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Sexual attraction between human beings is a pervasive phenomenon, impacting the process of psychotherapy, as well as other areas of social engagement. However, within ethical psychotherapy practice the experience of attraction could not lead to enactment without ethical misconduct or premature therapeutic termination. This qualitative study focused on female therapists' experiences of working with male clients who were sexually attracted to them. It employed Hollway and Jefferson's (2008) hybrid method 'free association narrative interview', which involved multiple unstructured interviews with five female participants. The results of the study suggested that participants' experience differed depending on whether they felt reciprocal sexual attraction. On occasions when therapists were not attracted towards their clients, they struggled with unwanted sexual attraction because they feared having to reject their client and the retaliation this may entail. On such occasions, therapists expressed a sense of vulnerability, discomfort with power inequality and a sense of being at fault. Conversely, when therapists felt sexually attracted to their clients, they managed the dynamic by framing it within a context of loving as opposed to purely erotic feelings. The study suggests that working directly with sexual feelings is a challenge for female therapists, requiring personal development work, supervision and institutional support to address the complex interplay of individual, clinical and societal issues, which appear to play a part in this difficulty. [ABSTRACT FROM AUTHOR]

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots., (© 2024 The Authors. Bioethics published by John Wiley & Sons Ltd.)

Studies have generally supported telehealth as a feasible, effective, and safe alternative to in-office visits. Telehealth may also be of particular benefit to couples/families interested in relational treatments, as it addresses some of the barriers that may be more prominent for families, such as childcare and scheduling difficulties. Therapists interested in expanding their practice to include telehealth should understand ethical and practical considerations of this modality. This article discusses areas unique to the delivery of telehealth to couples and families. Each broad domain is then elaborated upon with case examples from actual clinical practice and specific recommendations for addressing potential difficulties. Authors recommend further empirical research examining differences in modality outcome, as well as feasibility of the suggestions proposed here. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 50th annual meeting of Cheiron: The International Society for the History of the Behavioral and Social Sciences held from June 21-24, 2018, held at the University of Akron in Ohio. Topics covered include the problems in the use of inferential statistics in psychology publications, cases of unethical conduct in psychological research and therapy, and a demonstration on ways to guide undergraduates into primary sources in history of psychology.

Clinical supervision for psychotherapies is widely used in clinical and research contexts. Supervision is often assumed to ensure therapy adherence and positive client outcomes, but there is little empirical research to support this contention. Regardless, there are numerous supervision models, but it is not known how consistent their recommendations are. This review aimed to identify which aspects of supervision are consistent across models, and which are not. A content analysis of 52 models revealed 71 supervisory elements. Models focus more on supervisee learning and/or development (88.46%), but less on emotional aspects of work (61.54%) or managerial or ethical responsibilities (57.69%). Most models focused on the supervisee (94.23%) and supervisor (80.77%), rather than the client (48.08%) or monitoring client outcomes (13.46%). Finally, none of the models were clearly or adequately empirically based. Although we might expect clinical supervision to contribute to positive client outcomes, the existing models have limited client focus and are inconsistent. Therefore, it is not currently recommended that one should assume that the use of such models will ensure consistent clinician practice or positive therapeutic outcomes. Key Practitioner Messages There is little evidence for the effectiveness of supervision., There is a lack of consistency in supervision models., Services need to assess whether supervision is effective for practitioners and patients. [ABSTRACT FROM AUTHOR]

Providing psychotherapy changes the therapist in a variety of ways. This article discusses one doctoral student's perceptions of these changes, such as increasing her patience, gratitude, and reliance on faith; stretching her ability to tolerate ambiguity; and influencing her interpersonal relationships. [ABSTRACT FROM AUTHOR]

This article questions a number of widely held views of the role of values in psychotherapy. It begins with a discussion of the now largely discredited view that psychotherapy can be value free. It also broadens this challenge to question the popular idea that values form an inescapable part of the therapeutic encounter. While this view is correct in outline, it is necessary to reject the underlying conception of values as largely arbitrary preferences that the client and the therapist bring to the encounter, as this fails to do justice to the inherently ethical nature of psychotherapy. It argues that we should recover the Greek notion of therapy as essentially concerned with the character of a person. In other words, the goal of therapy is virtue. [ABSTRACT FROM AUTHOR]

In this article, we propose that emotional reactivity can influence dialogue around the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the wider issues included in the debate. We explore this emotional process and the impact that it has on our clinical practice, our clients' experiences, our experience of ourselves as clinicians and the ways we work with other professionals. We begin by presenting clinical scenarios, then briefly summarise key ideas from the DSM-5 debate, and draw on Bowen Family Systems Theory to explore a number of ways that emotional reactivity to these ideas can manifest itself in multidisciplinary and collegial relationships. We conclude that it is helpful to increase awareness of our own emotional processes to best avoid becoming reactive to, or dismissive of, alternative paradigms or knowledge bases that may be of use to our clients. We describe a number of principles and ideas that we have found useful in this context and identify ongoing dilemmas in our practice. [ABSTRACT FROM AUTHOR]

Background: A three‐stage independent audit of complaints made to the British Association for Counselling and Psychotherapy was conducted. The second stage is discussed in this paper. Primary objective: This project set out to examine complaints made under the Article 4.6 process, which allows the Association to respond swiftly to serious allegations of misconduct. The main aim was to gain a detailed picture of who complains, who is complained against, and the outcomes of such complaints. Method: Information from these cases was entered into a database to produce descriptive statistics. Main outcomes and results: A total of 91 cases covering the period from 1998–2007 were identified. Figures have been combined with totals from the first stage of the audit and show that the total number of complaints received represents less than two complaints for every 1000 members per year. Conclusions: Male members of the Association are over‐represented in the complaints and the majority of complaints are brought by people who are themselves involved in counselling. Further research into complaints made to other UK counselling and psychotherapy organisations is recommended as is research examining what prevents members of the public from making complaints. [ABSTRACT FROM AUTHOR]

The scientist-practitioner model, which is based on positivistic methodological assumptions, is influential in the development, training and practice of cognitive behavioural psychotherapists. As the emergence of 'Nurse Cognitive Behavioural Therapist' training in the early 1970s in Britain, many of those trained have been mental health nurses and with the emergence of the Increased Access to Psychological Therapies agenda many more are likely to undergo training. Despite some acceptance of its relevance, the scientist-practitioner model is subject of criticism on the grounds of its achievability and contemporary relevance, and its exclusion of other modalities of counselling and psychotherapy without an, as yet, disseminated evidence base. In line with key policy-related work, the empirical and political issues inscribed within the scientist-practitioner model have direct implications for the educational preparation and ongoing professional development of cognitive behavioural practitioners. Specifically, in this polemical paper it is argued that there is a moral and educational need for 'senior' practitioners to question the philosophy of science assumptions underpinning the overwhelming dominance of the quantitative-experimental approach in cognitive behavioural psychotherapy. Such a critically evaluative and pluralistic stance would arguably distinguish senior practitioners in terms of them being able to make broad rather than narrow appraisals of the evidence base for their practice. A recognition of the relevance of paradigmatic and epistemological pluralism in cognitive behavioural work would, it is argued, confer considerable advantages on our practice communities and clients. A range of emerging implications for cognitive behavioural education, practice and relational ethics are described and discussed. [ABSTRACT FROM AUTHOR]

Psychotherapists must deal with practical business matters such as advertising, billing, collecting fees, and other practice management topics. We review the enforceable standards of the American Psychological Association's (2002) Ethics Code that deal with advertising, fees, billing, and related business matters in psychotherapy. Using a principle-based perspective, we link each of the standards to overarching ethical values and illustrate the concerns with case vignettes. We argue that understanding the moral foundations of ethical standards helps psychotherapists to implement with greater integrity the spirit and the letter of the standards with regard to advertising and business practices. © 2008 Wiley Periodicals, Inc. J Clin Psychol: In Session 64: 1–13, 2008. [ABSTRACT FROM AUTHOR]

Psychotherapists confront a myriad of ethical dilemmas as they endeavor to provide effective services. This issue of the Journal of Clinical Psychology: In Session on Ethics in Psychotherapy provides psychotherapists with thoughtful reviews, case examples, and practical guidance in the major areas of ethics. Following this brief introduction, the subsequent seven articles cover Informed consent; confidentiality, privilege, and their limits; treatment of minors and their families; business matters of practice (e.g., money, fees, bartering, advertising); clinical competence and scope of practice; boundaries and nonsexual multiple relationships; and termination and abandonment. This issue is designed to promote ethical practice, to provide guidance on common ethical dilemmas, and to prevent ethical challenges before they occur. © 2008 Wiley Periodicals, Inc. J Clin Psychol:In Session 64: 1–7, 2008. [ABSTRACT FROM AUTHOR]

The successful termination of the psychotherapy relationship is each psychotherapist's goal. Yet, a number of circumstances may arise that interfere with the successful completion and termination of treatment. This article addresses both termination and abandonment and illustrates the applicable guidelines and standards from the American Psychological Association's (2002) Ethics Code. We conclude with 12 recommendations for proactively addressing termination and abandonment consistent with professional standards and each patient's best interests. © 2008 Wiley Periodicals, Inc. J Clin Psychol:In Session 64: 653–665, 2008. [ABSTRACT FROM AUTHOR]

This article situates family therapy in the politics of evidence-based practice. While there is a wealth of outcome research showing that family therapy works, it remains on the margin of mainstream therapy and mental health practice. Until recently it has been difficult to satisfy ‘gold standards’ of randomized control research which require manualization and controlled replication by independent investigators. This is because systemic family therapy is language-based, client-directed and focused on relational process rather than step-by-step operational techniques. As a consequence family therapy is an empirically supported treatment unable to join the evidence-based club. The politics here concerns what is ‘evidence’, who defines it and the limitations of a scientist-practitioner model. Therapy is art and science and its research needs to be grounded in real-life clinical practice. Common factors such as personal hope and resourcefulness and the therapeutic relationship contribute more to change than technique or model. While arguing for a wider definition of science and evidence it is politic to seek evidence-based status for family therapy. Family therapy is a best practice approach for all therapists where systemic wisdom helps to decide what to do with whom when. A systemic-practitioner model is informed by quantitative and qualitative research and holds modern and postmodern perspectives in tension, a stance I call paramodern. Family therapy is both scientific and systemic; it is a science of context, narrative and relationship. [ABSTRACT FROM AUTHOR]

Treating adolescents in psychotherapy presents a number of unique ethical challenges. Because many adolescents who enter treatment have not yet attained the age of majority, reside in families that include other people with emotional difficulties, attend school, become involved with community agencies (e.g., the courts), and must generally take direction from adult authority figures, the role of the therapist becomes particularly complex. The unique dilemmas include developing specialized clinical competence, treatment contracting, choice of treatment modality, direction of the therapeutic process, and confidentiality. This article discusses the range of ethical concerns involved in treating adolescents and suggests strategies for optimal ethical care. © 2003 Wiley Periodicals, Inc. J Clin Psychol/In Session. [ABSTRACT FROM AUTHOR]

Examines the role of ethics in psychotherapy. Focus on the psychotherapy of ethics; Special role of attentional dynamics; Effects of techniques of treatment on patients' ethical development; Case of performance anxiety; Redirection of ethical life; Focus of medical ethics.

Fragmentation of processes and interventions plague the psychotherapies (Gilbert & Kirby, ). Part of the problem is that we have not agreed on a framework that could be the basis for integrating knowledge and the scientific enquiry of processes and interventions. This paper outlines an approach that brings together a variety of different disciplines in the service of consilience (Wilson, , Consilience: The unity of knowledge, Vintage, New York, NY; Siegel, ). It presents the importance of an evolutionary framework for understanding the proclivities and dispositions for mental suffering and antisocial behaviour, and how they are choreographed in different sociodevelopmental contexts. Building on earlier models (Gilbert, , Human nature and suffering, Routledge, London, UK; Gilbert, , Clin. Psychol. Psychother., 2, 135; Gilbert, , Br. J. Med. Psychol., 71, 353; Gilbert, , Case formulation in cognitive behaviour therapy: The treatment of challenging cases, Wiley, Chichester, UK, pp. 50-89) the call is for an integrative, evolutionary, contextual, biopsychosocial approach to psychology and psychotherapy. PRACTITIONER POINTS: Evolutionary functional analysis is part of an evolutionary, contextual, biopsychosocial approach to mental health that can serve as a scientific platform for the future developments of psychotherapy. Therapist skills and training will increasing need to focus on the multidimensional textures of mental states especially the context-social-body linkages. Therapies of the future will also focus more on the moral aspects of therapy and address the need to promote prosocial and ethical behaviour to self and others., (© 2019 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

This article introduces questions in psychiatric ethics regarding the substantial field of qualitative and quantitative research into 'posttraumatic growth', which investigates how, after devastating experiences, individuals can come to feel that they have developed warmer relationships, increased spirituality, or a clearer vision of their priorities. In one area of this research, researchers of posttraumatic growth outline strategies for clinicians interested in assisting their patients in achieving such growth. In this article, I articulate two ethical concerns about this account of posttraumatic growth and the practice of growth-oriented therapy. The first is a concern about the status and effects of the ideal of posttraumatic health implicit in their account, and the second a concern about the ethical implications of the clinical recommendations for the post-trauma patient. I argue for the need for more attention to the hazardous implications of relating to patients as though they are on their way to, and themselves largely in control of, their own posttraumatic growth., (© 2015 John Wiley & Sons Ltd.)

Antidepressant medication and evidence-based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self-knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor-related decisions. I further argue that such an effect comprises a compelling moral reason for doctors to see evidence-based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression.

Objectives: To examine the issue of informed consent and how this is translated into clinical psychotherapy practice., Design: A qualitative approach was taken in which interviews were used to produce data., Methods: Nine clinical psychologists with specialist psychodynamic training took part in the research. Participants were interviewed using a semi-structured interview schedule. The interviews were transcribed and the data were analysed using interpretative phenomenological analysis., Results: The tensions between balancing the requirements of informed consent with psychodynamic practice were explored and the notion of whether clients can truly be informed prior to undertaking psychodynamic therapy was raised. Four major themes emerged from the data: 'psychodynamic therapy as risky'; 'balancing expectations between therapist and client'; 'psychodynamic therapy as unique and experiential'; and 'informed consent as complex: a linguistic conceit'?, Conclusions: This research has been valuable in identifying therapists' views and experiences of how the issue of informed consent is addressed in therapeutic practice. In the light of the findings of this research, future investigation would benefit from more detailed examination of the process of providing informed consent, examining whether, and how often, consent issues are revisited by therapists. More research focusing on the views and need of clients are also warranted.