Handbook of Professional and Ethical Practice for Psychologists, Counsellors and Psychotherapists

Rachel Tribe, Jean Morrissey

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9780415705288, 9780415705288
• eBook ISBN: 9781317602798
• Edition: 2
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

Closer regulation of psychological counselling means that an awareness of the professional, legal and ethical considerations is vital. The second edition of Handbook of Professional and Ethical Practice offers a clear, stimulating, and structured introduction to a number of contemporary issues of professional and ethical practice. Rachel Tribe and Jean Morrissey have brought together updated, re-written and new contributions from professionals in the interrelated fields of psychology, psychotherapy and counselling, which illustrate the professional and ethical dilemmas involved in mental health practice. Academic and clinical experiences are skilfully combined with personal reflection to produce a comprehensive resource that addresses challenges that therapeutic practitioners are faced with on a daily basis.

Each chapter places particular emphasis on the current codes of practice and ethical principles underpinning safe ethical practice and the implications for practitioners. Comprehensive coverage of the legal, clinical and ethical considerations involved in research and training is provided and the reflective questions at the end of every chapter serve to prompt further discussion of the issues. Chapters are enhanced by clinical vignettes that illustrate the particular issues at hand, as well as detailed bibliographies that point the reader towards the latest literature on the subject. The book is divided into 5 sections:

Professional practice and ethical considerations

Legal considerations and responsibilities

Clinical considerations and responsibilities

Working with diversity – professional practice and ethical considerations

Research Supervision and Training

This new, updated edition reflects the changes in the environment in which therapists and psychologists work. Covering a wide range of perspectives, clinical settings and client populations, Handbook of Professional and Ethical Practice 2 nd edition will be an invaluable source of both information and inspiration to psychologists, counsellors, psychotherapists and practitioners of diverse orientations and stages of professional development and to those interested in a contemporary, multi-disciplinary approach to best practice in mental health.

Chapter 1

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Introduction

Rachel Tribe and Jean Morrissey

 

 

 

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According to Spinelli, throughout life, the many dilemmas we are confronted with are not principally concerned with questions of right versus wrong but about the choices we make between actions, that in themselves, contain elements of both ‘right’ and ‘wrong’ (Spinelli, 1994: 124, cited in Gilbert and Evans, 2000: 131).

We are delighted to be writing an introduction to the second edition of the Handbook of Professional and Ethical Practice for Psychologists, Counsellors and Psychotherapists. We hope that this book will provide an overview of the major professional, ethical and research practice issues that a psychologist, counsellor or therapist¹ may need to consider in their therapeutic career. We believe that ethical, professional and research decision-making and practices need to be kept at the forefront of every therapist’s repertoire, particularly in the constantly changing environment in which we live. Professional, ethical and research practice issues form the backbone of therapeutic decision-making and good practice as well as being central to the curriculum requirements for all the major professional psychotherapy and psychology organisations worldwide. This is to ensure that clients or service users receive the best possible service which follows best ethical, professional and research based decision-making and that therapists are adhering to all aspects of best practice as well as working within appropriate guidelines.

There have been many developments since the first edition was published in 2005 and we have reflected and accommodated these. Changes to the environment include those in technology, the socio-political context and legislation; these have resonated around the world. Changes have included a move towards a more business-driven model in many services including the UK National Health Service (NHS) and therapists may find themselves trying to balance the demands of a target-driven service with fewer resources and a desire to provide an excellent service for clients/service users. In addition, regulatory arrangements have changed in various countries. For all therapists, an emphasis on time-limited therapy, revised commissioning arrangements and new roles within the various professions have all brought changes, while technological advances, for example, the widespread use of a range of social media, have led to a range of new challenges for therapeutic practitioners. Each chapter has therefore been written to reflect where necessary the current environment and recent developments in context, practice and research.

The contributors are all respected members of one of the professional bodies representing therapists and psychologists. We have also added several new chapters to this edition. These include chapters on the role of social media in therapeutic practice, trainee perspectives on professional and ethical practice as well as a chapter dealing with potential professional and ethical clinical scenarios.

Professional, ethical and research practices form a powerful, compelling and vibrant arena. Changes in legislation, professional and ethical guidelines in addition to changing research and practice requirements may all lead to incremental and paradigm shifts. In addition, changing professional codes of practice, cultural traditions and expectations, personal belief systems as well as the demands of clinical governance, lifelong learning and statutory registration will also impact upon professional, ethical and research practice. As such, we believe that the challenges in this area of practice are one of the things that make it such an interesting and vibrant field.

The juxtaposition of the personal and professional are central to professional ethical and research practice. We believe that continuing professional development is an essential requirement of professionalism and is another area where further consideration of professional, ethical and research dilemmas can be undertaken.

Throughout this book, particular emphasis is placed in each chapter on the current codes of practice and ethical principles underpinning safe ethical practice and the implications for practitioners. Therefore, each author was asked to focus on the particular professional and ethical issues in his or her area of expertise and the challenges they present in clinical practice. The importance of considering diversity is also paramount and this theme runs throughout the book. Different audiences may be guided by different ethical codes, cultures of practice and training, and there are many similarities and some differences between them. Notwithstanding this, the importance of ethical awareness and practice for all therapists or practitioners working in therapeutic environments has a common basis. Given the boundaries of this book it was not feasible to cover all eventualities related to professional and ethical practice or the contexts in which they occur. However, this book aims to foster the professional judgement of the reader, who is required to manage the often complex and challenging ethical issues unique to each situation. The latter is illustrated throughout the various clinical case examples in the respective chapters.

The book is divided into five Parts. The contributors represent different constituencies, including psychologists, counsellors and psychotherapists as well as a range of theoretical orientations. Part I is entitled ‘Professional practice and ethical considerations’, which describes the development and monitoring of professional ethics in contemporary society drawing upon incidences where professional and ethical considerations appear to have been largely ignored by hospital staff, as detailed using the findings of the Francis Report (2013) as a comparator, and considers what we as therapists might learn from them. The following three chapters address issues concerning the concept of professional contracts with and within organisations and how they can be negotiated to create healthier relationships and more positive working environments. The final chapter in Part I by Malcolm Cross and Joanne Wood discusses the person in ethical-decision making and the varying degrees of discomfort that can arise between ethical principles and personal values as well as their impact on the therapeutic work.

The first two chapters in Part II, ‘Legal considerations and responsibilities’, provide a comprehensive overview of the professional responsibilities as they relates to data protection, client confidentiality and the legal context of therapy. The following chapters focus on specific professional and legal considerations and responsibilities relating to the important areas of note keeping and record keeping. The next chapter is on writing a report for use in court reports and appearing as an expert witness. While Part III, ‘Clinical considerations and responsibilities’, covers specific areas and the accompanying professional and ethical challenges that apply to the practice of therapy, including managing referrals, dealing with complaints, fitness to practice, suicide risk, working in a multidisciplinary team in a health care setting and the increasing role of social media. The penultimate section, Part IV, ‘Working with difference: professional practice and ethical considerations’, focuses on issues of working with diversity, including age, sexual orientation, disability and race as well as detailing the importance of considering such issues in every area of our clinical and research practice and not merely in the consulting room. The final section, Part V, ‘Research, supervision and training’, highlights the importance of research and the challenges of undertaking research in clinical practice. The current debate surrounding evidence-based practice is also discussed. Part V presents an examination of personal therapy, the teaching and learning about ethics and professional practice from trainees’ and tutors’ perspectives, as well as a new chapter which considers the concept of the wounded healer. Next is a chapter on clinical supervision which is one of the key components in the process of becoming a psychologist, counsellor and psychotherapist. The final chapter presents a range of clinical scenarios which raise a range of professional and ethical issues and which may be encountered by any therapist. Each scenario is followed by a range of questions for consideration either alone or within a training or supervision group.

In conclusion, as editors, we hope the reflective questions at the end of each chapter will facilitate further discussion, reflection and learning concerning the many complex and challenging professional, ethical and research dilemmas each therapist is confronted within a fast-moving therapeutic environment.

Note

1 We will use the term ‘therapists’ to apply to psychologists, psychotherapists and counsellors throughout the Introduction.

References

Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, vols 1–3. London: The Stationery Office. Available at: w­w­w­.m­i­d­s­t­a­f­f­s­p­u­b­l­i­c­i­n­q­u­i­r­y­.c­o­m­/­r­e­p­o­r­t­

Gilbert, M. and Evans, K. (2000) Psychotherapy Supervision: An Integrative Relational Approach to Psychotherapy Supervision. Buckingham: Open University Press.

Part I

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Professional practice and ethical considerations

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Chapter 2

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New challenges for professional ethics and good practice guidelines for counsellors, psychotherapists and psychologists

Tim Bond

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Professional ethics in health and social care are currently undergoing some of the most radical changes since the 1940s when the current health service was founded. A series of scandals uncovering instances of abysmal standards, abuse and disregard for the dignity and suffering of patients and clients has led to changes in the ethical landscape for everyone working in health-related fields, including all practitioners of the talking therapies. Not surprisingly, the focus has become increasingly fixed on issues of the safety of service users and respect for their dignity as people while providing good quality services.

All countries share concerns about how to ensure that their health and social care services, which will often include counselling, are provided to an adequate standard. This concern becomes a priority when examples of poor practice are exposed. In the UK, there have been a series of scandals over poor practice, of which one of the most recent was the neglect and mistreatment of vulnerable and highly dependent elderly patients in a modern hospital leading to probably hundreds of premature deaths. The Francis Report (2013) into the causes of these deaths has attracted international attention because of its comprehensive and radical approach to improving services. Its recommendations accelerate established trends in the UK by calling into question whether services can be adequately protected by each profession having its own system of ethics and discipline. With each scandal, the tendency has been to move power away from the professions to systems of governance that apply across several professions in the same way and to strengthen employers’ responsibility for dealing with professional misconduct. If the recommendations of the Francis Report (2013), following the public inquiry into the events at Mid Staffordshire Foundation Trust are fully implemented, there will be a paradigm shift in the ethical landscape for everyone, including counsellors and related professions involved in providing health and social care.

In this chapter I want to examine the implications of these changes for psychologists and counsellors.

Background to ethical changes

Scandals have often been the driving force behind changes in professional ethics. The origin of medical ethics in modern times was the closure of the Manchester Infirmary during an epidemic of cholera and typhus because of a vehement disagreement between two surgeons. This resulted in an independent report by Thomas Percival in 1803 that set out some early principles for all staff involved in running a hospital. This report became the basis for medical ethics in the USA and then Britain. Since then, healthcare has become massively more complex, both in the range of treatments available and in the number of different professions involved. However, the wheel is turning full circle. Percival’s approach of one all-encompassing set of principles across all the different professions involved in health and social care is being promoted as a solution to a long line of failures in patient care since the 1990s.

One of the most notable of these scandals was the Bristol Heart Scandal in which surgeons continued to operate on young babies regardless of having a death rate twice the national average, from 1988 to 1994. The inquiry that followed this scandal heard evidence that exposed the retention of organs without parental knowledge on a large scale at Alder Hay Children’s Hospital from the early 1990s. The response to these scandals and others has been to develop progressively a single regulatory structure which oversees the work of most of the professional bodies from medicine and nursing, social work to specialised ancillary occupations including professions as diverse as a...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• Notes on contributors
• Acknowledgements
• 1 Introduction
• Part I Professional practice and ethical considerations
• Part II Legal considerations and responsibilities
• Part III Clinical considerations and responsibilities
• Part IV Working with diversity: professional practice and ethical considerations
• Part V Research supervision and training
• Index