Ethics and Values in Psychotherapy

Book Cover......Page 1
Half-Title......Page 2
Title......Page 3
Copyright......Page 4
Dedication......Page 5
Contents......Page 6
Preface......Page 8
Part I Developing a better understanding of the ethical character of psychotherapy......Page 10
Psychotherapy is inconsequentially value-laden......Page 11
Psychotherapy involves only mental health values......Page 12
Clients alone should choose therapy values......Page 15
Psychotherapy ought to be based on science, not values......Page 17
It is meaningless to claim that values or ethical assertions in psychotherapy can be true or correct......Page 18
Psychotherapy is not value-free. So what?......Page 19
Ethics, “values,” and psychotherapy intertwined: an overview......Page 21
Dimensions of ethics......Page 25
Professional ethics......Page 26
Theoretical ethics......Page 29
Clinical ethics......Page 31
Virtue ethics......Page 33
Social ethics......Page 34
Cultural ethics......Page 36
The science-ethics relationship......Page 37
“Ethics” and related terms......Page 38
Definition......Page 42
Can ethicists possess ethical expertise?......Page 43
Which persons warrant the honorific title “ethicist”?......Page 44
Professional ethics and limits on the nature of therapeutic interactions......Page 47
Reflecting about ethical issues......Page 48
Influencing others......Page 49
Individual differences......Page 52
Part II Intellectual tools for examining values and ethical theory in therapy......Page 55
4 The spectrum of ethical theories in psychotherapy......Page 56
Is it meaningful to talk about goodness, virtue, and moral obligation?......Page 62
The basis of goodness and moral obligation......Page 66
Social contract......Page 69
Tradition......Page 70
Definism......Page 71
Virtues......Page 74
Teleological or consequentialist theories......Page 75
Deontological theories......Page 77
Knowledge through tradition......Page 79
Knowledge through the scientific method......Page 80
Knowledge through an explicit combination of reason and nature......Page 81
Knowledge through divine revelation......Page 82
Knowledge through hermeneutics......Page 83
Ethical theory in relationship to religion......Page 84
Conclusion......Page 86
5 Unpacking diverse understandings of “values”......Page 87
A taxonomy of definitions of “values”......Page 88
The origins of diversity: a brief history of the manifold meanings of “values”......Page 93
Values in context......Page 101
The problem of multiple definitions of values: a proposed working solution......Page 103
The ethical relevance of psychological research on values in psychotherapy......Page 106
Conclusion......Page 108
Part III Ethical dimensions of the contexts of psychotherapy......Page 109
6 The intellectual contexts of psychotherapy......Page 110
The ethical critique of ethics......Page 111
The scientific context......Page 115
Science’s contribution to the ethical dimensions of psychotherapy......Page 116
Understanding psychotherapy’s ethical dimensions: “science alone” or “science and ethics”......Page 120
Science alone......Page 121
Values intrinsic to science......Page 123
Extra-scientific values......Page 126
Science and ethics......Page 128
Conclusion......Page 132
Psychotherapy’s medical heritage......Page 134
Bioethics: resource and source of problems......Page 135
A mixed medical/psychological/ethical concept: “mental health”......Page 136
Psychology’s curious estrangement from bioethics......Page 139
Clinical reality......Page 141
The context of business......Page 142
Economic considerations and the ethical dimensions of psychotherapy......Page 144
Limited financial resources......Page 150
Employing economic considerations alone......Page 151
Balancing economic with other considerations......Page 154
Conclusion......Page 155
Part IV Change in psychotherapy......Page 156
8 Ethical dimensions of the techniques, strategies, and processes of therapy......Page 157
Therapy process and ethics......Page 159
Ethical principles and virtues applied to therapy processes......Page 161
Therapy processes in ethical perspective......Page 163
Ethical underpinnings of professional standards and ethics......Page 166
Agreements about particular therapeutic relationships......Page 167
Preserving and enhancing client autonomy......Page 170
The quality of the therapist-client relationship and therapist treatment of clients......Page 172
Ethical dialogue......Page 173
Types of influence......Page 174
Inappropriate, appropriate, and ideal influence......Page 177
Choice of therapy goal(s)......Page 188
9 Ethical dimensions of the goals and outcome of therapy......Page 190
Unsuitable “solutions”......Page 194
Deciding what is good, right, and/or virtuous in therapeutic ends: principles, goodness, and virtues......Page 196
The perspectives of clients, therapists, and other therapy stakeholders......Page 198
Distinctions among mental health and other ideals......Page 199
A spectrum of psychological-ethical concepts of mental health......Page 203
Evaluating concepts of mental health and mental health-ethics distinctions......Page 205
Mental health as moral or nonmoral, obligatory or ideal......Page 207
Conclusion......Page 208
Tailoring goals to the individual, context, and culture......Page 209
Specific ethical ideals......Page 211
Principles......Page 214
Concepts of goodness......Page 216
Virtues......Page 221
Therapy ideals and ethical theory......Page 224
Addressing multiple therapy ideals......Page 225
Part V Implications......Page 230
10 Rethinking psychotherapy’s location in a society......Page 231
A public philosophy for psychotherapy......Page 232
Ethical dimensions of the role of therapy in a society......Page 234
Deciding the role of therapy in a society......Page 241
Addressing ethical diversity......Page 243
Revised social and therapeutic contracts......Page 251
11 Profession and professional ethics......Page 254
Profession......Page 255
Professional ethics and the ethical character of psychotherapy......Page 256
Commitment to clients, commitment to society......Page 257
Therapists’ ethical influence on clients......Page 258
Why professional ethics?......Page 265
Choosing in accord with professional ethics......Page 268
The challenge of improvement......Page 269
Making better choices about the ethical character of psychotherapy......Page 271
Balance......Page 272
An ethical character for therapy that is intellectually, psychologically, and culturally rich and nuanced......Page 274
Ethical alternatives......Page 277
Thinking......Page 281
Dialogue......Page 282
Ethical articulacy......Page 284
Retrieving and drawing upon ethical sources......Page 285
Notes......Page 287
References......Page 293
Index......Page 330