Philosophy says that life must be understood backwards. But . . . it must be lived forward. . , , It is more and more evident that life can never be really understood in Time. It was a pleasure to read Jason Thompson’s serious and thought-provoking piece, and I am grateful to the editors for giving me a chance to comment. The idea that the self is revealed in narrative is a popular one among different schools of psychotherapy, both in (...) terms of technique and theory; and my response addresses both these issues in turn. As a clinician, I have always liked people’s stories. As a junior psychiatrist, I used to love the moment when I first met someone and could say to them, ‘You were born; and then what .. (shrink)

According to insight-oriented psychotherapies, the change clients undergo during therapy results from insights gained into the “true” nature of the self, which entail greater self-knowledge and self-understanding. In this paper, I question such claims through a critical examination of the epistemological and metaphysical values underlying such forms of therapy. I claim that such psychotherapeutic practices are engaged in a process that subtly “absorbs” clients into the therapist’s philosophical framework which is characterized by a certain problematic conception of subjectivity, knowledge, and (...) reality. Through mechanisms which are intrinsic to the therapeutic encounter, such as suggestion and power, such therapies construct and reconfigure clients along the lines of socially accepted norms and values. Consequently, insight-oriented psychotherapy results in a deceptive form of social control. (shrink)

Basics of awareness : knowing yourself -- Basics of awareness : privilege and social responsibility -- The process of acculturation : developing your professional ethical identity -- The ethical culture of psychotherapy -- "I can't believe it's not therapy" : boundaries of the psychotherapy relationship -- Confidentiality : a critical element of trust in the relationship -- Informed consent : the three-legged stool -- Making the most of supervision -- Ending psychotherapy : the good, the bad, and the ethical -- (...) Putting it all together : toward ethical excellence. (shrink)

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from a cost (...) and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard. For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research. (shrink)

Using a couple of Paul Watzlawick's clinical cases as a starting point, the author shows how prescriptive behavioral strategies do not produce predictable effects: the theory of (nonlinear) complex systems prevents us from establishing a precise connection between a so-called psychotherapeutic act and what we consider therapeutic effects. It is precisely the consideration of the "Lorenz attractors" that thus brings us to reconsider the long psychoanalytic work as the condition for a general structural change of subjectivity: the result of this (...) work is a change of the neurotic "strange attractor.". (shrink)

Recent research supports the hypothesis that more active engagement of the patient in occurring illnesses improves quality of life and probably even life expectancy.In this study experience and theoretical knowledge from psychotherapy is transplanted to clinical practice in order to improve the physician''s engagement in the patient-disease relationship. By defining severe and long-term illnesses as a psychotrauma, the transfer of the psychotherapeutical model leads to the creation of a new triangular relationship: patient-illness-doctor. Practical examples are used as illustrations for the (...) conceptual differences between psychotherapy and clinical medicine. Options for dialogue show the difference between adaptation (learning to live with) and adjustment (active coping strategies and controlling). The hypothesis is that a better dialogue will reduce illness-related stress, giving the patient better and more effective access to personal psychic and physical support systems. (shrink)

In the process of individual psychotherapy, the client and the therapist work together towards clarifying the client's problems, unlocking vicious circles, opening new perspectives and creating a new narrative congruent with the client's experiencing. The real and undeniable situation in individual psychotherapy across different therapeutic systems is that therapists enter the therapeutic encounter equipped with their own vision of humanity and their own particular theory and methods of psychotherapy. Through the differences in power between therapists and clients and the powerful (...) role of language, clients in their dependent position are apt to assimilate the percepts and the ideas of their therapists. Consequently therapists tend to exert a dominant and influential force in their client's lives. This raises a main ethical concern: to what extent do therapists from different therapeutic systems really help clients to recover their freedom to live their lives congruent to their own authentic perceptions and experiences? (shrink)

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. (shrink)

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. (shrink)

Standards and Ethics for Counselling in Action is the highly acclaimed guide to the major responsibilities which trainees and counselors in practice must be aware of before working with clients. Author Tim Bond outlines the values and ethical principles inherent in counselling and points out that the counselor is at the center of a series of responsibilities: to the client, to him/herself as a counselor and to the wider community. Now fully revised and updated, the second edition examines issues fundamental (...) to the process of counselling. A wide range of ethical problems is discussed and advice is given for resolving these dilemmas. Topics covered include: confidentiality, legal aspects of counselling, working with suicidal clients, false or recovered memory, record keeping, and the importance of adequate supervision. Full of practical information and guidance, the second edition of Standards and Ethics for Counselling in Action will be essential reading and a continuing source of reference for all those involved in counselling training and practice. (shrink)

In this article, I discuss two principles that can be viewed as universally applicable in psychotherapy and counseling: respect for clients' welfare and respect for their self-determination. Consideration of the practical application of these principles leads to the formulation of a set of guidelines to aid therapists and counselors in making choices about instrumental and end goals. These guidelines are intended to be applicable regardless of the particular personal and cultural values of the therapist and client.

This article defines the nature of paternalistic interventions in psychotherapy and discusses reasons why the client's right to consent to treatment is important. We describe a reasoning process developed by Culver and Gert (1982) that can be used to determine when paternalistic actions are and are not ethically justifiable in mental health practice. We demonstrate how this procedure may be applied to psychotherapy by using a number of case illustrations.

We are very grateful to both Matthew Ratcliffe and Thomas Szasz for taking the time to read and respond to our paper. Ratcliffe is broadly sympathetic to our efforts and provides a very convincing argument against mind–body dualisms by drawing on work from the phenomenological tradition. His comments extend rather than challenge our central thesis. Szasz, however, is dismissive of our position. As a result, most of our response is directed to his commentary. Ratcliffe uses the work of van der (...) Berg to make the case that any easy distinction between bodily and mental illness or suffering is false to our lived reality as human beings. Of course, in the day-to- day world of contemporary medical practice .. (shrink)

This book is aimed primarily at the practitioners of morals such as psychiatrists,lawyers and policy-makers. My professional background is clinical psychiatry It is divided into three parts. The first of these provides an overview of moral theory, morality in non-human species and recent developments in neuroscience that are of relevance to moral and legal responsibility. In the second part I offer a new paradigm of free action based on the overlaps between free will, moral value and art. In the overlap (...) between free will and moral value we find moral responsibility and moral autonomy. Free will and art share characteristics of originality, spontaneity and creativity. Art and moral value are related by way of the moral content of art and the formal similarities of moral and aesthetic judgments. In the overlap between art, free will and moral value we find religious belief, the creation of moral value and the creation of moral identity. In the third part, I discuss the application of these ideas to common clinical conditions such as eating disorders, addictions, personality disorders, post-traumatic stress disorder and the dissociative disorders. Wherever possible, I illustrate the points that are made with real-life clinical examples. I finish by considering how ideas of free will and responsibility are relevant to psychotherapy. (shrink)

I have practiced psychotherapy, family therapy, and hypnotherapy for over 25 years without a single board complaint or lawsuit by a client. For over 3 years, however, a group of proponents of the false memory syndrome (FMS) hypothesis, including members, officials, and supporters of the False Memory Syndrome Foundation, Inc., have waged a multimodal campaign of harassment and defamation directed against me, my clinical clients, my staff, my family, and others connected to me. I have neither treated these harassers or (...) their families nor had any professional or personal dealings with any of them; I am not related in any way to the disclosures of memories of sexual abuse in these families. Nonetheless, this group disrupts my professional and personal life and threatens to drive me out of business. In this article, I describe practicing psychotherapy under a state of siege and place the campaign against me in the context of a much broader effort in the FMS movement to denigrate, defame, and harass clinicians, lecturers, writers, and researchers identified with the abuse and trauma treatment communities. (shrink)

The major argument of this article is that failing to measure what is taking place in treatment and control conditions can lead to scientifically invalid conclusions. It is argued that researchers are ethically responsible for being aware that variables related to the therapist, client, and the therapeutic relationship (as well as their interaction) might play a confounding role when treatment and control conditions are compared. As a consequence, they should either measure these variables or be tentative in their interpretation of (...) their findings. (shrink)

Two inimical interpretations of psychotherapy look to many of the same features of empirical research. One camp infers that placebo effects are impossible in principle in psychotherapy; the other camp infers from the same research that psychotherapy is essentially placebo. I examine the crucial discussions and conclude that these opposing evaluations ensue because each group presumes a different baseline from which the significance of the research is gauged. I show how different baselines set different standards of significance and invite different (...) comparisons between therapeutic and non-therapeutic practices. Attention to this point about the baseline of significance puts the placebo debate in sharper relief and frames more clearly the merits and demerits of each position. It also leads to the conclusion that neither group really lays hold of in-principle claims, since both interpretations rest on context-dependent features of the empirical situation. Along the way, I discuss salient features of outcomes research, meta-analysis, and the role of symbols in therapeutic transactions. I close with some remarks that link the proliferation of therapies with cultural splintering generally and suggest how this might bear on the placebo issue. (shrink)

John Greenwood (this issue) claims that neglect of an important methodological distinction has contributed directly to the "epistemic impoverishment" of empirical studies of all forms of professional psychotherapy. I challenge this claim, as well as other important claims he makes about the efficacy of psychoanalysis and other forms of psychotherapy.

How good is psychotherapy as a tool of research into human nature? There is an orthodox defence of it as a research tool, which relies on showing that interpretations are true of the patient when they satisfy certain criteria. This defence is examined and rejected. The reply is considered that an interpretation which 'keeps things moving' is true, or an approximation to the truth. This reply is rejected by comparing and contrasting an interpretation in psychotherapy with one from brainwashing sessions. (...) Two suppositions about psychotherapy (which weaken its discovery powers) are deliberately adopted — the suppositions that the material produced is 'perspective' and 'method' dependent. An unorthodox defence of psychotherapy is then offered — by means of a watery sense of 'discover'. This enables us to outline a weak sense in which psychotherapy is a valid enterprise, but one which is still strong enough for research purposes. (shrink)

Understanding Experience: Psychotherapy and Postmodernism is a collection of innovative interdisciplinary essays that explore the way we experience and interact with each other and the world around us. The authors address the postmodern debate in psychotherapy and psychoanalysis through clinical and theoretical discussion and offer a view of the person that is unique and relevant today. The clinical work of Binswanger, Boss, Fromm, Fromm-Reichmann, Laing, and Lacan is considered alongside the theories of Buber, Heidegger, Husserl, Merleau-Ponty, Sartre and others. Combining (...) clinical data from psychotherapy and psychoanalysis with insights from European philosophy, this book seeks to fill a major gap in the debate over postmodernism and bridges the paradigmatic divide between the behavioural sciences and the human sciences. It will be of great interest to clinicians and students of psychotherapy and psychoanalysis who wish to come to terms with postmodernism, as well as those interested in theinteraction of psychoanalysis, philosophy and social theory. experience. (shrink)

Are dual relationships always detrimental? Speaking the Unspeakable provides an in-depth exploration of client-practitioner dual relationships, offering critical discussion and sustained narrative on thinking about and being in dual relationships. Lynne Gabriel draws on the experiences of both practitioners and clients to provide a clear summary of the complex and multidimensional nature of dual relationships. The beneficial as well as detrimental potential of such relationships is discussed and illustrated with personal accounts. Subjects covered include: · Roles and boundaries in dual (...) and multiple role relationships · Client experiences and perceptions of being in dual and multiple role relationships · Developing a relational ethic for complex relationships This book offers an insightful and challenging portrayal of dual relationships that will be welcomed by therapists, trainers, trainees and supervisors. (shrink)

The status quo: dogmatism, the biopsychosocial model, and alternatives -- What there is: of mind and brain -- How we know: understanding the mind -- What is scientific method? -- Reading Karl Jaspers's General Psychopathology -- What is scientific method in psychiatry? -- Darwin's dangerous method: the essentialist fallacy -- What we value: the ethics of psychiatry -- Desire and self: Hellenistic and Islamic approaches -- On the nature of mental illness: disease or myth? -- Order out of chaos: from (...) insanity to DSM-III to a pluralistic nosology -- A theory of DSM-IV: ideal types -- Dimensions versus categories -- The perils of belief: psychosis -- The slings and arrows of outrageous fortune: depression -- Life's rollercoaster: mania -- Being self-aware: insight -- Calvinism or hedonism? -- Truth and statistics: problems of empirical psychiatry -- A climate of opinion: what remains of psychoanalysis -- Being there: existential psychotherapy -- Beyond eclecticism: teaching psychotherapy in the twenty-first century -- Bridging the biology/psychology dichotomy: the hopes of integrationism -- Why it is hard to be pluralist. (shrink)

The Freud Wars offers a comprehensive introduction to the crucial question of the justification of psychoanalysis. Part I examines three powerful critiques of psychoanalysis in the context of a recent controversy about its nature and legitimacy: is it a bankrupt science, an innovative science, or not a science at all but a system of interpretation? The discussion makes sense of the entrenched disagreement about the validity of psychoanalysis, and demonstrates how the disagreement is rooted in the theoretical ambiguity of the (...) central concept of psychoanalysis, the unconscious. This ambiguity is then presented as the pathway to a new way of understanding psychoanalysis, based on a mode of thinking that precedes division into mental and physical. The reader is drawn into a lively and thought-provoking analysis of the central issues: · What would it mean for psychoanalysis to count as a science? · Is psychoanalysis a form of hermeneutics? · How can mental and physical explanations coincide? Part II contains the source material for Part I: the influential critiques of psychoanalysis by Adolf Grünbaum, Thomas Nagel and Jürgen Habermas. No specialised knowledge is assumed, and the book is clear and accessible while still conveying the complexity and richness of the subject. It provides a fascinating introduction to philosophical thinking on psychoanalysis for students and practitioners of psychoanalysis, psychotherapy and philosophy. (shrink)

In this paper, I respond to some criticisms of Greenwood (1996) advanced by Grunbaum (1996) and Erwin (1996). I argue that Grunbaum's problematic account of "placebo effects" and placebo control treatments does not really address, far less resolve, the problems with experimental evaluations of psychotherapy documented in my original paper.

We analyzed a sample of 356 forms containing information that Colorado law legally requires both licensed and unlicensed therapists to disclose to clients. The majority of forms contained the legally mandated information; fewer forms contained ethically desirable information. The average readability grade level was 15.74, corresponding to upper-level college, and 63.9% of the forms reached the highest (most difficult) readability grade of 17 +. Therapists are obeying the law, but do not appear to be taking advantage of the opportunity to (...) provide their clients useful information in an accessible way. (shrink)

I take the APA publication A Spiritual Strategy for Counseling and Psychotherapy (Richards and Bergin 2005), along with a devoted issue of Journal of Psychology and Theology (Nelson and Slife 2006), as a paradigmatic example of a trend. Other instances include the uncritical use of "Eastern" philosophy in Humanistic and Transpersonal Psychology, almost normative appeal to the "Sacred" within the psychology of spirituality, talk of "God in the brain" within neurological research, the neologism entheogen referring to psychedelic drugs, and calls (...) for new specializations such as neurotheology and theobiology. In response to the legitimate ethical requirements of respect and openness regarding clients' religious worldviews, the trend is to make God an essential component in psychological theory. The argument is that God is active in the universe and especially in human affairs to such an extent that any accurate account of strictly psychological matters, not just a comprehensive, interdisciplinary purview that could include a distinct theological dimension, must include God as an explanatory factor. Less nuanced than standard theological thought about divine intervention—including a range of opinions from supernaturalism, to occasionalism, to providential and deistic naturalism—this trend would blur the epistemological differences between religion and science by appeal to claimed knowledge sources such as inspiration and revelation and thus undermine the achievements of evidence-based science and establish particularistic religious beliefs as standard explanatory accounts. The concern to include a spiritual, in contrast to a religious or theist, dimension in psychological theory is welcome; but elaborated approaches, such as my own and those of Roberto Assagioli, Viktor Frankl, and Ken Wilber, open to varied theological applications, already exist. (shrink)

Most books about ethics focus either on the origins of ethics, or on the application of ethical thinking to a single form of therapy. This book sets out to span a range of very different forms of therapy and explores the similarities and the differences between the ethical thinking of the practitioners concerned. By looking at ethical issues in different therapeutic settings the reader is challenged to reconsider the working assumptions which underpin familiar therapeutic practice. Readers of Forms of Ethical (...) Thinking in Therapeutic Practice are offered the unique opportunity to gain insights into the ethical thinking of experienced practitioners offering strikingly different services to their clients and working in contrasting contexts. Essential reading for all practitioners in counselling and the therapies, students, trainers, supervisors and providers of therapeutic services. (shrink)

In the first collection of his essays to be published, Jeremy Holmes discusses the wider application of psychotherapy within psychiatry and suggests that psychoanalysis needs to escape from its esotericism by taking into account contemporary advances in cognitive science, family therapy and the realities of psychiatric work in a public health setting. Illustrating his arguments with literary as well as clinical examples, he emphasizes the importance of creativity in psychotherapy and the connections between the artistic and psychotherapeutic impulse.

This chapter introduces the central concerns of Humberto Maturana's theory of autopoiesis as they relate to the domain of psychotherapy. Several common terms which are redefined within his theory in an unusual manner are unpacked as to their idiosyncratic significance including the expressions, 'linguistic behaviour', 'languaging', 'structure determinism', 'organisation', 'structure' and others. The source material used for this exposition include not only the cited texts but also several workshops from which verbatim transcripts are often used in the form of brief (...) quotations. I have attempted to stay as close to the original material as possible in order to convey both the meaning and the texture of Maturana's work. This is not an easy theory to grasp ranging as it does across several specialist fields from the neurophysiology of perception through social communication to epistemology. Nor are the implicative transitions from a theory of biology to the praxis of psychotherapy without complexity and controversy. Nonetheless, Maturana offers a novel theory of conversations which could form the basis of a much needed new paradigm for personal change. (shrink)

As is widely known, the last 25 years have seen an acceleration in the development of theories of emotion. Perhaps less well-known is that the last three years have seen an extended defense of a predominant, though not universally accepted, framework for the understanding of emotion in philosophy and psychology. The central claim of this framework is that emotions are a form of evaluative response to their intentional objects, centrally involving cognition or something akin to cognition, in which the evaluation (...) of the object relates to the concerns, interests, or well-being of the subject. I aim to summarize and review the work of five authors on three of the central themes of this framework, and to note some implications for the understanding of emotion in different psychotherapeutic approaches. (shrink)

Mental health professionals face many complex questions in the course of their work with clients and patients. Among the most difficult are dilemmas that involve ethical issues. This book presents a forthright exploration of these dilemmas and the ethical considerations they raise. Drawing on extensive interviews, the author identifies common ethical problems that practitioners encounter. What happens, for example, when personal interests intrude into therapy? How can the therapist make an accurate assessment of his or her appropriateness as a care (...) provider for a particular patient? What about confidentiality? How are problematic financial arrangements best addressed? The author goes on to show how these dilemmas may be intensified by the unique assumptions of different therapeutic orientations--individual, group, family, marital, and organizational--and how professionals can learn from such experiences to better understand and apply their particular approach. This analysis--and the words of the therapists themselves--provide both a guide to practice and a unique store of experience for the growing number of researchers and students concerned with ethical problems in psychotherapy. (shrink)

This article explores the relations among and between intimacy, psychotherapeutic relationships and moral advice. The article concludes that a psychotherapeutic relationship is not usefully explained in terms of intimacy. Instead, a psychiatric relationship is a form of moral advice, and it is this dimension of a psychotherapeutic relationship as a form of moral advice that poses a natural limit to the confidentiality necessary for engaging in psychotherapy.

Heart and Soul is a collection of essays which examine those concepts and questions which are at the heart of both psychotherapy and philosophy. Topics discussed include the nature of the self, motivation and subjectivity, the limits of certainty and subjectivity in interpersonal situations, and the scope of narrative, dialogue and therapy itself. Looking at the work of key figures such as Wittgenstein, Socrates, Kierkegaard, Foucault, Lacan and Klein, contributors draw on a wide range of philosophical approaches and examine how (...) they can deepen our understanding of the processes involved in different types of psychotherapy in a wide range of clinical settings. Each chapter includes a summary of the implications to clinical practice of the ideas discussed. Contributors: Joady Brennan, John M. Heaton, Jeremy Holmes, Joan Hurd, Paul Sepping, Geraldine Shipton, Paul Sturdee, Digby Tantam, Myra Thomas, Emmy van Deurzen, Werdie van Staaden, John Wheway, and Catherine Wieder. (shrink)

Psychotherapy and counselling services are now available on-line, and expanding rapidly. Yet there appears almost no ethical analysis of this on-line mode of delivery of such professional services. In this paper I present such an analysis by considering the limitations on-line contact imposes on the nature of the professional–client relationship. The analysis proceeds via the contrast between the face-to-face case and the on-line case. At the core of the problem must be the recognition that on-line interaction imposes a physical barrier (...) largely permitting only those disclosures of self we choose to make available, and greatly restricting the range of involuntary features and behaviours. I show why this is problematic, first, for the development of a close professional–client relationship, with particular emphasis on such failures as diagnosis and monitoring of the patient. Second I describe the importance of the development of professional character, and of how the on-line environment fails to provide a context for such character traits to emerge and develop. (shrink)

Although touch frequently occurs in psychotherapy with children, there is little written on the ethical considerations of therapeutic touch. Because physical contact does occur, therapists must consider if, how, and when it is used, for both their clients' safety and their own. In this review, I further develop the issues suggested by Aquino and Lee (2000) in the use of nurturing touch in therapy by considering many types of touch that occur in psychotherapy with children; the possible positive role of (...) touch; clients' perception of touch in therapy; considerations related to the therapist, the child's safety, and any history of abuse in the child's and family's background; and other practical considerations. I list guidelines. (shrink)

Intimacy and Alienation puts forward the author's unique paradigm for psychotherapy and counselling based on the assumption that each patient has suffered a disruption of the `self', and that the goal of the therapist is to identify and work with that disruption. Using many clinical illustrations, and drawing on self psychology, attachment therapy and theories of trauma, Russell Meares looks at the nature of self and how it develops, before going on to explore the form and feeling of experience when (...) self is disrupted in a traumatic way, and focusing on ways towards the restoration of the self. Written in an accessible style from the author's singular perspective, Intimacy and Alienation will appeal to professionals in the fields of psychotherapy, counseling, social work and psychiatry, as well as to students and the lay reader. (shrink)

This book is a scholarly mongraph on Sigmund Freud's understanding of the basics of psychotherapy theory and practice from the perspective of phenomenology.

Traditionally, there have been few legal actions brought against psychotherapists that allege negligent psychotherapy and negligent treatment of psychiatric disorders. However, in the case of Osheroff v. Chestnut Lodge, a patient-physician (Dr. OsheroE) sued Chestnut Lodge, a private psychiatric facility, for negligence based on the staff's decision to apply a psychodynamic model of treatment (through psychotherapy) and not a biological model. The case sparked a heated debate between adherents of the psychodynamic model and those of the biological model. This article (...) explores the implications of the Osheroff litigation for mental health professionals. It is proposed that an interactive informed consent process be used to protect psychotherapists against Osheroff-type litigation. (shrink)

I shall begin with the "anti-psychiatry" view that the lack of a physical basis excludes many familiar mental disorders from the category of "illness". My response to this argument will be that anti-psychiatrists are probably right to hold that most mental disorders do not involve any physical disorder, but that they are wrong to conclude from this that these mental disorders are not illnesses.

Neuroscience and psychiatry -- Psychotherapy and psychiatry -- Diagnosis in psychiatry -- The boundaries of mental disorders -- Mood and mental illness -- Psychiatry's problem children -- Evidence-based psychiatry -- Psychiatric drugs: miracles and limitations -- Talk therapies: the need for a unified method -- Psychiatry in practice -- Training psychiatrists -- Psychiatry and society -- The future of psychiatry.

This book takes the discursive and postmodern turn in psychotherapy a significant step forward and will be of interest to all those working in mental health who want to work wiht clients in ways that will facilitate challenges to oppression and processes of emancipation. It achieves this by: · reflecting on the role of psychotherapy in contemporary culture · developing critiques of language in psychotherapy that unravel its claims to personal truth · the reworking of a place in the transforative (...) therapeutic practice Deconstruction is brought to bear on the key conceptual and pragmatic issues that therapists and clinical psychologists face, and the project of therapy is opened up to critical attention and reconstruction. The book provides clear reviews of different viewpoints and will help readers to orient themselves on the complex terrain of debates. (shrink)

This book tracks a particular understanding of self, philosophically, from research evidence and its implications for psychotherapy.

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

Praise for Ethics in Psychotherapy and Counseling, Third Edition "This is absolutely the best text on professional ethics around. . . . This is a refreshingly open and inviting text that has become a classic in the field." —Derald Wing Sue, professor of psychology, Teachers College, Columbia University "I love this book! And so will therapists, supervisors, and trainees. In fact, it really should be required reading for every mental health professional and aspiring professional. . . . And it is (...) a fun read to boot!" —Stephen J. Ceci, H. L. Carr Professor of Psychology, Cornell University "Pope and Vasquez have done it again. . . . an indispensable resource for seasoned professionals and students alike." —Beverly Greene, professor of psychology, St. John's University "[The third edition] focuses on how to think about ethical dilemmas . . . with empathy for the decision-maker whose best option may have to be a compromise between different values. If there is only room on the shelf for one book in the genre, this is it." —Patrick O'Neill, former president, Canadian Psychological Association "This third edition of the classic ethics text provides invaluable resources and enables readers to engage in critical thinking in order to make their own decisions.?This superb reference belongs in every psychology training program's curriculum and on every psychologist's?bookshelf." —Lillian Comas-Diaz, 2006 president, APA Division of Psychologists in Independent Practice "Ken Pope and Melba Vasquez are right on target once again in the third edition, a book that every practicing mental health professional should read and have in their reference library." —Jeffrey N. Younggren, risk management consultant, American Psychological Association Insurance Trust "Without a doubt, this is the definitive book on ethics within psychology that can inform students, educators, clinical researchers, and practitioners." —Nadine J. Kaslow, professor, Department of Psychiatry and Behavioral Science, Emory University School of Medicine "This stunningly good book . . . should be on every therapist's desk for quick reference." —David Barlow, professor of psychology and psychiatry, Boston University. (shrink)

A dual relationship in psychotherapy occurs when the therapist engages in another, significantly different relationship with the patient. The two relationships may be concurrent or sequential. For both sexual and nonsexual dual relationships, men are typically the perpetrators and women are typically the victims. This article presents examples of dual relationships, notes the attention that licensing boards and other agencies devote to this topic, reviews the meager research concerning nonsexual dual relationships, and discusses common strategies that promote both sexual and (...) nonsexual dual relationships. (shrink)

This article aims to summarize the current ethical issues in the field of clinical and counseling psychology and the process of developing professional ethical standards in China. First, through a review of the history of counseling and psychotherapy in China, general background information is provided. Important ethical issues are then discussed based on the results from several empirical studies. Finally, the process of developing the new edition of the Chinese Psychological Society Code of Ethics for Clinical and Counseling Psychology, the (...) main contents as well as the considerations taken into account in the development of this code are presented. (shrink)

This book explores the literature on spirituality as an important dimension of psychology, and explains the relationship between psychological treatment and ...

This volume describes the main theoretical aspects of this practice based on an open-ended dialogue between a philosophical practitioner and a client or a group ...

This book aims to present the control-mastery theory in a more accessible format, and introduce it to a wider audience, expanding the scope of the theory beyond ...

The text is extensively referenced, but practical in its approach, giving real life examples and cases based on therapeutic practice.

This work, which questions the medical model of psychiatry as the basis of psychotherapy, seeks to help professionals return their field to an activity that is ...

In this paper, I have examined in some detail a number of examples of actual and potential consensus between Jewish ethics and the practice of modern psychotherapy, psychology, and psychiatry. Moreover, I have posited cpecific halakhic models which represent analogies to modern psychotherapeutic principles and practices, which through analogy lend specific halakhic guidelines to modern practice. The unitary halakhic approach presented here is thus both heuristic – in that it seeks to demonstrate the ways in which psychotherapeutic processes are essentially (...) halakhic ones – as well as practical. Through this approach, psychological theory and practice have been brought into intimate contact with the ethical requirements of the halakhically committed mental health practitioner and his or her patient, filling an inexcusable void in halakhic application to modern technology, and setting a direction for future work in this area. CiteULike Connotea Del.icio.us What's this? (shrink)

Reviews the contribution of neural network models in psychiatry and psychopathology, including diagnosis, pharmacotherapy and psychotherapy.

Psychotherapy clients read two consumer-oriented brochures: a general brochure on psychology and a brochure on the topic of client-therapist intimacy. Half of the participants read the general brochure first and the brochure on client-therapist intimacy second, and half the participants did the reverse. Participants reported favorable reactions to the brochures, indicating they thought both should be made available to psychotherapy clients; that neither were too long, too sensitive, or too difficult to read; and that the brochures should be made available (...) early during the therapeutic process. After reading the client-therapist intimacy brochure, participants also showed some changes in Likert-type scores measuring attitudes regarding intimate contact between clients and therapists. Although participants were more negative about issues of sexual misconduct after reading the client-therapist intimacy brochure, they did not indicate a decrease in trust of therapists, nor did they indicate a greater likelihood of filing a false complaint. We concluded that therapists' reservations about presenting clients with factual information regarding therapist sexual exploitation of clients are not empirically founded. (shrink)

Ethics and Values in Psychotherapy examines the ways in which the ethical convictions of both therapist and client contribute to the practical process of psychotherapy. Practitioners are increasingly focusing on the issue of their extensive--and often problematic--ethical influence on clients as they attempt to agree on guidelines and standards for professional practice. Alan C. Tjeltveit argues that any discussion of ethical practice in psychotherapy must be carried out in connection with traditional ethical theories. The author draws on scientific, clinical, and (...) philosophical approaches to address issues such as: the role of therapy in society; the goals and outcomes of psychotherapy; techniques and practices; the existence and operation of values; and the intellectual and social context in which therapy takes place. This comprehensive study is a significant contribution to the debate on the ethical character of psychotherapy. (shrink)

In this book, Emmy van Deurzen addresses the taboo subject of the moral role of psychotherapists and counselors.

The Great Psychotherapy Debate: Models, Methods, and Findings comprehensively reviews the research on psychotherapy to dispute the commonly held view that the benefits of psychotherapy are derived from the specific ingredients contained in a given treatment (medical model). The author reviews the literature related to the absolute efficacy of psychotherapy, the relative efficacy of various treatments, the specificity of ingredients contained in established therapies, effects due to common factors, such as the working alliance, adherence and allegiance to the therapeutic protocol, (...) and effects that are produced by different therapists. In each case, the evidence convincingly corroborates the contextual model and disconfirms the prevailing medical model. (shrink)

In this paper it is argued that the general problem of indication, increasingly discussed in the field of psychotherapy in recent years, actually is a pseudoproblem with no solution to be expected. In its objectives and premises it is trongly suggestive of conceptions and ideas of early logical empiricism, to be considered as out-of-date today. The concept of indication is identified as ambiguous, and preliminary remarks aiming at an explication of the concept are made. Finally, the consequences of our arguments (...) for the immediate problem of integration of the different therapeutic approaches are pointed out. (shrink)

Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

I want to begin by saying that the terms of reference of this series of lectures grated on me, in particular, the word ‘power’. One thing it conjured up was the criticism made by people who say we use our power over our patients to brainwash them, that the psychotherapeutic relationship is inescapably authoritarian, domineering, coercive. This was widely said in the sixties by leftist and feminists and others who sought a therapeutic relationship that was more equal, co-counselling, for example, (...) where the client and the therapist took turns exposing their problems. In my experience, most people who took up that position eventually saw the merits of relatively orthodox psychotherapy, and many have trained in conventional psychodynamic psychotherapy. I asked my partner, who is also a psychoanalytic psychotherapist, what the term power conjured up for her and got an uncharacteristically sharp response. She said, ‘I hate that word. It’s used by humanistic therapists who are afraid of authority, difference and knowledge and want us all to be the same. It’s like saying colour doesn’t matter. They confuse the abuse of power with the use of power. They assume that all exercise of power is abusive.’. (shrink)