Cultural Sensitivity: A Critical Examination

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility.

An Ethic of Possibility: Relationship, Risk, and Presence

In the course of psychotherapy, psychologists need to make important clinical decisions regarding treatment goal selection, measurement procedures, and treatment methods. These decisions can be made without regard to the epistemic and ethical responsibilities that accompany professional status. Epistemic duties are obligations to obtain and have knowledge, while ethical duties are obligations to apply this knowledge accurately. We argue that these epistemic and ethical responsibilities are invoked and can be adequately addressed in the informed consent process. When the informed consent process is violated or done poorly, our epistemic and ethical responsibilities are not met and the client may be harmed. We argue that what the public assumes it is buying from us (and what we purport to sell) are specialised knowledge and skills; when psychologists are not meeting their epistemic duties, what our clients are receiving instead is intuition and performance art. We discuss errors that occur in the course of psychotherapy, as well as how we as professionals must seek to reduce or eliminate them.

Epistemic and Ethical Duties in Clinical Decision-making

This thesis is presented in four parts: an introduction, a critical literature review, an empirical research study, and a case study. The first part introduces the thesis and highlights the linking theme of ethical practice. It also clarifies the provenance of the research study, introduces the researcher, and comments on the writing style of the thesis. The critical literature review examines the ways in which ethics have been applied to counselling psychology. Firstly, the literature asserting the value-laden nature of therapeutic practice is explored. This is followed by a consideration of principle ethics, the frameworks through which principles have been applied to practice, the advantages of virtue ethics, cultural ethics, and finally the increasing focus on social ethics. The review concludes that a closer engagement with moral philosophy would be beneficial for counselling psychology. The empirical research study explores counselling psychologists' perspectives on professionalism. Following a pilot study involving two participants, fourteen counselling psychologists were interviewed by means of semi-structured interviews. The interviews were transcribed and analysed using social constructionist grounded theory methodology. An overall theme of ethical practice in its widest sense emerged from the data. The main findings were an "arc" of professional identity that emerged from participants' histories of work in social contexts and positions of dissent; a pattern of professional identity involving a stable central core of ethical practice and a penumbra of professional legitimacy; and the identification of tensions between the perspectives of the participants and traditional forms of professionalism. The research concludes that ethical practice is the defining factor of participants' professionalism. Habermas's theory of communicative rationality is suggested as ,a philosophical basis for ethical practice and as an appropriates substitute for the scientist-practitioner model. I The case study explores therapeutic work with a student who had been refused refugee status. It considers the development of a therapeutic relationship in a context of fear and powerlessness. It also reviews the ethical obligations of being a witness in therapeutic and judicial processes.

Richard Mangold

Papers

A critical examination of the ethical principles of psychologists and code of conduct