NOTE: The following article is adapted from Ethics in Psychotherapy and Counseling: A Practical Guide, Third Edition by Ken Pope and Melba Vasquez (Jossey-Bass, an Imprint of Wiley, 2007). © John Wiley & Sons.

The recently published third edition of our book Ethics in Psychotherapy and Counseling: A Practical Guide contains much that is new. All chapters reflect extensive updating and revision, and some chapters—on such topics as “Ethics and Critical Thinking,” “Creating Strategies for Self-Care,” and “Creating a Professional Will”—did not appear in previous editions.

We expanded the scope of the book to include the very different approach taken by the Canadian Psychological Association’s ethics code. We cite passages from both the APA and CPA ethics codes throughout the book, and include a history of both codes along with discussion of how discontent with the APA code and the perception that it was not a good fit for Canadian psychologists set the stage for the creation of the Canadian code. (CPA had previously used the APA code.) Both the APA and the CPA codes are among the book’s 7 appendices.

Part of the process of deciding what to change in the book included trying to figure out what would remain constant. Some basic assumptions shaped both the first edition back in 1991 and the 1998 second edition. After considerable questioning, discussion, and rethinking, we decided that these assumptions continued to be valid, important, and worth maintaining, and that they would shape the third edition.

Here are 7 of these basic assumptions that have shaped all three editions:

1. Ethical awareness is a continuous, active process that involves constant questioning. Conflicts with managed care companies, the urgency of patients’ needs, the lack of adequate support, the threat of formal complaints, mind-deadening routines, tiredness, and so many other factors can begin to block our personal responsiveness and dull our sense of personal responsibility. They can overwhelm us and lull us into ethical sleep. It is crucial to practice continued alertness and mindful awareness of the ethical implications of what we choose to do and not do.
2. Awareness of ethical standards and codes is important, but standards and codes cannot take the place of an active, thoughtful, and creative approach to our ethical responsibilities. Formal standards and codes prompt and inform rather than preclude our ethical considerations. Each new client, regardless of similarities to other clients, is unique. Each situation is unique and constantly evolves. Standards and codes may identify some approaches as clearly unethical. They may identify significant ethical values and concerns, but they cannot tell us what form these values and concerns will take. They may set forth essential tasks, but they cannot spell out the best way to accomplish those tasks with a unique client facing unique problems with limited resources.
3. Awareness of the scientific and professional literature, the evolving research and theory is another important aspect of ethical competence, but the claims and conclusions emerging in the literature can never be passively accepted, no matter how popular or authoritative, or reflexively applied. A necessary response to published claims and conclusions is active, careful, informed, persistent, and comprehensive questioning.
4. We believe that the overwhelming majority of therapists and counselors are conscientious, dedicated, caring individuals, committed to ethical behavior. But none of us is infallible. Whatever our experience, accomplishments, or wisdom, all of us can—and do—make mistakes, overlook something important, reach conclusions that are wrong, hold tight to a cherished belief that is misguided. An important part of our work is questioning ourselves, asking “What if I’m wrong about this? Is there something I’m overlooking? Could there be another way of understanding this situation? Are there other possibilities? Could there be a more creative, more effective, better way of responding?”
5. Many of us find it easier to question the ethics of others than to question our own beliefs, assumptions, and actions. It is worth noticing if we find ourselves preoccupied—overshadowing the questioning our own personal approach and behavior—with how wrong others are in some area of ethics and certain that we are the ones to set them right, or at least to point out repeatedly how wrong they are. It is a red flag if we spend more time trying to point out the weaknesses, flaws, mistakes, ethical blindness, destructive actions, or error-filled beliefs of a colleague or group of colleagues than we spend questioning and challenging ourselves in positive, effective, and productive ways. It is important to question ourselves at least as much as—and probably more often than—we question others.
6. Many of us find it easier and more natural to question ourselves in areas where we are uncertain. It tends to be much harder—but often much more productive—to question ourselves about what we are most sure of, what seems beyond doubt or question. Nothing can be placed off-limits for this questioning. We must follow this questioning wherever it leads us, even if we venture into territories that some might view as “politically incorrect” or—much more difficult for most of us— “psychologically incorrect” (Pope, Sonne, & Greene, 2006).
7. As psychologists, we repeatedly encounter ethical dilemmas without clear and easy answers. We confront overwhelming needs unmatched by adequate resources, conflicting responsibilities without prospect of adequate reconciliation, frustrating limits to our scientific understanding of conditions or interventions, and countless other challenges as we seek to help people who come to us because they are hurting and in need, sometimes because they are desperate and have no where else to turn. There is no legitimate way to avoid these ethical struggles. We must be prepared to actively examine these dilemmas as a normal and expected part of our work.

References

Pope, K.S., Sonne, J.L., & Greene, B.G. (2006). What Therapists Don’t Talk About And Why: Understanding Taboos That Hurt Us And Our Clients. Washington, DC: American Psychological Association.

Pope, K.S., & Vasquez, M.J.T. (2007). Ethics in Psychotherapy and Counseling: A Practical Guide, 3rd Edition. San Francisco, CA: Jossey-Bass, An Imprint of Wiley.