Michael C. Gottlieb

Avoiding exploitive dual relationships: a decision-making model.

Ethical principles provide general guidelines for professional behavior. Unfortunately, these principles are not adequate for practical decision-making. One ethical principle which generates frequent consternation is that of avoiding dual relationships. Some models have been developed to address this problem, but they are typically general and not especially helpful when specific ethical dilemmas arise. The principle of avoiding dual relationships is briefly reviewed, and problems with the principle are noted. This article presents a specific decision-making model to avoid exploitive dual relationships; the models uses and limitations are critically examined. Avoiding dual relationships is an ethical injunction which frequently generates dilemmas for psychologists. Ethical principles provide general guidelines for professional conduct, but often provide little or no specific guidance for practical decision-making. This article reviews the relevant literature and presents a specific decisionmaking model for avoiding exploitive dual relationships. Examples of its use and pertinent limitations are noted.

Training Ethical Psychologists: An Acculturation Model.

This article presents an approach to graduate (and professional) training that views becoming an ethical psychologist as an acculturation process. J.W. Berrys (1980, 2003) model of acculturation strategies is used as a framework for understanding ethical acculturation, a developmental process during which students can use several types of adaptation strategies. Students enter training with their own moral value traditions and concepts but are confronted with new ethical principles and rules, some of which may be inconsistent with their ethics of origin. The article explores several applications of the framework to ethics courses, practicum supervision, and other areas of training.

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.

Ethical Issues with Managed Care Challenges Facing Counseling Psychology

With the advent of managed care, counseling psychologists are encountering vexing ethical issues. These issues arise not only for practitioners but for researchers, educators, and trainers as well. In this article, the authors briefly describe the evolution of managed care and review basic biomedical ethics and ethical decision-making models. The authors then examine specific ethical issues and offer suggestions for practice, research, and education and training. This article concludes with a research agenda, a review of projected general trends in health care delivery, and a discussion of counseling psychology’s role in addressing current concerns as well as influencing the future evolution of health care delivery.

Avoiding the road to ethical disaster: overcoming vulnerabilities and developing resilience.

Psychotherapists may, despite their best intentions, find themselves engaging in ethically problematic behaviors that could have been prevented. Drawing on recent research in moral psychology and longstanding community mental health approaches to prevention, we suggest that psychotherapists can reduce the likelihood of committing ethical infractions (and move in the direction of ethical excellence) by attending carefully to 4 general dimensions: the desire to facilitate positive (good) outcomes, the powerful opportunities given to professionals to effect change, personal values, and education. Each dimension can foster enhanced ethical behavior and personal resilience, but each can also contribute to ethical vulnerability. By recognizing and effectively addressing these dimensions, psychotherapists can reduce their vulnerabilities, enhance their resilience, reduce the risk of ethical infractions, and improve the quality of their work.

When Laws and Ethics Collide: What Should Psychologists Do?

At times the laws under which psychologists function may appear to contradict generally recognized ethical values and/or good clinical care. When these circumstances arise, psychologists must determine if a conflict really exists and, if so, seek solutions that reconcile respect for the law with their ethical values. At times, psychologists may decide to follow the law despite their ethical concerns. At other times, they may determine that a conscientious objection is warranted. The authors recommend options to consider when these situations arise and offer a decision-making process.

Some principles for ethics education: Implementing the acculturation model

In 2005, the authors (Handelsman, Gottlieb, & Knapp, 2005) proposed that ethics education be conducted based on a model of ethics acculturation. Here, the authors extend that work by offering some principles that support implementation of an ethics acculturation model (EAM) over the full course of professional preparation. The authors argue that ethics education should be life-long and provide students and trainees with positive, ongoing, experiential, and supportive educational environments and activities. After presenting and explaining each principle, the authors offer a detailed example showing how various exercises from the existing literature may be employed to facilitate students’ ethical development.

Working With Adult Clients Who May Have Experienced Childhood Abuse: Recommendations for Assessment and Practice

The delayed memory debate has generated many questions about therapeutic practices that are likely to be beneficial and detrimental to clients. This article proposes components of optimal practice for working with adult clients who may have been abused as children. The recommendations are organized around the following themes: (a) competence, (b) assessment and treatment planning, (c) psychotherapy process and technique, (d) memory issues, (e) and ethics. The authors emphasize the importance of a collaborative therapeutic relationship and urge clinicians to proceed cautiously when encountering treatment issues for which scientific knowledge and consensus are still evolving.

Initial practice recommendations for teleneuropsychology.

Telemedicine refers to the use of electronic communications to deliver health-related services from a distance, and is particularly useful in bringing specialty services to remote and/or underserved areas. Despite the increasing use of videoconference technology in psychology, there are very few guidelines to direct practitioners as to the ethical practice and utilization of telemedicine, and even fewer resources for practitioners of telecognitive assessment or teleneuropsychology. This paper seeks to outline several practical and ethical considerations that are relevant to the practice of telecognitive assessment and to assist practitioners in providing safe, ethical, and competent care to their patients by proposing some initial practice recommendations.