Ethics for Psychotherapists and Counselors

A Proactive Approach

Sharon K. Anderson, Mitchell M. Handelsman

• Publisher: Wiley-Blackwell
• Year: 2011
• ISBN:
  9781444356168
• Edition: 1
• Topic: Medicine
• Subtopic: Ethics in Medicine

Ethics for Psychotherapists and Counselors utilizes positive discussions accompanied by a variety of thought-provoking exercises, case scenarios, and writing assignments to introduce readers to all the major ethical issues in psychotherapy.

• First book designed to engage students and psychotherapists in the process of developing a professional identity that integrates their personal values with the ethics and traditions of their discipline
• Authors take a positive and proactive approach that encourages readers to go beyond following the rules and to strive for ethical excellence
• Utilizes a variety of thought-provoking exercises, case scenarios, and writing assignments
• Authors present examples from their own backgrounds to help clarify the issues discussed
• Text emphasizes awareness of one's own ethical, personal, and cultural backgrounds and how these apply to one's clinical practice

Praise for Ethics for Psychotherapists and Counselors

“Anderson and Handelsman have written a truly unique ethics book; one that will be of value to every new as well as seasoned psychotherapist in professions from social work to psychiatry. They write about professional ethics as a process of acculturation that requires the reader to consider themselves, their motivations, and their feelings about the ethical requirements of the professions. In order to facilitate the process of self-awareness, they provide a series of activities like journaling to help the professional continue to expand their awareness as they encounter topics like confidentiality or multiple relationships. Whether or not instructor chooses this book as a primary text, it should be a supplement to every course that is taught.”

Karen Strohm Kitchener, Professor Emeritus, University of Denver

“This book is unique in my experience in that it encourages readers to reflect on their own ethical predispositions as they think about psychotherapy ethics. The book also helps students understand differences between being an ethical person and an ethical psychotherapist – a distinction that is difficult for most students, and many professionals, to appreciate. The authors’ emphasis on helping readers know themselves as well as the professional ethical guidelines is an important advance over other ethics texts. The discussion of ‘positive ethics’ is also unique and helpful for professionals.”

William E. Sobesky, Clinical Associate Professor of Psychiatry and Pediatrics, University of Colorado Health Sciences Center

“This excellent book for students or any professionals in psychotherapy and counseling is part of a welcome trend in ethics education that challenges students to strive for their highest ethical ideals. Anderson and Handelsman do far more than repeat rules and facts; they use the ethical acculturation model to encourage students to reflect on their professional identity and values. The book contains useful learning aides and exercises such as the ethics autobiography, the ethics journal, realistic vignettes, appendices, and useful charts. Anderson and Handelsman succeed in presenting their well considered perspectives on psychotherapy in a clear and personal style of writing. I highly recommend this book!”

Samuel Knapp, Director of Professional Affairs, Pennsylvania Psychological Association

“This book is interesting and engaging. A variety of scenarios and exercises make the process come alive for the reader and encourage self-assessment and self-reflection. As an instructor I think the text would generate many meaningful class discussions. It is easyto-read and easy to follow.”

Robin Lewis, Old Dominion University

“I really like this book….it approaches ethics in a manner that is hopeful, positive, but no-nonsense and thorough. I think it is one of the best integration of concepts around ethics and ethical decision-making processes that I have seen, and one of the most easily applied to a variety of levels of training. I also like the application of an acculturation model as a way to understand our initiation into the part of our profession that has to do with ethics, ethical decision-making, and ethical behavior.”

Susan L. Prieto-Welch, Counseling Center Director, University of Notre Dame

To KK – mentor, colleague, and friend.

And JC – thank you! You are so good to me.

Sharon

To my mother, Eleanore Welsh. To my wife, Margie Krest.

And to all my teachers, including all my students.

Mitch

This edition first published 2010

© 2010 Sharon K. Anderson and Mitchell M. Handelsman

Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been merged with Wiley’s global Scientific, Technical, and Medical business to form Wiley-Blackwell.

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Library of Congress Cataloging-in-Publication Data

Anderson, Sharon K.

Ethics for psychotherapists and counselors: a proactive approach/Sharon K. Anderson, Mitchell M. Handelsman.

p.; cm.

Includes bibliographical references and index.

ISBN 978-1-4051-7767-2 (hardcover: alk. paper) – ISBN 978-1-4051-7766-5 (pbk.: alk. paper) 1. Psychotherapists–Professional ethics. 2. Counselors–Professional ethics.

I. Handelsman, Mitchell M. II. Title.

[DNLM: 1. Psychotherapy–ethics. 2. Counseling–ethics. WM 420 A549e 2010]

RC455.2.E8A53 2010

616.89′14-dc22

2009009595

A catalogue record for this book is available from the British Library.

Set in Palatino 10/13 pt by SPi Publisher Services, Pondicherry, India Printed in Singapore

About the Authors

Sharon K. Anderson received her Ph.D. in counselling psychology from the University of Denver. She has taught in masters level counselling program at Colorado State University since 1994. As a professor, she teaches the professional ethics and legal issues course and supervises practicum and internship experiences for master level counsellors. For several years, Sharon delivered state approved jurisprudence workshops to psychotherapists from many disciplines seeking state licensure. She herself is a licensed psychologist. During her time as faculty, Sharon has published 2 books, 10 book chapters, and 17 articles.

Mitchell M. Handelsman received his Ph.D. in clinical psychology from the University of Kansas. He has taught psychology at the University of Colorado Denver since 1982. He was an APA Congressional Science Fellow during 1989–1990, and in 2003–2004 he was president of the Rocky Mountain Psychological Association. He is a licensed psychologist and a Fellow of the American Psychological Association. In addition, he has won the CASE (Council for the Advancement and Support of Education) Colorado Professor of the Year Award and APA’s Division 2 Teaching Award. He has served on numerous professional ethics committees, and has chaired the Colorado Psychological Association Ethics Committee.

Preface

Becoming an ethical psychotherapist or counselor is more than memorization of rules – it is a journey. We wrote this book to help students and practitioners navigate this journey toward a professional identity in a way that integrates their personal ethics and values with the professional ethics and traditions of psychotherapy and counseling.

Our book presents a variety of discussions, case scenarios, thought exercises, and writing assignments to (a) introduce readers to all the major ethical issues in psychotherapy, including boundaries, confidentiality, informed consent, supervision, and terminating therapy; (b) help readers explore their own moral and ethical backgrounds, personal values, ethical thinking, cultural awareness, and professional goals; and (c) take a proactive and preventive approach to applying ethics to every facet of their professional behavior.

The book can be used as a primary or ancillary text for ethics courses in all the mental health fields. It can also be used as a supplemental text for courses in professional issues, psychotherapy methods, counseling theories and techniques, and survey courses in clinical and counseling psychology, social work, counseling, and marital and family therapy.

Because this book focuses on the basic aspects of professional identity and ethical reasoning skills, it will be useful to readers over time as they readjust their professional identities in reaction to inevitable changes in life situations, professional positions, laws/regulations, and ethics codes.

After years of discussion – between ourselves and with colleagues and students – about what it means to be ethically excellent, not just aware of how to stay out of ethical trouble, we decided to write a book that takes a unique approach. Students will find the book engaging, positive in its approach, and respectful of their backgrounds. We invite them to become active explorers, not passive recipients of disembodied rules and laws.

We also wrote this book to help us teach our own courses, and for our fellow instructors who may be new to teaching ethical issues as an entire course or part of a course. Instructors will find that they can organize class discussions and assignments around the exercises and vignettes from the chapters, or they can use the book to supplement their own methods and materials.

We wish to thank many people who have been involved in the long journey we’ve taken since our initial conversations about an ethics book. Our agent, Neil Salkind of Studio B, was instrumental in helping us conceive of this book in its present form and in encouraging us to undertake the project. Our editor, Christine Cardone, has been consistently supportive and instructive – providing just the right amount of guidance to bring this project to fruition. Thanks to Sam Knapp and Michael Gottlieb for their essential work on the ethical acculturation model, and to Allison Bashe for her work on the ethics autobiography. We thank those who provided such careful reviews of this text: R. Rocco Cottone, Robin Lewis, Susan Prieto-Welch, William Sobesky, and Rita Sommers-Flanagan. The following people have provided valuable assistance and feedback to us regarding previous iterations of the book: Tamar Ares, Bill Briggs, Pam Daniel, Pam Fritzler, Sharon Hamm, Susan Heitler, Mark Kirchhofer, Teresa Kostenbauer, Margie Krest, Amos Martinez, Natalie Meinerz, Amber Reed, and Deb Wescott.

Any imperfections that remain in the book, of course, are our responsibility alone.

Introduction

Imagine, if you would, sitting at a first-row table at a psychotherapist comedy club. You’d probably hear something like this from one of the bright young performers:

“What’s the deal with becoming a psychotherapist? I mean, really! I figured the ethical issues – the issues of right and wrong – would be easy. Don’t date your clients, keep their interests at the top of the list, be helpful, have nice furniture. But noooo!! Learning to be an ethical psychotherapist feels like going through the security lines at the airport! You can’t do this, you can’t do that, you can’t bring that with you, and you can only bring so much of this. And then … there’s this thing about how people start to treat you. I thought I would have years to learn all this stuff about being ethical. But, nooo! I mean I just started graduate school and right away friends and family members start treating me differently – like I’m Sigmund Freud or Dr Phil. I mean they want me to solve their problems. The first day of graduate school, right? I haven’t even paid tuition or read the syllabus and when I get home my sister-in-law is there in my apartment asking how she should raise her kid! I go out to get some air and think about all her questions and my friend who lives on the floor below me asks me what I’ve been up to. I tell him that I’ve started graduate school to become a therapist and he tells me about his crazy sister – and asks if I have any time to “fix” her! My aunt calls up and says, ‘Listen, call your cousin Marty and tell him he needs to see a shrink. He’ll listen to you now.’ I don’t know how to respond to any of these pleas!”

Some audience members, mostly trainees, might not get the humor – or the reality behind the humor – in these stories because they don’t see the ethical problems inherent in them. Why doesn’t our young performer just see his friend’s sister for treatment? Other members of the audience, mostly beginning therapists, might giggle and sigh at the same time because they understand the ethical dimensions and the situations are all too familiar. They recognize that psychotherapists face ethical decisions every day. How are new professionals to know the right things to do and to discern right and wrong professional behavior? Older, more experienced therapists among the audience members might shake their heads because they know that ethical situations, dilemmas, and decisions do not go away and often become more complex over the course of their careers. Of course, our young comedian can’t tell the best stories – about clients – because of confidentiality.

Our book will have little impact on the fantasy psychotherapy-comedy club business, but it will help you in your journey toward becoming an ethical professional. We have written this book for all students of psychotherapy and counseling, whether you are (a) taking an undergraduate class and figuring out whether psychotherapy might be a profession for you; (b) taking graduate courses in psychotherapy and ethics; or (c) practicing psychotherapy and exploring ways to become more ethical and or more fulfilled.

A Quick Note on Terminology

Pardon this interruption but we think it is important that we have a common understanding of some terminology. When people write about morals and ethics in philosophy, mental health, medicine, and other fields, they define the words “moral” and “ethical” in a myriad of ways. Some authors use the two terms synonymously; others give them very specific and different meanings. Both terms refer to judgments of right and wrong behavior and the justifications we make for those judgments. In this book we will use the term “ethics” when we are referring to professional behaviors and judgments, and “morals” when we are referring to a wider range of behaviors and judgments including those in personal relationships.

The term positive ethics (Handelsman, Knapp, & Gottlieb, 2002; in press) may be a brand new term to you. It refers to the study of ethics as more than a series of rules you must follow to avoid punishment. Behaving ethically by following rules to avoid punishment has been termed remedial ethics (Knapp & VandeCreek, 2006). We are all for avoiding punishment, but behaving ethically is not just a matter of following rules – although your professional career might go better when you do. We also believe that professionals are motivated to do good work and actualize their highest moral and ethical selves. It is these higher levels of motivation and behavior that constitute positive ethics. We don’t think you have to be perfect, but we think focusing on positive themes is more effective, more professionally sustaining, and more fun than focusing on rules and what we shouldn’t do.

Mental health professionals use a variety of terms to describe what they do – the two major terms being psychotherapy and counseling. In the interest of clarity and brevity, we will use the terms counseling, psychotherapy, and therapy interchangeably.

Ethical Acculturation

Behaving ethically and growing toward ethical excellence are complex processes which involve adapting to a new culture – the culture of psychotherapy. This adaptation, which we call ethical acculturation (Handelsman, Gottlieb, & Knapp, 2005), involves awareness and action on two major fronts at the same time. The first front is you. Who are you, morally and ethically? What is your sense of right and wrong professional behavior? Who have you been throughout your life, in the many types of relationships of which you have been a part? The second front is the profession of psychotherapy. The profession of psychotherapy has its own culture, including ethical traditions, values, rules, rituals, and language.

As you begin your acculturation into this new culture, one of the key tasks is to explore this question: “How do I integrate the ethical traditions, values, rules – in short, the culture of psychotherapy – with my own moral intuitions, values, and backgrounds?”

This question or task might take you by surprise. You might be thinking that you already have enough of a personal foundation or moral compass to be an ethical practitioner. For example, (a) you are very motivated to listen and to help people; (b) others tell you that you are a nice person; and (c) you have never been convicted of a felony. These statements may all be true; however, psychotherapy is a complex profession and the therapeutic relationship includes a unique combination of behaviors and factors.

A major premise of this book is that psychotherapy is both very powerful and very fragile. Like a carefully produced chemical compound, psychotherapy has the potential to cause significant impact on people’s lives. On the other hand, if not handled in a diligent manner, psychotherapy can cause great damage. Additionally, when impurities – ethical lapses are equivalent to such foreign substances – enter the picture, psychotherapy can become quite harmful. At the least, such impurities can reduce or destroy the effectiveness of psychotherapy.

This book is a step-by-step guide to ethical acculturation that will help you understand yourself, your ethical culture of origin, and what it means to be or become an ethical psychotherapist. By the way, you will not be finished with your ethical acculturation when you’ve finished reading this book and made your office furniture purchase. Acculturation is a lifelong process because we change over time – as does the culture of psychotherapy.

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