The Handbook of Professional Ethical and Research Practice for Psychologists, Counsellors, Psychotherapists and Psychiatrists

Rachel Tribe, Jean Morrissey, Rachel Tribe, Jean Morrissey

• Publisher: Routledge
• Year: 2020
• ISBN:
  9780429768170
• Edition: 3
• Topic: Philosophy
• Subtopic: Ethics & Moral Philosophy

This exciting new edition provides an overview of the main professional, ethical and research issues that are required knowledge for counsellors, therapists, psychologists and psychiatrists engaging in therapeutic or clinical work. These issues form part of the curriculum and practice requirements of all the major counselling, psychotherapy, psychology and psychiatry professional organisations (including BACP, BPS, HCPC, RCP, UKCP, IACP, IPS andIAHIP).

Divided in six clearly defined sections, this book will provide a comprehensive overview of all the major professional practice and ethical issues in one edited volume. The authors are well-known experts in their fields and their work has been brought together with clarity and helpful features, including reflective questions and case vignettes. This new edition has also been updated to include content on social justice, community psychology and professional guidelines, reflecting the latest academic research and clinical developments.

This book is unique in the breadth of issues covered and its focus on therapeutic practice. It will be of interest to practitioners and students of psychotherapy, counselling and psychiatry.

Part 1

Professional practice and ethical considerations

Chapter 1

Introduction

Rachel Tribe and Jean Morrissey

This 3rd edition of the Handbook of Professional, Ethical and Research Practice for Psychologists, Counsellors, Psychotherapists and Psychiatrists, has been updated and enhanced in line with developments in the external environment. Changes have been made that include new practice guidelines being issued by several professional organisations, the expanding role of social media and the latest research. Professional, ethical and research practice issues that are experienced in a fast changing and complex landscape are of concern to all practitioners and service users/experts by experience, regardless of the therapeutic or clinical context or the modality used. The need to be an effective, ethical and socially responsible practitioner is a central requirement of clinicians irrespective of their professional grouping. In an increasingly multifaceted and litigious environment, practitioners may face a range of perplexing demands and issues that can feel challenging, anxiety provoking and, on occasions, isolating. Preparation, knowledge, understanding and reflection are key to dealing with these professional and personal demands. It can feel difficult to keep abreast of all developments, be familiar with up to date research and any current policy changes taking place.

This book contains chapters written by counsellors, psychologists, psychotherapists and psychiatrists. New additions to the book include chapters detailing the new challenges for professional ethics and good practice guidelines, the possible adverse effects of therapy, conducting research in therapeutic practice settings, Continuing Professional Development (CPD), Social Justice and Community Psychology. The book has six sections these are; Professional and practice and ethical considerations, Legal considerations and responsibilities, Clinical considerations and responsibilities, Working with diversity: professional practice and ethical considerations, Research, supervision and training and Social inclusion. Each chapter contains a range of clinical vignettes to illustrate the points made as well as four reflective questions which can be considered by individuals, teams, supervision groups or in lectures, workshops and seminars. We hope that the handbook will provide guidance to practitioners whether they are very experienced clinicians, researchers or just starting out as trainees.

Significantly, the book starts with an important chapter which sets the tone for the book; this is written by a service user/expert by experience who reflects on her experience of using a range of therapeutic services. She also challenges the reader to consider how the voice of the service user is often not heard, is marginalised, or is considered in a tokenistic manner. Some of the issues raised are those which practitioners may ignore and/or fail to consider adequately. The author raises a number of seminal issues which, practitioners will find helpful to consider if they are to work with experts by experience effectively and ethically and to meet best practice guidelines.

Professional, ethical and research questions are often multi-dimensional and changes in the environment require continuous reflection and discussion with supervisors or consultation with guidelines. The latter is illustrated in the contributions from authors from the British Psychological Society and the United Kingdom Council for Psychotherapy, who reflect upon the development of new codes of professional and ethical practice which their organisations have recently published. For example, the British Psychological Society (BPS) updated their code of ethics and conduct in 2018 and their Practice Guidelines in 2017, the United Kingdom Council for Psychotherapy (UKCP) are currently undertaking a second consultation with their members on their draft Code of Ethics and Practice. In July, 2018 the British Association for Counselling and Psychotherapy launched a new version of their ethical framework, whilst the Royal College of Psychiatrists issued new guidance in 2017 on confidentiality and information-sharing. We invited the BACP to contribute to the chapter on guidelines, unfortunately the timing coincided with them undertaking a major reorganisation around their professional and ethical codes and therefore they had to decline this invitation.

Internationally, the American Counseling Association updated their guidance in 2015, whilst the Canadian Counselling and Psychotherapy Association updated their standards of practice in 2015. Changes in the environment are occurring on a global scale and professional, ethical and research practice requires ongoing attention to ensure best practice is followed and that service users requirements are foregrounded. The importance of the psychological contract is then discussed and how the psychological contract differs from an overt contract is reviewed. This refers to the hidden contract and contains the personal assumptions, expectations and presumptions that influence everyone, which underpin our clinical work, the relationships with the people that use our services as well as the relationships experts by experience have with clinicians. A psychological contract is also in operation in the relationship between individual clinicians and the organisations or clinics they work with. This chapter details the importance of actively considering these to ensure that ethical, professional and research practice guidelines are upheld.

The second section of the handbook on legal considerations and responsibilities, discusses issues relating to client confidentiality and data protection, with reference to legal and clinical requirements. The chapter also examines what is meant by the public interest, disclosures and access to information by the courts. It discusses why it is important for clinicians to be cognisant of statutory duties alongside clinical responsibilities. The chapter on the legal context of therapy details the legal parameters of clinical work generally and includes a description of the structure of the legal system and summarises negligence case, contract, statute, mental health and laws relating to children. A further chapter on Writing a report for use in court and appearing in court as a health professional or expert witness provides an introduction to medico-legal report writing. It also covers such issues as the different types of report that may be requested and discusses issues the practitioner needs to be cognisant of in advance of, during the writing of and in presenting the report and provides a possible template for a report and has a section on appearing in court.

In the third section of the handbook on clinical consideration and responsibilities, the chapter on complaints explores a number of the professional ethical issues associated with complaints including having a complaint made against you and the impact for the practitioner as well as triggers for complaints. The next chapter looks at the vital issue of the fitness of the clinician to practice. Issues relating to fitness to practice are complex, but are an important ethical and professional issue and one that many professionals will have to consider themselves or in their role as colleagues, students or supervisors at some points during their career, either when they may personally experience some of life’s difficulties or when a colleague is giving cause for concern. This chapter looks at the associated challenges of definition, examines the related ethical and professional frameworks, and discusses common factors as well as issues of responsibilities and finally taking action. This is followed by the chapter on social media, which addresses the often overlooked issues relating to the role of social media in therapy. The role of social media in a therapeutic context requires consideration from many angles and is one area that is changing faster than many others. It is one that practitioners who are not so active in or conversant with recent developments in social media may ignore at their peril. The divisions between digital and non-digital therapy is becoming increasingly complex, with issues such as personal social media accounts, the storage of records and privacy, confidentiality and informed consent in social media use. The next chapter looks at the under researched issue of the possible adverse effects of therapy. It examines definitions of adverse effects before moving on to consider how these may be identified, understood and worked with. It also considers the strategies that can be used by practitioners to address adverse effects and the implications of being mindful of these to ensure that professional, ethical and research practice standards are upheld. It also provides some data showing how older adults are often not referred for therapy although when they do the results are good.

The fourth section of the handbook on working with diversity – professional, practice ethical and research consideration starts with a chapter on working with children and adolescents. This focuses on the issue of minors being legally positioned differently and how this may impact upon the therapeutic relationship, the role of the clinician and the relationship of the clinician with the service users’ families. It explores some of the complexities that may be connected with multiple agency work, specifically the issue of therapeutic disclosures and confidentiality when working with young people. Moving to the other end of the age range, the next chapter focuses on professional and ethical issues with older adults. The issues of ageism, stigma, service usage and age discrimination are discussed in relation to mental health and therapeutic services offered. Practitioners are asked to question their own views and assumptions about older adults and therapy. There has frequently been a prevailing discourse that older adults will not benefit from talking therapies although evidence disproves this. A variety of links to guidelines and documents are provided. The issue of elder abuse is foregrounded and the need for all practitioners to be mindful of this. An important chapter on working with lesbian, gay, bisexual and transgender people is also included. This chapter, like the previous one, asks the reader to reflect upon their own views and positioning in relation to the client group being considered. It draws attention to the common humanity of all people as well as the diversity of the lesbian, gay, bisexual and transgender community/ies. It also explores the marginalisation that LGBT people face in the wider society and the potential impact of this on mental health and wellbeing. The final chapter in this section is on Professional and ethical practice in a multicultural and multiethnic society and this examines the concept of culture and cultural competence. It draws on a range of national and international guidelines and explores racism and potential racist dynamics in the clinical relationship.

The fifth section in the handbook is on research, supervision training and Continuous Professional Development (CPD) and learning. The first chapter in this section is on research in therapeutic practice settings: ethical considerations and it reviews the reciprocal and often unrecognised but vital and interactive relationship between research and practice in therapeutic training and all aspects of practice including service development and health related policy. It discusses how research and practice are often seen as separate which fails to account for the importance of each to the other and the informative and symbiotic relationship they have. The chapter also details the importance of research in every aspect of clinical work. The chapter then reviews a range of ways to undertake research in organisations offering therapy and reviews some the practical, methodological and ethical challenges as well as the opportunities and possible important outcomes of undertaking this work. This is followed by a chapter on evidence based practice – the ethical dimension. This chapter deconstructs what is meant by evidence-based practice, it examines its epistemological basis, its values and discusses the competing interests in evidence based practice. It then examines how applicable the evidence is, as well as considering how complete and unbiased the evidence base is. It reviews the ethical, professional and research issues at the micro, meso and macro levels and discusses the complex challenges involved in making the best use of resources when delivering the best care while not losing site of the multifaceted needs of individuals. The next chapter is on the issue of personal therapy for therapists, the chapter examines and comments upon the related ethical and professional issues. Some professional groupings view personal therapy as essential to the personal and professional training and the development of the practitioner, whilst a few do not see it as essential. This chapter looks at the evidence for and against and the differing rationales. It also examines accounts of personal therapy and also at the context and complexity of referrals and differences in professional trainings. The next chapter discusses teaching ethics for professional practice and will be an essential chapter for anyone teaching ethical, professional and research practice. This chapter briefly reviews the dominant professional ethical codes which are in existence in parts of Europe to show how professional ethical codes develop from specific contexts. The chapter links the personal and professional development of the trainee and considers ho...

Table of contents

• Cover
• Endorsements
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• List of contributors
• Acknowledgements
• PART 1: Professional practice and ethical considerations
• PART 2: Legal considerations and responsibilities
• PART 3: Clinical considerations and responsibilities
• PART 4: Working with diversity: professional practice and ethical considerations
• PART 5: Research, supervision and training
• PART 6: Social Inclusion
• Resources and links
• Conclusion
• Index