Report from the
EAP Symposium “Ethics in Psychotherapy”
Sunday: 25-Feb-2018, in SFU Vienna
The Ethical Guidelines Committee initiated this Symposium once again to bring the ethical questions in psychotherapy more into the light. There have been EAP events before, such as “Teaching Ethics” in 2006 or the 2011 3-country Symposium in Vienna, when a proposal for a seminar on Ethics was developed, which aimed to produce the content framework for ethics seminars as a part of psychotherapy trainings and produce suggestions how to develop a national legal framework which might apply to the practice of psychotherapy.
Almost a decade later, this EAP Symposium “Ethics in Psychotherapy 2018” was organized to highlight the contemporary situation and current developments for reflection and discussion concerning ethics in psychotherapy practice and training. The key-note presenters: Tom Warnecke (UK); Marie Christine Soulie (France); and Margaret Aull (Austria) were invited to cover the three main fields of discussion:
1. Ethical Questions as context-bound dilemmas – professional ethical identity and subjectivity.
Tom Warnecke presented this topic in his lecture “Cat and Mouse – The Ethical Crucible in Psychotherapy Practice” which illustrated how crucial it is to reflect on ethical issues because these questions are complex, and in spite of codes and rules, the subjectivity and personal responsibility of the therapist plays often a central role: “Without failure, there are no ethics”; “Ethical behaviour means taking responsibility for our actions”; “As a psychotherapist, I don't protect confidentiality because of some rule, but because confidentiality is at the core of psychotherapy”.
2. Teaching Ethics in Psychotherapy – Marie Christine Soulie teaches Ethics at the SFU in Paris, and she presented the framework of her teaching aimed at developing students awareness concerning ethical issues. In her lecture, “Teaching Ethics in Psychotherapy Training – What does this mean?”, she presented the legal framework, core principles and case-based teaching, since “ethics is not a risk-management, but a decision-making process”.
3. The level of a national legal framework for Ethics in Psychotherapy – Margaret Aull, who is working in the commission advising the Austrian Ministry of Health concerning ethical questions in psychotherapy, presented her experiences in dealing with ethical questions on the national legal level protecting the integrity of the psychotherapy profession. In her lecture, “The professional ethics of psychotherapists”, she showed that the professional ethical code of psychotherapists is a necessary guideline since “We all know that ethical behaviour can't be produced by the law” and what helps to develop psychotherapy ethical framework is “the transparency of all decision-making procedures”.
After the lectures, participants worked in small groups addressing ethical issues from their own field of work, discussing it with colleagues from other countries and different psychotherapy modalities. The topics discussed in the small groups were later presented to the plenary group – The themes put forward by the participants could be used as a guideline for the next symposium, or another professional gathering on ethical issues in psychotherapy:
Ethical Responsibility to the Self: Meta-level
Regulation (rules) vs. Legislation (laws) – the “culture” of raising ethical issues
How ethical are various laws, rules, codes? - How ethical is the process? - How ethical/appropriate are the sanctions? There are conflicts between principles (relativistic).
Political and cultural contexts of the work
Differences in political orientation, differences in sexual orientation; what about multicultural clients? (Example: a religious man with psychosomatic problems beats his wife, – what is the responsibility of the therapist – to inform ... or to report to court: does the client give consent to release information? With a report from a psychiatrist – for youngsters up to 14 – reports to parents – discusses with parents about therapy.
What about body psychotherapy and touch? Or psychotherapy practiced by a unqualified psychotherapist due to lack of a law
Ethical complaints against colleagues – How to support the complaint? How to support the colleague?
No clear process/ support for complainant – how ethical is this? What about the validity of the complaint and the process of dealing with the complaint; the frightened complainant – making complaint could be damaging for the client; complaints against an organisation, training institutes, other professionals; complaints about non-members; consent - contracting (implicit – explicit) - consistency policies; taping the sessions ... supervision – shared professional secrets
Ethics of Competition among psychotherapy training institutes and different practice modalities; the
ethics of attacks / defences;
Advertising, abuses of marketing – tax situation avoiding fees, advertisements, contracts
Different roles in addressing ethical questions: Doctor – Psychiatrists – Therapist – Clients, who are abusing others (a “difficult client” - is this an ethical label)
Implementing ethics into the training courses – institutes have responsibility for students – no ethical codex binds the students
The discussion in the small groups brought up important everyday ethical issues in psychotherapy, like:
- Development of one’s own explicit ethical policy (“What do I normally do in a psychotherapy setting – What is my contract with the client”) Do I accept clients on Facebook; Do I inform client exactly what am I doing; How to go on with the rumours and gossiping – anonymous complaints about colleagues – is it a dance between confrontation and ignorance. Is it an ethical obligation to take action if we suspect that something unethical is going on – what to do with our knowledge ...
* Ethical issues in working with children and adolescents – questions around reporting child abuse
* Fees in psychotherapy – how much is it ok to charge? – is a “scale of fees” really good for clients, or just a good feeling for the therapist …? Is it ok to have first session for free?
As a conclusion, we can see this Ethics Symposium as another step towards creating a platform for the psychotherapists of Europe (from different modalities and different countries) together to find answers to the ethical dilemmas of their everyday professional life. It was nice to see how these common questions, around the core of psychotherapy, can bring psychotherapists together, no matter which modality or nation they come from.