This is the Chapter 9 of the book The Individual (de Bruin, E., 1st Edition). Which is content for the exam of the Theory component of Module 4 (The Individual) of the University of Twente, in the Netherlands

Ch.9: Therapist & ethical/moral framework

“The dilemma for the therapist is to allow themselves to be influential without imposing their moral values and choices. Therapy needs to possess and informed awareness of the ways in which moral and ethical issues may arise in their work”

Ethical knowing

• Ethical knowing relevant for therapists:
  • Personal moral or ethical responses: understood as intuitive, taken for granted. Therapist rely on their intuitive moral judgment of ‘what feels right’ rather than on any more explicit guidelines
  • Value: enduring belief that a specific end-state or mode of conduct is preferable --> therapists values tend to influence values held by clients
  • Ethical principles (Kitchener, 1984):
    
    • Autonomy
    • Non-maleficence (healer must above all do no harm)
    • Beneficence (injunction to promote human welfare)
    • Justice
    • Fidelity
  • Utilitarian approach: ethical decision in the light of the costs/benefits for each participant
  • Professional organizations --> ensure ethical standards of practice. They have ethical codes/ethical guidelines for practitioners; accompanied by procedures for dealing with complaints about unethical behaviour --> allows for systematically reflection on ethical and moral issues
  • Relational ethics: lived experience of acting/responding in the right way --> it’s contextual as well as relational
    
    • Process ethics: build on experience and maturity

Ethical good practice

“Therapy organisations need to be aware of the kinds of ethical challenges and develop strategies for responding to them”

• Confidentiality: fundamental cornerstone of therapeutic practice
• Accountability: difficult dilemmas…
  
  • When client threatens to harm another person
    
    • Consultation and documentation is a safeguard to the therapist in case of future complain/inquiry --> also supports their sense of confidence in a scenario in which they could become paralysed with self-doubt and indecision
  • Disclosure of information of current/past abuse/harm to a child or vulnerable adult

Informed consent:

“One of the main strategies for ensuring ethical principles reflected in practice”

• Difficulties involved in achieving a satisfactory consent procedure:
  • Making information available in a form that the client will understand
  • Providing information that will cover every eventuality in therapy
  • Conveying information in an even-handed manner, rather than steering the client in the direction of the therapist’s preferred approach
  • Knowing whether client is genuinely in agreement , or is merely deferring to what they regard as the superior wisdom of an expert therapist

Boundaries within therapy relationship:

• Time boundary (start/end session)
• Information boundary (what therapist knows about client and vice versa)
• Geographical boundaries (meeting in the therapy versus meeting in an everyday setting)
• Dual relationships: when therapist is also engaged in another different type of relationship with a client
  
  • Dual relationships conflict (Pope, 1991)
    
    • Compromise the professional nature of the relationship
    • Conflict of interest: no longer is the therapist there solely for the client