Walking the Line: Ethical and Educational Concerns  for Therapist Self-disclosure Bryn A. Robinson  Mary Ann Campbell, PhD...
Ethical Decision-Making Process or Constant? <ul><li>Many therapists clear on sexual SD </li></ul><ul><ul><li>98% believe ...
Objectivity and Self-Disclosure A Fine Balance <ul><li>Subjectivity is framed negatively  </li></ul><ul><li>Objectivity fr...
<ul><li>Advocated only to promote objectivity </li></ul><ul><li>… or “after-the-fact” when therapist is too subjective  </...
<ul><li>What is meant by harm? Well-being? </li></ul><ul><li>Appropriate for aspirational preamble  </li></ul><ul><ul><li>...
<ul><li>Inadequate coverage of ethical self-disclosure in the classroom </li></ul><ul><li>In general, clinical students ar...
<ul><li>Specific SD ethical dilemmas </li></ul><ul><li>Mock therapy sessions in pairs </li></ul><ul><ul><li>Alternate role...
<ul><li>Overcome perception that self-disclosure is human error or will be punished  </li></ul><ul><li>Encourages collegia...
<ul><li>Self-care is a preventative measure against inappropriate self-disclosure </li></ul><ul><li>Encourage clinical con...
<ul><li>Above all..  </li></ul><ul><ul><li>Ethical decision-making is a process, not instant  </li></ul></ul><ul><ul><li>I...
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Walking The Line: Ethical and Educational Concerns of Therapist Self-Disclosure

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My presentation on therapist self-disclosure ethics, delivered to the 3rd International Conference on Clinical Ethics and Consultation, June 1/07, Toronto ON

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  • Good morning and thank you for giving me the opportunity to speak with you today. My name is Bryn Robinson, and the title of my presentation is “Walking the Line: Ethical and Educational Concerns for Therapist Self-Disclosure.” Before I begin my talk, I’d like to take a moment and engage in some ethical self-disclosure myself: I’m not a clinician, but rather a graduate student training in experimental psychology. Impetus for paper / talk : was based on my ethics courses in psychology, which were largely composed of clinical students. As we worked through ethical principles involved in the therapeutic relationship, I was interested in how these students would learn to deal with ethical self-disclosure. It seemed that they learned about other ethical dilemmas but this appeared to be avoided or assumed to be learned. Worked with three clinicians at UNB to research the strengths and weaknesses of ethical self-disclosure. From there, we were able to make several practical recommendations for future graduate student training. Further, although much of my knowledge is rooted in a psychological standpoint, we feel that what we have to say about SD applies to any doctor-patient relationship. Thus, this talk is from an experimentalist’s outsider perspective on SD in therapeutic relationships, and looks at both the theoretical and practical applications.
  • Walking The Line: Ethical and Educational Concerns of Therapist Self-Disclosure

    1. 1. Walking the Line: Ethical and Educational Concerns for Therapist Self-disclosure Bryn A. Robinson Mary Ann Campbell, PhD University of New Brunswick, Saint John ICCEC Toronto, ON June 1st, 2007
    2. 2. Ethical Decision-Making Process or Constant? <ul><li>Many therapists clear on sexual SD </li></ul><ul><ul><li>98% believe it is unacceptable </li></ul></ul><ul><li>Non-sexual therapist SD is cloudy: </li></ul><ul><ul><li>70% therapists = rarely / sometimes appropriate </li></ul></ul><ul><ul><li>93% therapists use SD </li></ul></ul>Professional Affective Personal
    3. 3. Objectivity and Self-Disclosure A Fine Balance <ul><li>Subjectivity is framed negatively </li></ul><ul><li>Objectivity framed as “only option” to promote non-maleficence </li></ul><ul><li>Suggestions : </li></ul><ul><li>Modify codes to promote balance </li></ul><ul><li>Discuss appropriate times for subjectivity & self-disclosure </li></ul>
    4. 4. <ul><li>Advocated only to promote objectivity </li></ul><ul><li>… or “after-the-fact” when therapist is too subjective </li></ul><ul><li>Suggestions : </li></ul><ul><li>Promote constant self-reflection = therapist considers effective use of objectivity and subjectivity </li></ul>Promoting Self-Reflection An Ongoing Process
    5. 5. <ul><li>What is meant by harm? Well-being? </li></ul><ul><li>Appropriate for aspirational preamble </li></ul><ul><ul><li>But enforceable standards require greater precision </li></ul></ul><ul><li>Suggestions : </li></ul><ul><li>Complement broad terms with specific language to guide use of ethical codes </li></ul>Clarifying Language All-Purpose
    6. 6. <ul><li>Inadequate coverage of ethical self-disclosure in the classroom </li></ul><ul><li>In general, clinical students are … </li></ul><ul><ul><li>Reluctant to discuss therapist reactions / SD </li></ul></ul><ul><ul><li>Told to use “common sense” to ethically deal </li></ul></ul><ul><li>The “letter” versus the “spirit” </li></ul>Ethics Training Teaching students self-disclosure
    7. 7. <ul><li>Specific SD ethical dilemmas </li></ul><ul><li>Mock therapy sessions in pairs </li></ul><ul><ul><li>Alternate roles of client and therapist </li></ul></ul><ul><li>In-class seminars on real SD dilemmas </li></ul><ul><ul><li>Teach students to defend use of SD… </li></ul></ul><ul><ul><li>… and evaluate if SD was warranted </li></ul></ul>Ethics Training Role-Playing Exercises
    8. 8. <ul><li>Overcome perception that self-disclosure is human error or will be punished </li></ul><ul><li>Encourages collegial discussion and a check that decisions are ethical </li></ul><ul><li>Interview established professionals and discuss responses in a seminar </li></ul>Ethics Training Promote Dialogue
    9. 9. <ul><li>Self-care is a preventative measure against inappropriate self-disclosure </li></ul><ul><li>Encourage clinical consultation to foster emotional self-awareness </li></ul><ul><li>A good habit to start early on! </li></ul>Ethics Training Self-Care Activities
    10. 10. <ul><li>Above all.. </li></ul><ul><ul><li>Ethical decision-making is a process, not instant </li></ul></ul><ul><ul><li>It is not immediate “common sense” </li></ul></ul><ul><li>Promote balance of objectivity and subjectivity in written codes </li></ul><ul><li>Implement more training opportunities to raise students’ awareness of ethical SD </li></ul>Conclusion

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