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The last few years have seen a marked increase of interest in the ethics of psychotherapy. As the field of mental health has recently taken on a new level of prominence, renewed commitment to the ethical analysis of psychiatric and psychological treatment is clearly required. In this review essay, we survey recent work on psychotherapy ethics, taking a critical yet generally sympathetic view of the new literature. There are important considerations that remain neglected or overlooked entirely, in our view, and several substantive and methodological trends are in need of diagnosis and critical response. We structure the discussion around several themes, including the inherently moral nature of psychotherapy, the heterogeneity of such practices, the significance of social, cultural, and historical context, and, finally, questions concerning prevailing methodological assumptions. [ABSTRACT FROM AUTHOR]

Patients' access to their psychotherapy records may be assumed to be well protected; however, the matter is intricately regulated. In fact, the statutes and rights pertaining to patient access to psychotherapy notes vary across states. Taken together, federal and state laws indirectly and inconsistently delineate lawful access-as well as clinical exceptions to providing access-to psychotherapy notes. Federal law defers to state laws when the latter afford individuals greater access to their notes. Both federal and individual state levels vary in providing for possible conditions under which access may be restricted. Right of access to psychotherapy notes is a matter of importance for all mental health clinicians in the United States. Awareness and integration of pertinent laws and regulations allow clinicians to manage such matters without a negative impact on their clinical care. Further consideration of how clinical practice interacts with other dimensions of health care administration (clinical, ethical, and legal) may serve to enhance the integrity of a clinician's work and the ability to adapt to difficult clinical circumstances with confidence., Competing Interests: The authors report no financial relationships with commercial interests.

In Spain and many other countries, psychotherapy training is heterogeneous and not very evidence-based. This contribution addresses related ethical, normative and legal issues with the aim of clarification, as well as certain relevant aspects of psychological work in the field of mental and behavioural health in Spain. It will analyse professional responsibility and possible intrusiveness in the clinical-psychological field. The authors have scrutinised national legislation along with PubMed/Medline content, as well as a wide variety of scientific papers collected using the search engines Google Scholar and Scientific Electronic Library Online. For clinical psychologists and psychiatric doctors, when appropriate, it is their professional responsibility to choose among the various and sometimes conflicting interventions proposed as the most appropriate or priority psychotherapies. Psychotherapy, as a treatment, although not regulated, should only be undertaken by health personnel who are suitably qualified in mental health with the guarantee of the State, at least in Spain. This would probably help to mitigate the perennial crisis of replication in psychology, particularly as applied to mental health. Likewise, it is a relevant and popular issue, antagonistic to intrusiveness, that any common intervention of interpersonal psychic help should be considered therapeutic, or preferably be undertaken by personnel with a degree in psychology. There is no mandatory psychotherapeutic standard for clinical psychologists and psychiatrists, nor is there an official common international system of accreditation in clinical psychology outside Spain. In the field of mental health, any intervening psychologist, like any medical doctor, is ethically and legally responsible for their actions, omissions and consequences.

Background: Ethics is an inherent part of psychotherapy that protects the interests and rights of all parties engaged in the therapeutic relationship. This article focuses on ethical issues and dilemmas that may arise when using schema therapy., Method: We created a narrative review by searching the databases PubMed, Web of Science, and Scopus with the keywords "psychotherapy", "schema therapy", "therapeutic relationship", "ethics", "ethical questions", and "ethical dilemmas". In addition, we focused on the clinical experience of therapists, training instructors, and supervisors., Results: Ethical psychotherapy requires adherence to ethical codes and standards. Among the most important ethical principles are confidentiality, informed consent, boundaries of the therapeutic relationship, and dual relationships. Understanding transference, countertransference, and one's modes and schemas is essential to ethical reflection in schema therapy. The article presents examples of ethical dilemmas in schema therapy and suggests possible solutions. At the same time, we point out the need for further research in this field., Conclusion: Similarly to other psychotherapeutic approaches, one of the schema therapist's core competencies is following the profession's ethical principles and productively finding solutions to the occasional ethical dilemmas. Ethics is a prominent part of all psychotherapeutic sessions. Still, it becomes even more central when working with challenging issues such as personality disorders that schema therapy routinely treats. More research on the topic is needed.

Bias in Mental Health Care of Children and Adolescents with Intellectual Disabilities Implicit and explicit bias and distortions of perception are partly responsible for the unequal and significantly deficient psychotherapeutic and psychiatric care situation for children and adolescents with intellectual disabilities and additional behavioral problems. The extent to which these biases influence misdiagnoses and treatment errors, refusals and exclusions from professional care, and grossly hostile rejections of people with disabilities requires empirical evidence (Bartig et al., 2021). The fact that all forms occur - probably to a considerable extent - contradicts the ethical principles of the medical and psychotherapeutic profession. In order to avoid misdiagnosis and treatment as a result of bias, this must be openly addressed. Selfawareness, supervision and second views, the concept of working diagnosis and, above all, the full application of child and adolescent psychiatric standards help to reduce bias.

Background: Since the creation of legal requirements for advance directives by the legislator in 2009, special aspects of their application in the treatment of people with mental illnesses have been discussed., Goal of the Paper: Important questions on dealing with advance directives in everyday life will be answered in a practice-oriented manner., Results: Among other things, this document answers the question of the conditions under which a patient can refuse or consent to hospitalization and treatment in advance, and in particular how to deal with advance directives whose implementation would also affect the rights of third parties. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) has addressed these and other questions in the present document and added practical advice on how to formulate advance directives for people with mental illnesses and how to deal with psychiatric advance directives., Discussion: The DGPPN has developed an advance directive for the area of mental health and published it on its website together with detailed explanations. With the help of this advance directive, people can decide on their treatment in phases of incapacity to consent in the context of a mental crisis or illness., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

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.)

Unlabelled: This paper explores a significant shift in the field of mental health in general and psychotherapy in particular following generative artificial intelligence's new capabilities in processing and generating humanlike language. Following Freud, this lingo-technological development is conceptualized as the "fourth narcissistic blow" that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, interrelationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act following the emergence of what we term the artificial third in the field of psychotherapy. The introduction of an artificial third marks a critical juncture, prompting us to ask the following important core questions that address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships? (2) How does it reshape our perception of ourselves and our interpersonal dynamics? and (3) What remains of the irreplaceable human elements at the core of therapy? Given the ethical implications that arise from these questions, this paper proposes that the artificial third can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy., (© Yuval Haber, Inbar Levkovich, Dorit Hadar-Shoval, Zohar Elyoseph. Originally published in JMIR Mental Health (https://mental.jmir.org).)

Psychotherapy ethics, open notes, patient autonomy, informed consent, electronic health records, evidence- based practice, psychotherapy. [Extracted from the article]

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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]

This paper aims at continuing the conversation, slowly building over time, concerning the inclusion of the social-political sphere within our analytic/therapeutic dialogues and theories. Exploring examples of how larger cultural contexts always flow through us, the paper also notes our tendency through the years to narrow our own field of vision and quiet our anxieties about the world in which we, our patients and ourselves, live. This constriction affects our therapeutic work. If we do not listen for the contextual flow, or wonder about the absence of the social-political in our therapeutic dialogues, then we are in danger of reinforcing “malignant normality” and abdicating our moral responsibility. [ABSTRACT FROM AUTHOR]

Philip Cushman is right to call our attention to the Hoffman Report, the formal detailing of the American Psychological Association’s (APA’s) collusion with the torture program implemented by the U.S. government in the aftermath of September 11. My perspective differs from Cushman’s in viewing the APA’s collusion as fundamentally a failure of moral action, as opposed to a failure of moral reasoning; in questioning the value of a hermeneutic perspective as offering a way of forestalling such ethical disasters; and in questioning the role that a relationally refashioned psychotherapy can play in the “remoralization” project he calls for. [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.

Evidence-based practice in psychotherapy carries widely unacknowledged consequences for ethical clinical practice. Informed consent to psychological treatments is an ethical imperative in clinical practice, and there is an ethical obligation for psychiatrists, psychotherapists, and clinical psychologists to provide adequate disclosure to patients about treatments. This is codified within the professional guidelines of the American Psychological Association (APA) and the American Medical Association. Given the APA’s commitment to evidence-based practice, the objective of this paper is to argue that the provision of information about how treatments work should be based on evidence-based research on psychotherapeutic treatments. Case-based scenarios are used to illustrate a range of ethical issues pertaining to evidence-based practice and informed consent in psychotherapy. This paper argues that informed consent processes in psychotherapy must be commensurate with the latest integrated findings on empirically—supported treatments; process research into psychological treatments; research into therapist expertise; as well as evidence about individual patients’ characteristics, culture, and preferences. Our conclusions for practice are challenging: standard ethical interpretations of informed consent to psychotherapy must go further. It is not sufficient for therapists only to describe the specific techniques associated with particular treatment modalities, it is also necessary to disclose information about nonspecific factors. There appears to be consensus among therapists and psychotherapy researchers that these factors are relevant to successful treatment outcome. Our paper aims to launch fresh, serious, pragmatic debate in professional psychotherapy about necessary revisions of ethical codes with respect to information disclosure. [ABSTRACT FROM AUTHOR]

Past life regression therapy is used by some physicians in cases with some mental diseases. Anxiety disorders, mood disorders, and gender dysphoria have all been treated using life regression therapy by some doctors on the assumption that they reflect problems in past lives. Although it is not supported by psychiatric associations, few medical associations have actually condemned it as unethical. In this article, I argue that past life regression therapy is unethical for two basic reasons. First, it is not evidence-based. Past life regression is based on the reincarnation hypothesis, but this hypothesis is not supported by evidence, and in fact, it faces some insurmountable conceptual problems. If patients are not fully informed about these problems, they cannot provide an informed consent, and hence, the principle of autonomy is violated. Second, past life regression therapy has the great risk of implanting false memories in patients, and thus, causing significant harm. This is a violation of the principle of non-malfeasance, which is surely the most important principle in medical ethics. [ABSTRACT FROM AUTHOR]

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]

Challenges and opportunities for psychologists and psychotherapists in respect to explicit and implicit discrimination issues in therapy are explored, both from the side of the therapist and the client. Furthermore, personal reflections on such issues are discussed drawing on examples of indirect discrimination on the basis of race and sexual orientation. It is suggested that a combination of professional anti-discriminatory guidelines, a willingness to understand deeply the client's frame of reference and self-reflection can guard against such phenomena that can harm ethical and constructive psychotherapy. [ABSTRACT FROM AUTHOR]

Values nonpaternalism—the ethical imperative to avoid imposing values onto clients—is implicit in most widely used ethical frameworks employed by psychotherapists. Although changes in client values may represent desired psychotherapeutic outcomes, some such changes may be ethically problematic. Interventions are characterized by values paternalism when they are intended to promote client welfare but are accompanied by impositions against client values. Providers and consumers of psychotherapy may routinely lack awareness of this consideration. Psychotherapists may have a duty to be informed about ethically problematic value change accompanying psychotherapy and to inform clients about this phenomenon. [ABSTRACT FROM PUBLISHER]

Some people want to modify their bodies through hormonal and surgical treatments in order to resolve gender dysphoria, the distress they experience when their bodies do not align with their gender identity. The World Professional Association for Transgender Health (WPATH) offers guidelines to clinicians regarding treatment of people wanting to modify their bodies for this reason. Prior to these modifications, WPATH advises that mental health screening is needed and that psychotherapy is recommended though not a requirement. In fact, these advisories allow clinicians some freedom in applying the standards to specific cases. Although some variation from the WPATH Standards of Care can be clinically acceptable, informed consent remains an essential component of clinical encounters involving body modifications. [ABSTRACT FROM AUTHOR]

Advances in neuroscience research are often enlisted as evidence for the belief that mental disorders are biologically based diseases of the brain, and have contributed to the continued prominence of the biomedical model within the field of mental health. Psychologists' use of neuroscience in marketing their services, explaining behavioral phenomena, and legitimizing the efficacy of psychotherapeutic treatments may contribute to "neurocentric" understandings of psychology, at the expense of a more comprehensive biopsychosocial model of mental disorders. These issues raise concerns about the ethical and responsible use of neuroscience language and research findings by psychologists in the promotion and practice of psychotherapy. This article reflects critically on the ethical principles and standards of the ethics code of the American Psychological Association (2010a) regarding competency, the basis of professional judgments, and the veracity of statements about psychotherapy, and provides considerations and recommendations for practicing psychologists, faculty, and graduate students when making use of neuroscience research. [ABSTRACT FROM AUTHOR]

This article is about ethics, specifically, the myriad of unethical practices characterizing recruitment for psychiatric trials. Using a case study approach, honing on recruitment material, and examining the typical, the author explores recruitment in two studies—one involving electroconvulsive therapy, the other, a psychiatric drug. The bulk of the article is on these trials. The ethical problems which surface include minimization of risk; euphemism; lack of transparency; false and misleading claims, unfair inducement; failure to mention most of the common and serious negative effects; and a predatory quality. The author also identifies some worrisome new trends. Of special interest to the humanistic counselor is the attempt to implicate people’s own counselors and therapists in recruitment. The article ends with reflections on the onus that such practices place on all practitioners striving to be ethical. The author concludes that it is critical that counselors and therapists not be complicit and beyond that they take it on themselves to confront and expose. Concrete practice suggestions include adopting an explicit policy against such referrals, alerting any clients who may be considering such trials of the danger, and countering false claims. [ABSTRACT FROM AUTHOR]

While agreeing with the mainstream view that psychotherapeutic practice must be grounded in science, including research on the effectiveness of psychotherapy, the author advocates giving more weight to the venerable philosophical literature on ethics that bears directly on what patients bring to therapists: problems in living. These problems have been the domain of ethics since Socrates, who-like psychotherapists-promoted reflective dialogue. This article reviews some contemporary thought regarding the importance of reflection and the limits that patients and therapists face in promoting it. Relying on attachment theory and the process of mentalizing, the author identifies a convergence of science and ethics in the therapeutic aspiration to cultivate epistemic trust and illustrates this convergence with a case example. [ABSTRACT FROM AUTHOR]

In the past 20 years, mindfulness therapeutic programs have moved firmly into the mainstream of clinical practice and beyond. As they have, we have also seen the development of an increasingly vocal critique. At issue is often less whether or not these mindfulness practices "work," and more whether there is a danger in dissociating them from the ethical frameworks for which they were originally developed. Mindfulness, the argument goes, was never supposed to be about weight loss, better sex, helping children perform better in school, helping employees be more productive in the workplace, or even improving the functioning of anxious, depressed people. It was never supposed to be a merchandized commodity to be bought and sold. The larger clinical and religious community, however, has not always been troubled by the idea that meditation might sometimes be used as a highly pragmatic remedy for various ailments. Why, then, are people troubled now? This essay is an effort to recapture a bigger historical perspective on current ethical qualms: to move beyond criticism and instead to try to understand the anatomy of our discontent. [ABSTRACT FROM AUTHOR]

The deployment cycle presents unique challenges for military couples. Marital outcomes have been shown to be negatively impacted throughout the deployment process, and at-home stressors can serve as distractions for service members that can compromise their effectiveness and safety. Tele-mental health, specifically the delivery of therapy via videoconferencing, has been shown to be an effective therapy medium, particularly for reaching underserved or isolated populations. A case can be made for the use of tele-mental health as a means of delivering therapy to military couples throughout the deployment process in an effort to strengthen their relationship and enhance service member well-being during deployment. This form of therapy may be particularly valuable to couples experiencing barriers to care due to stigma, rural location, or limited access to military resources (i.e. National Guard service members). Three general recommendations for this form of treatment are first provided, which include (1) work within the military culture, (2) capitalize on existing support structures, and (3) receive training in tele-mental health delivery. Five additional recommendations are provided which are specific to delivering couples therapy while the service member is deployed. These recommendations include (1) tailor treatment to fit the service member's context, (2) prioritize service member safety, (3) encourage the development of couple skills in therapy, (4) be intentional about session management, and (5) engage the at-home spouse. Legal and ethical considerations, as well as intended benefits for this method of treatment are also discussed. [ABSTRACT FROM AUTHOR]

Important change in competent practice in psychological therapy is increasingly being influenced by evidence-based practice. This paper explores major issues related to the evidence-based literature with regard to specific techniques and common factors. Increasing evidence that support common factors provides validity for the psychotherapy integration movement. This movement is explored in relation to the three waves of behavior therapy that indicate an increasing integration of a wide range of therapies. The discussion concludes with implications for therapists who wish to adopt an ethical and evidence-based approach. [ABSTRACT FROM AUTHOR]

This article covers the relatively new topic of writing an ethical will as part of conveying the testator’s values, beliefs, and lessons learned in living to one’s relatives, particularly one’s beneficiaries. It addresses how the ethical will may become an addendum or codicil to one’s legal/financial will or be crafted as a separate document. The meaning of and reasons for ethical wills are highlighted as are its value to the progenitor and those who will be affected by the document. We consider how and when to broach this topic with clients, when one may be serving as a consultant, coach or therapist, as well as some of the reasons people who learn about the possibility of writing an ethical will may decide against it. When beneficiaries (and would-be beneficiaries) first learn the contents of a recently deceased person’s will when it is read at probate, surprise can lead to negative consequences such as turning them against one another. An ethical will can temper the surprise and remind the beneficiaries of the testator’s values, beliefs, and lessons. Five brief case vignettes, each based on the combining of several real life situations, are recounted. The concluding section summarizes the efficacy of promulgating (and even self-authoring), and discussing one’s ethical will with the intended beneficiaries as well as some of the reasons posited by those, including many estate attorneys, who are not in favor of such documents. Our clinical and consulting experiences with those who have drawn up ethical wills have been predominantly positive; perhaps this reflects the self-selective nature of those who choose to engage in this process. [ABSTRACT FROM PUBLISHER]

Clinical social workers' use of digital and other technology to provide distance counseling services is proliferating. Increasing numbers of contemporary practitioners are using video counseling, email chat, social networking websites, text messaging, smartphone apps, avatar-based websites, self-guided web-based interventions, and other technology to provide clinical services to clients, some of whom they may never meet in person. The advent of this technology has produced a wide range of ethical challenges related to social workers' application of traditional social work ethics concepts: client informed consent; client privacy and confidentiality; boundaries and dual relationships; conflicts of interest; practitioner competence; records and documentation; and collegial relationships. The principal purpose of this article is to identify pertinent ethical and ethically-related risk-management issues that clinical social workers need to consider if they contemplate using this technology to assist people in need. The author addresses compelling ethical issues concerning (1) social workers' use of digital technology to communicate with clients in relatively new ways, and (2) whether social workers' use of digital technology alters the fundamental nature of the therapeutic relationship and clinicians' ability to provide clients with a truly therapeutic environment. [ABSTRACT FROM AUTHOR]

The article focuses on the clinical and ethical problems that may arise when an interpreter is introduced into the psychodynamic psychotherapy patients in a resident-run clinic. Clinical cases in which interpreters are involved in a psychotherapeutic sessions include a patient diagnosed with adjustment disorder with anxiety and social anxiety disorder, a patient who experienced depression and anxiety, and a patient diagnosed with generalized anxiety disorder and panic disorder.

The article focuses on the clinical and ethical problems that may arise when an interpreter is introduced into the psychodynamic psychoterapy patients. These complications include a possible break of the psychotherapist-patient bonding, the dilution of the meaning of countertransference and transference, and the boundary crossings and enactments between the interpreter and patient. The difficulty by which professionalism could develop between an interpreter and patient is discussed.

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]

Hope has long been identified as an important therapeutic factor in counselling. Further, research evidence for the importance of hope to counselling practice and outcome is abundant. However, the field is only beginning to explicitly consider how hope can be effectively and intentionally practised. One of the most challenging dilemmas encountered by counsellors committed to working with this important therapeutic factor is that of so-called unrealistic hope. In this paper, we outline two real-life counselling vignettes illustrating unrealistic hope, and consider these scenarios alongside relevant scholarship and practice experience. Guiding principles and practices for conceptualising and working with unrealistic hope are offered as a means of beginning the conversation about this complex aspect of working with client hope. [ABSTRACT FROM AUTHOR]

Although the psychotherapist's personal psychotherapy has received considerable research attention in recent years, little systematic investigation of the ethical issues involved has been published. This article provides a rigorous interrogation of mandatory personal psychotherapy (MPP) as a training requirement for mental health professionals, a topic that remains ethically contentious. The article begins with a discussion of why MPP is an explicitly ethical issue, before debating the ethics of MPP under six questions, each worded to capture a salient ethical issue relevant to the appropriateness of making personal treatment a mandatory training requirement. Using principle, virtue, and care ethics perspectives, the arguments for and against MPP are critically investigated. The article concludes with an ethical position statement. [ABSTRACT FROM PUBLISHER]

A common rhetoric of the intellectuals of the State in Greece is that what impedes the economic 'development' of the country is the deficient and insufficiently developed selfhood of its people. Amidst the so called 'Greek crisis', namely the pressing and intensified demands on the part of the elites for the deepening of the neoliberalisation of the country and the imposition of an entrepreneurial ethic, the reconfiguration of the Greek psyche has become an imperative. Psychology and generic psychotherapy have shown a striking rapidness in tuning themselves to the spirit of the times echoing its underlying logic, and promoting social atomisation and social selection based on personal skills and capabilities. In the current article, I explore the discursive affinities between the entrepreneurial ethic and the spirit of psychotherapy within the context of the 'Greek crisis'. I develop my argument on the resonance of the two, along three, albeit intersecting and often overlapping, dominant social logics: the importance to develop one's creativity, the need to adapt and build one's personal defenses against the hostile outside and the understanding of the crisis as an opportunity for personal betterment, development and rediscovery of the meaning of life. It is my argument that more than ever in this country, generic psychotherapy is totally deprived of a language of its own and parrots unashamedly the language of entrepreneurial neoliberalism, showing both its theoretical and practical destitution, as well as its undisputable role as a State and corporate technology of control. [ABSTRACT FROM AUTHOR]

The article presents a report on a conference on moral and ethical aspects of psychiatry and psychotherapy, convened from July 24-25, 2013, in Frankfurt an der Oder, Germany. Topics of discussion included involuntary commitment and treatment, the work of Polish psychiatrist Antoni Kępiński, and the use of art in psychotherapy.

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]

The purpose of this phenomenological study was to examine how therapists use prayer in the therapeutic process. Researchers recruited via a maximum variation sampling method 17 diverse participants in terms of race and faith, including Muslim, Buddhist, Jewish, Catholic, Protestant, and Latter-Day Saints. Results revealed seven themes across faiths: (a) definition of prayer; (b) prayer as connection with God/transcendent and with client; (c) ethical boundaries; (d) use of prayer depends upon the context of therapeutic practice; (e) direct versus indirect prayer interventions; (f) prayer as use for self-of-therapist care; and (g) use of prayer changes as the therapist grows and develops over time. [ABSTRACT FROM PUBLISHER]

The purpose of the article is to present a literature review regarding mechanical restraint in psychiatry. The main area of analysis is directed at the untitethical relationship between "restraint" and "containment", in the light of legal, ethical, medical and psychodynamic factors, in specific the concept of "setting". The ensuing assumption is that "mechanical restraint" constitutes "breach" of "setting"; namely, it is considered to be "non-treatment", "malpractice" and "maltreatment". The concept of "restraint" is given an operational definition, in contrast with that of "containment", and is stated as the distancing of the therapeutists from the patient with consequential damage to the therapeutic relationship. An alternative to restraint can be found by training the group of therapeutists. [ABSTRACT FROM AUTHOR]

The ethical implications for psychological practice of genetic testing are largely unexplored. Predictive testing can have a significant impact on health and well-being, and increasing numbers of individuals with knowledge of their risk for various disorders are likely to present for psychotherapy. In addition, more people will struggle with the decision of whether to obtain information regarding their genetic material. Psychologists will need to have the appropriate knowledge and clinical skills to effectively counsel this population. This article highlights the relevant ethical issues surrounding psychological treatment of individuals pursuing or considering undergoing genetic testing. These issues are extended to psychologists working in research, education, and policy domains. Recommendations for graduate training programs to facilitate current and future practitioner competence are also discussed. [ABSTRACT FROM AUTHOR]

Treatment of sexual minority youth presents psychologists with a number of challenging ethical considerations. The APA Ethics Code is a valuable resource for addressing these issues, but psychologists require additional guidance in order to provide ethical treatment. This article provides relevant background, an overview of the ethical considerations of treating sexual minority youth, and recommendations to improve upon the current state of awareness and available resources. Psychologists must continually strive to improve our understanding of ethical decisions around treatment, training, and research that will serve to address this vulnerable population's unmet mental health needs. [ABSTRACT FROM AUTHOR]

The article discusses the protection of psychotherapy notes under the "Privacy Rule" of Health Insurance Portability and Accountability Act of 1996 (HIPAA) of the U.S. Department of Health and Human Services (HHS). It presents three ethical principles for treating patients including psychotherapist-patient confidentiality, ethical record keeping, and ethical goal of sharing information. It reflects that changes should be made to the "Privacy Rule" to enhance protection of psychotherapy notes.