Ethical Dilemmas in Psychotherapy: Positive Approaches to Decision Making

In practice, ethical dilemmas are rarely solved by following simple formulas. The quandaries presented by real-life circumstances when ethical standards clash or fail to fully apply can require thoughtful analysis to resolve. This book presents positive ethics as a means to overcome such ethical challenges. The positive approach focuses not only on avoiding negative consequences but also on reaching the best possible outcomes for both the psychotherapist and the client. The authors outline a clear decision-making process that is based on three practical strategies: (a) the ethics acculturation model to help therapists incorporate personal ethics into their professional roles, (b) the quality enhancement model for dealing with high-risk patients who are potentially harmful, and (c) ethical choice-making strategies to make the most the best ethical decision when two ethical principles conflict. Throughout the decision-making process, psychotherapists are encouraged to follow four basic guidelines: (a) focus on overarching ethical principles; (b) consider intuitive, emotional, and other nonrational factors; (c) accept that some problems have elusive solutions; and (d) solicit input from colleagues and consultation groups. Numerous vignettes are provided to illustrate the many ethical challenges that psychotherapists may encounter-and resolve-using positive ethics.