Reflection...
This picture represents the straight path that I need to follow as an ethical psychologist. Staying on the path and abiding by the CPA Code of Ethics is the first competency upon which all the other competencies have to lay upon.
"Even the most rational approach to ethics is defenseless if there isn’t the will to do what is right" -- Alexander Solzhenitsyn
The process towards establishing an ethical practice may be a challenging one. Ethics in psychology involves more than a simple adherence to rules or codes of conduct, it also requires the desire to do what's right, awareness, knowledge and skills (Truscott & Crook, 2004). Furthermore, the development of ethical awareness and practice is a life long journey (Corey, Schneider-Corey, & Callahan, 2007). In order to truly engage in ethical practice, ongoing self-reflection is essential. I took my ethical training with Derek Truscott at the University of Alberta. An essential learning I got from the course is the importance of integrating the ethical principles and values in our SELF and practice ethical behavior in all circumstances so that our actions become a reflection of a coherent state and an integration between all aspects of ourselves— emotions, cognitions, and behaviors (Truscott & Crook, 2004).
The Dalai Lama (2011, p. 103):
Ethics is not simply a matter of knowing. More important, it is about doing. For this reason, even the most sophisticated ethical understanding if it is not applied in daily life, is somewhat pointless. Living ethically requires not only the adoption of an ethical outlook but also a commitment to developing and applying inner values in our daily lives
Truscott and Crook (2004, p. 132):
Integrity is engendered through consistently striving to be ethical in every situation. It cannot merely be gained as knowledge; it must be practiced. Therefore, we encourage you to be mindful of your ethical self and the ethics of your actions in all of your activities. There is one important potential pitfall of integrity— becoming overly rigid in upholding ethical values. Thus, integrity must be moderated by wisdom. Wisdom is intellect in the service of compassion. Compassion is the realization that others are as important as ourselves and not behaving purely out of self-interest. Wise psychologists draw upon their knowledge, skills, and judgment to further the welfare of others out of a deep respect for their suffering and innate worth
Ethical principles
The Canadian Code of Ethics for Psychologists (2000) sets not only the minimum standards for what is considered ethical conduct as a counselling professional, but encourages one to aspire to the highest ethical behaviors in practice. It is an implied social contract between members of the psychological profession and the society they serve (Sinclair & Pettifor, 2001). In order to help assure ethical behavior and attitudes on the part of psychologists, the Code of Ethics articulates four ethical principles comprised of values statements which include several standards of practice.
Principle I:
Respect for the Dignity of Persons This principle is given the highest weight and corresponds to the deontological principles of autonomy and justice. It deals with the right of individuals to make choices about self-determination, be free from the control of others and have their innate worth respected (Sinclair & Pettifor, 2001; Truscott & Crook, 2004). In the context of professional ethics it refers to fairness and equity in the allocation and access to service, and avoiding bias and discrimination in all professional related actions (Truscott & Crook, 2004). |
Principle II: Responsible Caring
“A man is truly ethical only when he obeys the compulsion to help all life which he is able to assist and shrinks from injuring anything that lives”. Albert Schweitzer This principle is the second in weight and relates to the deontological principle of beneficence and non-maleficence. This involves contributing to the well-being of others and at the same time not causing harm to others. According to Beauchamp and Childress (2008), ethicists agree that psychologists’ obligation to not harm clients is stronger than their obligation to contribute to their welfare. |
Principle III:
Integrity in relationships This third principle in weight is rooted in the deontological principle of fidelity, which include faithfulness, loyalty, honesty and trustworthiness (Truscott & Crook, 2004). This principle is of primordial importance for counselors because it is the foundation of trust which is at the heart of the working alliance with clients. This principle also involves placing the interests of our clients before our own even when it's inconvenient or uncomfortable (Truscott & Crook, 2004). |
Principle IV:
Responsibility to Society "Be the change you wish to see in the world ". Mahatma Gandhi If there is conflict between principles in a decision making process, this principle should be given the lowest weight of the four principles. It relates to the extended responsibility that psychologists have to promote the welfare of all human beings as practitioners but as private citizens as well. |
Ethical Decision-Making
"What is important is not the choice but the process and the reasons for that choice". Derek Truscott
Even with the above mentioned principles, ethical dilemmas are difficult to resolve. Ethically challenging situations are those in which many ethical values are at stake and it’s hard to know what to do. Situational pressures, strong feelings, personal biases, conflicting ethical duties and harm resulting from all decisions make decisions difficult. Nonetheless, decisions have to be made and psychologists are expected to follow a rigorous decision-making process. Ethical reasoning is actually the product of two levels of processing, experiential and analytical, which operate on two kinds of information, social and personal, and not, as is often thought, simply the outcome of logical analysis (Craigie, 2011). Only by incorporating all four of these aspects into our ethical reasoning can we make reliable and responsible decisions. (Truscott & Crook, 2004, p.88). The Canadian Psychological Association outlined a 10 steps decision-making process:
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Using the Ethical Decision-Making Model
When confronted with ethical dilemmas, psychologists are expected to proceed through a rigorous decision-making process in order to discover what course of action is best, rather than justify what we want to do or what we have done (Truscott & Crook, 2004). In the course Ethical and Professional Issues in Psychological Practice at the University of Alberta (EDPY 536) in the Winter of 2010, students were asked to write a midterm to reflect on various ethical questions using the principles of the Canadian Code of Ethics for psychologists (2000). In the final exam, we were asked to apply the decision making model of the CPA to ethical dilemmas but unfortunately we were unable to keep copies of that exam. Here is one situation from the midterm that we were asked to write on:
As psychologists, we are expected to avoid harmful dual relationships. However, there may be situations when it is unclear whether a dual relationship will be harmful or not. Discuss what is meant by 'harmful', and some ways in which a psychologist can gauge whether a dual relationship will be harmful.
See the images below to view my complete ethical process for this vignette.
Using the Ethical Decision-Making Model
When confronted with ethical dilemmas, psychologists are expected to proceed through a rigorous decision-making process in order to discover what course of action is best, rather than justify what we want to do or what we have done (Truscott & Crook, 2004). In the course Ethical and Professional Issues in Psychological Practice at the University of Alberta (EDPY 536) in the Winter of 2010, students were asked to write a midterm to reflect on various ethical questions using the principles of the Canadian Code of Ethics for psychologists (2000). In the final exam, we were asked to apply the decision making model of the CPA to ethical dilemmas but unfortunately we were unable to keep copies of that exam. Here is one situation from the midterm that we were asked to write on:
As psychologists, we are expected to avoid harmful dual relationships. However, there may be situations when it is unclear whether a dual relationship will be harmful or not. Discuss what is meant by 'harmful', and some ways in which a psychologist can gauge whether a dual relationship will be harmful.
See the images below to view my complete ethical process for this vignette.
Lessons learned
Addressing ethical subjects with client in therapy is not only a one time intake thing, it's an ongoing process throughout therapy. As I mentioned in this excerpt from CAAP 601 discussion board, "I think that most of the agencies/clinics today approach informed
consent as a “one time contract signature” before the beginning of the therapy.
As a professional psychologist, I think our responsibility towards our client’s
right for autonomy is to address informed consent as an ongoing process
throughout therapy not only at the beginning. It’s very unlikely that the
client by having a general knowledge of any therapeutic approach would be able
to infer what will be happening 10 or 20 sessions from session 1, and
realistically be able to give an “informed” consent at that point in time for all the therapy. Regularly going
over how the client feels about the approach we are using and what is going on in the
sessions is an ethical duty of any psychologist regardless of the agency’s procedure".
Through my practicum placement, I had the chance to reflect on ethical situations concerning dual roles, informed consent and confidentiality. I became aware that when something feels "ethically wrong", it's because it probably is. I was able to discuss of these situations with my supervisor and colleagues at the placement site so that we all come with a plan to improve our ethical practice. A key learning that I take with me from studying, discussing and applying ethics in this program is that the assimilation of professional values into my personal moral system is the crucial factor in becoming an ethical psychologist. However, those decisions will not necessarily be easy to make. For example, during my practicum the issue of dual relationships was a source of dilemma for me. In the discussion board of my practicum (EDPS 644) I said that "dual relationships are not perceived as an ethical issue by some in the general population. For example, within the Muslim community here in Edmonton, counsellors from the Muslim faith are very rare. People from various Muslim communities don't go for counselling because they perceive counsellors as not being able to understand their beliefs. Due to a lack of Muslim counsellors, dual roles happen more often; it's like in rural areas of Alberta where there's only 1 or 2 counsellors for the whole city. I personally had to refuse to see the daughter of my husbands' friend to avoid dual relationships. I brought up the Code of Ethics and the possible complications that might occur but my husband and his friend didn't seem convinced that I made the right decision. However, I felt much more comfortable refusing than accepting to see that client, even if it created some conflict between me and my husband because he perceived my decision as a proof that I didn't want to help the daughter of his friend".
Another essential piece of learning is that experience as a counselor doesn't make ethical decisions easier. Irene Estay, my practicum professor and a member of the ethics committee of the College of Alberta Psychologists, explained that most of the psychologists who lose their license due to unethical practice have many years of professional experience. Haas, Malouf and Mayerson (1988) also confirmed that professional experience alone is inversely related to professionals' willingness to choose the most ethical course of action.
Through my practicum placement, I had the chance to reflect on ethical situations concerning dual roles, informed consent and confidentiality. I became aware that when something feels "ethically wrong", it's because it probably is. I was able to discuss of these situations with my supervisor and colleagues at the placement site so that we all come with a plan to improve our ethical practice. A key learning that I take with me from studying, discussing and applying ethics in this program is that the assimilation of professional values into my personal moral system is the crucial factor in becoming an ethical psychologist. However, those decisions will not necessarily be easy to make. For example, during my practicum the issue of dual relationships was a source of dilemma for me. In the discussion board of my practicum (EDPS 644) I said that "dual relationships are not perceived as an ethical issue by some in the general population. For example, within the Muslim community here in Edmonton, counsellors from the Muslim faith are very rare. People from various Muslim communities don't go for counselling because they perceive counsellors as not being able to understand their beliefs. Due to a lack of Muslim counsellors, dual roles happen more often; it's like in rural areas of Alberta where there's only 1 or 2 counsellors for the whole city. I personally had to refuse to see the daughter of my husbands' friend to avoid dual relationships. I brought up the Code of Ethics and the possible complications that might occur but my husband and his friend didn't seem convinced that I made the right decision. However, I felt much more comfortable refusing than accepting to see that client, even if it created some conflict between me and my husband because he perceived my decision as a proof that I didn't want to help the daughter of his friend".
Another essential piece of learning is that experience as a counselor doesn't make ethical decisions easier. Irene Estay, my practicum professor and a member of the ethics committee of the College of Alberta Psychologists, explained that most of the psychologists who lose their license due to unethical practice have many years of professional experience. Haas, Malouf and Mayerson (1988) also confirmed that professional experience alone is inversely related to professionals' willingness to choose the most ethical course of action.
references
Beauchamp,
T. L., & Childress, J. F. (2008). Principles
of biomedical ethics (6th ed). New York: Oxford University
Press.
Canadian Psychological Association. (2000). Canadian code of ethics for psychologists (3rd ed.). Ottawa, ON: Author. Retrieved
from http://www.cpa.ca/docs/File/Ethics/cpa_code_2000_eng_jp_jan2014.pdf
Corey, G., Schneider-Corey, M., & Callanan, P. (2007). Issues and ethics in the helping professions (7th ed.). Belmond, CA: Thomson Brooks/Cole.
Craigie, J. (2011). Thinking and feeling: Moral deliberation in a dual-process framework. Philosophical Psychology, 24 . p. 53– 71.
Dalai Lama. (2011). Beyond Religion: Ethics for a whole world. India: HarperCollins.
Haas, L.J., Malouf, J.L., & Mayerson, N.H. (1988). Personal and professional characteristics as factors in psychologists’ ethical decision making.
Professional Psychology: Research and Practice, 19.p. 35– 42.
Sinclair, C. & Pettifor, J. (Eds.). (2001). Companion manual to the Canadian code of ethics for psychologists (3rd ed.). Ottawa: Canadian Psychological
Association.
Truscott, D., & Crook, K. H. (2004). Ethics for the practice of psychology in Canada. Edmonton, AB: The University of Alberta Press.
Canadian Psychological Association. (2000). Canadian code of ethics for psychologists (3rd ed.). Ottawa, ON: Author. Retrieved
from http://www.cpa.ca/docs/File/Ethics/cpa_code_2000_eng_jp_jan2014.pdf
Corey, G., Schneider-Corey, M., & Callanan, P. (2007). Issues and ethics in the helping professions (7th ed.). Belmond, CA: Thomson Brooks/Cole.
Craigie, J. (2011). Thinking and feeling: Moral deliberation in a dual-process framework. Philosophical Psychology, 24 . p. 53– 71.
Dalai Lama. (2011). Beyond Religion: Ethics for a whole world. India: HarperCollins.
Haas, L.J., Malouf, J.L., & Mayerson, N.H. (1988). Personal and professional characteristics as factors in psychologists’ ethical decision making.
Professional Psychology: Research and Practice, 19.p. 35– 42.
Sinclair, C. & Pettifor, J. (Eds.). (2001). Companion manual to the Canadian code of ethics for psychologists (3rd ed.). Ottawa: Canadian Psychological
Association.
Truscott, D., & Crook, K. H. (2004). Ethics for the practice of psychology in Canada. Edmonton, AB: The University of Alberta Press.