When we sat down to write the 4th edition of Ethics in Psychotherapy and Counseling: A Practical Guide (2011) we ended up revising and updating all chapters and adding much that is new.
But part of the process of deciding what to change included trying to figure out what would remain constant. Some basic assumptions shaped the prior editions. 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 fourth edition also. What follows is adapted from the 4th edition and repeats some of the basic assumptions outlined in all 4 editions dating back to 1991.
Here are 7 basic assumptions about ethics:
1) Ethical awareness is a continuous, active process that involves constant questioning and personal responsibility. Conflicts with managed care companies, the urgency of patients' needs, the lack of adequate support, the possibility of formal complaints, mind-deadening routines, endless paperwork, worrying about making ends meet, fatigue, and so much else can begin to block our personal responsiveness and dull our sense of personal responsibility. They can overwhelm us, drain us, distract 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 codes and legal standards is important, but formal codes and standards cannot take the place of an active, thoughtful, creative approach to our ethical responsibilities. Codes and standards inform rather than determine our ethical considerations. They can never substitute for thinking and feeling our way through ethical dilemmas, and cannot protect us from ethical struggles and uncertainty. Each new client, regardless of similarities to other clients, is unique. Each therapist is unique. Each situation is unique and constantly evolves. Our theoretical orientation, the nature of our community and the client's community, our culture and the client's culture, and so many other contexts influence what we see and how we see it -- every ethical decision must take account of these contexts. 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 in a specific time and place with limited resources.
3) Awareness of the evolving research and theory in the scientific and professional literature is another important aspect of ethical competence, but the claims and conclusions emerging in the literature can never be passively accepted or reflexively applied no matter how popular, authoritative, or seemingly obvious. 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. All of us can -- and do -- sometimes make mistakes, overlook something important, work from a limited perspective, 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 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 supposed 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 that awaken us to new perspectives and possibilities. It is important to question ourselves at least as much as 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 often encounter ethical dilemmas without clear and easy answers. We confront overwhelming needs unmatched by adequate resources, conflicting responsibilities that seem impossible to reconcile, frustrating limits to our understanding and 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. They are part of our work.