  Google Scholar 

  • Bhola, P., Sinha, A., Sonkar, S., & Raguram, A. (2015). Ethical dilemmas experienced by clinical psychology trainee therapists. Indian Journal of Medical Ethics, 12(4), 206–212.

    Google Scholar 

  • Blum, L. A. (1988). Gilligan and kohlberg: Implications for moral theory. Ethics, 98, 472–491.

    Article  Google Scholar 

  • Borys, D. S., & Pope, K. S. (1989). Dual relationships between therapist and client: A national study of psychologists, psychiatrists, and social workers. Professional Psychology: Research and Practice, 20(5), 283–293.

    Article  Google Scholar 

  • Botes, A. (2000). A comparison between the ethics of justice and the ethics of care. Journal of Advanced Nursing, 32, 1071–1075.

    Article  PubMed  Google Scholar 

  • British Association of Counselling and Psychotherapy. (2010). Ethical framework for good practice in counselling & psychotherapy. Retrieved December 15, 2013 from http://www.bacp.co.uk/admin/structure/files/pdf/9479_ethical%20framework%20word%20feb2010%20%28revised%29.pdf

  • Clemente, M., Espinosa, P., & Urra, J. (2011). Ethical issues in psychologists’ professional practice: agreement over problematic professional behaviors among Spanish psychologists. Ethics and Behavior, 21(1), 13–34.

    Article  Google Scholar 

  • Corey, G., Corey, M., & Callanan, P. (2011). Issues and ethics in the helping profession (8th ed.). Belmont, CA: Brooks/Cole.

    Google Scholar 

  • Cottone, R. R., & Claus, R. E. (2000). Ethical decision-making models: a review of the literature. Journal of Counseling & Development, 78(3), 275–283.

    Article  Google Scholar 

  • De Sousa, A. (2010). Ethical issues in child and adolescent psychotherapy: A clinical review. Indian Journal of Medical Ethics, 7(3), 157–161.

    PubMed  Google Scholar 

  • Edwards, S. D., & Street, E. (2007). Clinical ethics committees: a practical response to ethical problems in clinical practice. Clinical Child Psychology and Psychiatry, 12(2), 253–260.

    Article  PubMed  Google Scholar 

  • Evans, A. M., Levitt, D. H., & Henning, S. (2012). The application of ethical decision-making and self-awareness in the counsellor education classroom. Journal of Counselor Preparation and Supervision, 4(2), 41–52.

    Google Scholar 

  • Fennig, S., Secker, A., Treves, I., Ben Yakar, M., Farina, J., Roe, D., et al. (2005). Ethical dilemmas in psychotherapy: comparison between patients, therapists and laypersons. The Israel Journal of Psychiatry and Related Sciences, 42(4), 251–257.

    PubMed  Google Scholar 

  • Fisher, M. A. (2008). Protecting confidentiality rights: The need for an ethical practice model. American Psychologist, 63, 1–13.

    Article  PubMed  Google Scholar 

  • Fisher, C. B. (2012). A code of ethics for psychology. How did we get here? (pp.3–18). In C. B. Fisher (Ed.), Decoding the ethics code: A practical guide for psychologists (2nd Edn). California: Sage Publications.

    Google Scholar 

  • Forsyth, D. R. (1980). A taxonomy of ethical ideologies. Journal of Personality and Social Psychology, 39, 175–184.

    Article  Google Scholar 

  • Gibson, W. T., & Pope, K. S. (1993). The ethics of counseling: A national survey of certified counsellors. Journal of Counseling and Development, 71, 330–336.

    Article  Google Scholar 

  • Gilligan, C. (1982). In a different voice: psychological theory and women’s development. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Gray, G., & Gibbons, J. (2007). There are no answers, only choices: Teaching ethical decision making in social work. Australian Social Work, 60, 222–238.

    Article  Google Scholar 

  • Gutheil, T. G., & Gabbard, G. O. (1993). The concept of boundaries in clinical practice: theoretical and risk-management dimensions. American Journal of Psychiatry, 150, 188–196.

    Article  PubMed  Google Scholar 

  • Handelsman, M. M., Gottlieb, M. C., & Knapp, S. (2005). Training ethical psychologists: An acculturation model. Professional Psychology: Research and Practice, 36(1), 59–65.

    Article  Google Scholar 

  • Haas, L. J., Malouf, J. L., & Mayerson, N. H. (1986). Ethical dilemmas in psychological practice: Results of a national survey. Professional Psychology: Research and Practice, 17(4), 316–321.

    Article  Google Scholar 

  • Helbok, C. M. (2003). The practice of psychology in rural communities: Potential ethical dilemmas. Ethics and Behavior, 13(4), 367–384.

    Article  PubMed  Google Scholar 

  • Hemchand, L. (2016). A practitioner’s guide to understanding sexual orientation. In A. Narrain, & V. Chandran (Eds.), Nothing to Fix: Medicalisation of sexual orientation and gender identity (pp. 223–230). New Delhi: Sage Yoda Press.

    Google Scholar 

  • Hill, M., Glaser, K., & Harden, J. (1998). A feminist model for ethical decision-making. Women and Therapy, 21(3), 101–121.

    Article  Google Scholar 

  • Indian Association of Clinical Psychologists. (2015). Ethics and code of conduct of clinical psychologists: Guidelines 2012–13. Retrieved April 20, 2015 from http://www.iacp.in/node/159

  • International Society for Mental Health. (2000). International Society for Mental Health Online (ISMHO) Principles. Retrieved December 15, 2013 from http://www.ismho.org/suggestions.asp#Principles

  • Isaac, R. (2009). Ethics in the practice of clinical psychology. Indian Journal of Medical Ethics, 6, 69–74.

    PubMed  Google Scholar 

  • Jacob, P., Golhar, T., Seshadri, S., Nandan, R. M., & Purushothaman, K. (2014). Child and adolescent mental health in the juvenile justice system in India: challenges and initiatives. Adolescent Psychiatry, 4(4), 278–283.

    Article  Google Scholar 

  • Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. Counseling Psychology, 12, 43–55.

    Article  Google Scholar 

  • Knapp, S., & VandeCreek, L. (2004). A principle-based analysis of the 2002 American Psychological Association Ethics Code. Psychotherapy: Theory, Research, Practice, Training, 41(3), 247.

    Article  Google Scholar 

  • Kurpad, S. S., Machado, T., & Galgali, R. B. (2010). Is there an elephant in the room? Boundary violations in the doctor-patient relationship in India. Indian Journal of Medical Ethics, 7(2), 76–81.

    PubMed  Google Scholar 

  • Margolin, G. (1982). Ethical and legal considerations in marital and family therapy. American Psychologist, 37(7), 788–801.

    Article  PubMed  Google Scholar 

  • McNamee, S. (2009). Postmodern psychotherapeutic ethics: relational responsibility in practice. Human Systems: The Journal of Therapy, Consultation & Training, 20, 57–71.

    Google Scholar 

  • Miller, P. M., Bener, A., Ghuloum, S., Commons, M. L., & Burgut, F. T. (2012). Differences and similarities in cross-cultural perceptions of boundaries: a comparison of results from two studies. International Journal of Law and Psychiatry, 35, 398–405.

    Article  PubMed  Google Scholar 

  • Nair, M. R. H. (2015). RTI v medical ethics: Some questions arising from the recent decision of the chief information commissioner under the RTI Act. Indian Journal of Medical Ethics, 12, 182–185.

    PubMed  Google Scholar 

  • Narayan, C. L., & Shekhar, S. (2015). The mental health care bill 2013: A critical appraisal. Indian Journal of Psychological Medicine, 37(2), 215–219.

    Article  PubMed  PubMed Central  Google Scholar 

  • National Academy of Psychology. (2010). National Academy of Psychology (NAOP), India Ethical Principles for Psychologists. Retrieved December 15, 2015 from https://docs.google.com/viewer?a=v&pid=sites&srcid=bmFvcGluZGlhLm9yZ3x3d3d8Z3g6MTQ5YTUzNTQyOWMxZjZhNA

  • National Association of Social Workers. (2008). Code of ethics of the national association of social workers. Retrieved from http://www.naswdc.org/pubs/code/default.asp

  • Orinam. (2014). Indian Psychiatric Society official statement: Homosexual is not a mental illness. Retrieved December 20, 2015 from http://orinam.net/indian-psychiatric-society-homosexual-not-mental-illness/

  • Pomerantz, A., Ross, M. J., Gfeller, J. D., & Hughes, H. (1998). Ethical beliefs of psychotherapists: Scientific findings. Journal of Contemporary Psychotherapy, 28, 35–44.

    Article  Google Scholar 

  • Pope, K. S., & Bajt, T. R. (1988). When laws and values conflict: A dilemma for psychologists. American Psychologist, 43, 828–829.

    Article  Google Scholar 

  • Pope, K. S., Tabachnick, B. G., & Keith-Spiegel, P. (1987). Ethics of practice: The beliefs and behaviors of psychologists as therapists. American Psychologist, 42(11), 993–1006.

    Article  PubMed  Google Scholar 

  • Pope, K. S., & Vetter, V. A. (1992). Ethical dilemmas encountered by members of the American Psychological Association: A national survey. American Psychologist, 47(3), 397–411.

    Article  PubMed  Google Scholar 

  • Pope, K. S., & Vasquez, M. J. T. (2016). Ethics in psychotherapy and counseling: A practical guide (5th ed.). NJ: John Wiley & Sons Inc.

    Google Scholar 

  • Proctor, G. M. (2014). Values and ethics in counselling and psychotherapy. London, UK: Sage.

    Google Scholar 

  • Slack, C. M., & Wassenaar, D. R. (1999). Ethical dilemmas of South African clinical psychologists: International comparisons. European Psychologist, 4(3), 179.

    Article  Google Scholar 

  • Sporrong, S., Arnetz, B., Hansson, M. G., Westerholm, P., & Hoglund, A. T. (2007). Developing ethical competence in health care organizations. Nursing Ethics, 14(6), 826–837.

    Google Scholar 

  • Strous, R. D. (2007). Psychiatry during the Nazi era: Ethical lessons for the modern professional. Annals of General Psychiatry, 6, 8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sullivan, K. (2002). Australian psychologists’ ethical beliefs and behaviours. Australian Psychologist, 37(2), 135–141.

    Article  Google Scholar 

  • Tolich, M. (2014). What can Milgram and Zimbardo teach ethics committees and qualitative researchers about minimizing harm? Research Ethics, 10(2), 86–96.

    Article  Google Scholar 

  • Toulmin, S. (1996). Introduction. In S. Toulmin & B. Gustavsen (Eds.), Beyond theory: Changing organizations through participation (pp. 1–7). Philadelphia: Benjamins.

    Chapter  Google Scholar 

  • Walker, K. D. (1994). Notions of “ethical” among senior educational leaders. The Alberta Journal of Educational Research, 40, 21–34.

    Google Scholar 

  • Zhang, A., Qian, M., & Yao, P. (2007). A survey on ethical beliefs of Chinese counselors and psychotherapists and comparison with American professionals. Chinese Mental Health Journal, 21(1), 55–61.

    Google Scholar 

  • Zhao J., Cheng, W., Fu, S. (2009). A multi-center survey on dual relationships and associated factors among Chinese counselors and psychotherapists. Chinese Medical Ethics. Retrieved April 12, 2016 from http://en.cnki.com.cn/Article_en/CJFDTOTAL-XNLX200905014.htm

  • Zhao, J., Ji, J., Yang, X., Yang, Z., Hou, Y., & Zhang, X. (2011). National survey of ethical practices among Chinese psychotherapists. Professional Psychology: Research and Practice, 42(5), 375–381.

    Article  Google Scholar 

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Correspondence to Poornima Bhola .

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Bhola, P., Raguram, A. (2016). Navigating the Ethical Landscape: Critical Issues in Practice and Training. In: Bhola, P., Raguram, A. (eds) Ethical Issues in Counselling and Psychotherapy Practice. Springer, Singapore. https://doi.org/10.1007/978-981-10-1808-4_1

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