email page print pageAll Topic Reviews
Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow Clients Make Therapy WorkHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex TherapyPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy and ConfidentialityPsychotherapy As PraxisPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersPsychotherapy Is Worth ItPsychotherapy Isn't What You ThinkPsychotherapy with Adolescent Girls and Young WomenPsychotherapy with Children and AdolescentsPsychotherapy without the SelfPsychotherapy, American Culture, and Social PolicyRapid Cognitive TherapyRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRebuilding Shattered LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
I can understand why the first edition
(1998) of this book received the many accolades it did. As the books sub title indicates, this is
indeed a practical guide to ethical behavior for therapists and
counselors. This means its primarily a
How to book, rather than a Why book.
Theres little discussion of meta-ethical themes such as how ethical
principles are arrived at, which ethical theory works best in what situation,
or why one should bother to be ethical.
The first six chapters offer basic information on how to develop ethical
awareness, the relationship between the law and ethics, and the relationship
between the personality of the mental health care provider and ethical
principles of behavior. Included in the
first chapter is a fascinating list of arguments that have been used to justify
unethical conduct such as, Its not unethical as long as no one can prove you
did it, Its not unethical as long as your client wanted you to do it, and Its
not unethical as long as you dont know a law, ethical principle, or
professional standard that prohibits it.
Chapter six deals with a central issue in all of therapy and
counseling: the problem of how to ask
questions that dont unintentionally manipulate the patient or client into
giving the kind of answers the questioner wants to hear. There is a commendable critical discussion
of the issue of false memory syndrome as a case in point, both from the
perspective of how and why therapists were able to lead patients into
developing memories of events which never happened, and from the ironic
perspective of therapists who are now treating the so-called syndrome that
their profession itself created, then diagnosed and labeled, and now claims to
be able to treat.
From chapter seven onwards topics include how to
begin and end a therapeutic relationship, the meaning and importance of
informed consent, the pitfalls inherent in testing and diagnosing, the problem
of sexual relations with clients, the question of the appropriateness of
non-sexual social relationships with clients, the effects of cultural
differences on the therapeutic relationship, the limits of confidentiality, the
therapists responsibilities when it comes to a suicidal patient, and the
supervisory relationship between instructor and student therapist. Each of these chapters ends with a section
titled Scenarios for Discussion in
which several fictitious problems and brief case studies are presented,
followed by a number of pointed questions to be considered by the individual
reader or discussed by the class of students.
At the end of the book are four
appendices with useful information and a detailed example of a code of ethics
for psychologists, a statement of patients mental health rights, ethical
guidelines for professional care in a managed care environment, and a sample
informed consent form.
I found one area of discussion
especially interesting in light of the fears about litigation Ive heard
expressed by counselors on many occasions.
The authors point out that, contrary to popular belief, therapists and
counselors are not sued primarily by hostile clients out for irrational
revenge. By far the overwhelming reason
theyre dragged into court (20% of total claims) is because of sexual
impropriety or improper personal relationships with their clients/patients. At the same time 35 per cent of disciplinary
actions taken against practitioners by licensing boards were also due to sexual
misconduct. Civil suits against a
therapist/counselors for incompetence account for only 14 percent of all
claims. Claims of incompetence include
inadequately trained therapists/counselors working with specific populations
such as rape victims or incest perpetrators, and attempting to use specific
techniques such as hypnotism.
Practitioners who believed that so-called malpractice suits are always
perpetrated against innocent therapists by malicious clients just wanting to
make a quick buck will be relieved to know that litigation is in fact most
often precipitated by therapists unprofessional conduct.
I must admit that I found it
disturbing to note how often the issue of sexual misconduct comes up in this
book. There are two whole chapters (and a sizable list of index entries) that
deal specifically with sexual misconduct and unprofessional relationships with
clients/patients. Also appearing in a
number of assessment questionnaires in various other locations in the book are
questions dealing with issues such as the therapist/counselor having sexual
feelings for the client/patient, the therapist having sexual dreams about the
patient, improper sexual holding and touching between therapist and patient,
and so on. Perhaps Im naïve, but I had
no idea, prior to reading this book, that sexual misconduct is such pervasive
ethical issue in the fields of therapy and counseling.
While I suggest that this book be
on every therapists shelf, I have to admit I found myself becoming
uncomfortable with the dates on some of the data to which the authors have
referred. For example they write, . . . married teenagers show an extremely
high suicide rate and cite a source
dated 1975 (p. 247). In the next sentence they admit that data is
generally not static and that new research
is refining our understanding as well as reflecting apparent
changes. But their attention then
turns to the comparison of suicide rates for women and men. This means that the comment made about the
1975 statistics on married teenager suicides stays in the readers mind as
relevant and current. But surely there
is more up to date data available on suicides among married teens than this!
Again, this book lives up to its
subtitle: A Practical Guide. In my opinion this is the sort of
information that ought to be carefully studied by every practitioner and student
of therapy or counseling. But its also
an easy to read resource for mental health services consumers. Students and practitioners will gain a very
thorough understanding from it of how to behave in a professional manner, while
mental health services consumers will learn what they may legitimately expect
and demand from their therapists and counselors.
© 2002 Peter B. Raabe
Peter B. Raabe
teaches philosophy and has a private practice in philosophical counseling in
North Vancouver, Canada. He is the author of the books Philosophical
Counseling: Theory and Practice (Praeger, 2001) and Issues
in Philosophical Counseling (Praeger, 2002).