The book “Ethical Dilemmas in Psychotherapy: Positive Approaches to Decision Making” by Samuel J. Knapp, Michael C. Gottlieb, and Mitchell M. Handelsman presents a five-step model for ethical decision-making in psychotherapy, emphasizing a “positive ethics” approach. This approach goes beyond merely preventing harm, aiming to actively promote the patient’s well-being.
Ethical Dilemmas: Balancing ethical principles like patient autonomy and the need to protect the patient or others from harm.
Five-Step Model:
Positive Ethics: Focuses on the patient’s well-being, emphasizing self-awareness, self-regulation, and self-improvement for psychologists.
Ethical Acculturation Model (EAM): Describes how psychologists integrate personal and professional ethical values through strategies like assimilation, separation, marginalization, and integration.
Professional Competence: Involves clinical skills, ethical knowledge, self-awareness, self-regulation, and collaboration.
Boundary Issues: Importance of maintaining professional boundaries and managing multiple relationships.
Informed Consent: Clear communication and obtaining consent at all stages of treatment.
Dangerous Patients: Ethical dilemmas related to patients posing risks to themselves or others.
Morally Diverse Patients: Challenges of working with patients with differing values and beliefs.
Dr. Yasuto and the Suicidal Patient: Balancing patient autonomy with the obligation to protect.
“Billy” and the Anonymous Email: Dealing with requests for help from unknown sources.
The Psychologist and the Patient with Intrusive Thoughts: Balancing confidentiality with the need to protect potential victims.The book provides a practical guide for psychologists to navigate ethical dilemmas, using the five-step model and principles of positive ethics to prioritize patient well-being and professional integrity.