Jeffrey N. Younggren

Nonrational processes in ethical decision making.

Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasilegal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior, including context, perceptions, relationships, emotions, and heuristics. For example, a large body of behavioral research has demonstrated the importance of automatic intuitive and affective processes in decision making and judgment. These processes profoundly affect human behavior and lead to systematic biases and departures from normative theories of rationality. Their influence represents an important but largely unrecognized component of ethical decision making. We selectively review this work; provide various illustrations; and make recommendations for scientists, trainers, and practitioners to aid them in integrating the understanding of nonrational processes with ethical decision making.

Managing risk when contemplating multiple relationships

Entering into dual relationships with psychotherapy patients has been a topic of significant controversy in professional psychology. Although these types of extratherapeutic alliances have generally been considered to be unethical conduct, some authors recently have supported their development as both ethical and, in some cases, even therapeutic (A. Lazarus & O. Zur, 2002). In this article, the authors briefly review the general literature regarding dual relationships and offer the reader guidelines in applying an ethically based, risk-managed, decision-making model that could be helpful when a practitioner is considering entering into such relationships or when such relationships inadvertently develop.

Can you keep a secret? Confidentiality in psychotherapy

Confidentiality is the secret-keeping duty that arises from the establishment of the professional relationship psychologists develop with their clients. It is a duty created by the professional relationship, it is set forth in the American Psychological Associations (2002) Ethical Principles and Code of Conduct, and it is codified in many state regulations. However, the difference between confidentiality and legal privilege; how, why, and when it can be violated; and the reasons for so doing are not well understood by many practitioners. While on the surface confidentiality might seem to be an easy concept to apply to professional practice, in fact it is quite complex and filled with exceptions that frequently differ from circumstance to circumstance and from state to state. A lack of respect for and a lack of familiarity with the significance of these exceptions could have dire professional consequences. This article reviews the ethical imperative of confidentiality and then provides examples of legal cases that help to better understand its complexity. Then, we offer strategies designed to help metal health practitioners when they are confronted with questions regarding confidentiality and privilege.

The certification of emotional support animals: Differences between clinical and forensic mental health practitioners.

There is a growing trend of individuals requesting emotional support animal (ESA) “letters” from licensed mental health professionals. However, no current standards exist for making these evaluations. The current study sought to examine, within a specific sample, (1) roughly how many and what type of mental health professionals are making ESA evaluations and (2) to explore what instruments these practitioners used, or would use, for making such an evaluation. Through the use of a sample of 87 mental health professionals, 31.4% of whom have actually made ESA recommendations, the current study demonstrates that both clinical and forensic practitioners within the current sample are making ESA recommendations and believe it is appropriate for treating mental health professional to offer an opinion on the need for an ESA. This demonstrates that neither group in the current sample recognizes the potential role conflicts this presents when one mixes forensic and clinical functions. Further, results of the survey revealed that forensic practitioners were significantly more likely to choose more complex and forensically valid assessment instruments (e.g., malingering assessment) for ESA evaluations when compared with clinical practitioners. We conclude with a set of recommendations for practitioners to choose to conduct ESA evaluations.