This workshop was dedicated to understanding ethical and moral foundations of exceptional mental health treatment.

1. John D. Gavazzi, PsyD ABPP
Psychologist
Ethics Educator
TW Ponessa and Associates
July 18, 2014

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3. At the end of the presentation, the participant
will be able to:
1. List the five foundational principles
2. Apply two NBCC directives or ACA principles
to clinical practice
3. Explain how one personal, moral value
integrates with good clinical practice

4. Personal Moral Development
Principle-based ethics
Ethical Codes
Examples of Morality in Treatment
Vignette Analysis

5. • Creating a safe environment
• Avoid the word “unethical”
• We are all learning in this process
• Demonstrate courtesy and respect for others

6. Personal moral compass-Believe it to be right
Knowing the difference between right and wrong
Emotional responses to dilemmas and actions
Implicit/rapid/automatic/internal/affective
Research shows people judge themselves and others
based on moral characteristics – evolutionary and
social reasons to judge “character”

7. Rules of Conduct – Profession/society
More external – Community (of peers)
Easier means to judge others’ actions
Can constrain individual choices or create
dilemmas
Explicit/cognitive/external/measured

8. Don't get caught. (Prep is important)
Killing must serve a purpose. (Murder?)
Be sure. (Evidence must add up)
Blend in. (Hired as forensic spatter expert.)
Control urges, and channel them.

9. 1. Religion/Family of Origin
2. Education: College and CE
3. Personal Education: Reading and Experience
4. Honest self-reflection

10. Care - Harm
Fairness – Cheating
Loyalty-Betrayal
Authority – Subversion
Sanctity (Purity) – Degradation
Liberty - Oppression

11. How did it develop?
How often do you use it to reflect on
professional life?
How often do you use it to reflect on personal
life?
How do you integrate your morals into your
ethical practice?

12. Do you use it “before the fact”?
Is it intuitive and unconscious?
Is it more cognitive?
Is it written down?

13. Is it acceptance of another person’s or
institution’s code in full?
If yes, why?
If not, why?

14. Do you use it “after the fact”?
Fundamental Attribution Error
Actor-Observer Bias
Motivated Moral Reasoning

15. Moral Licensing (Karmic balance or Cognitive
Distortion)
Emotional Reasoning (Disgust)
Moral Dumbfounding (Do I really know?)
Personal Identity Protection Bias

16. Acculturation Model of
professional development
Integration Separation
Assimilation Marginalization
Higher on
Professional Ethics
Higher on Personal
Ethics
Lower on Personal
Ethics
Lower on
Professional Ethics

17. Matrix: Lower on professional ethics
Lower on personal ethics
Risks: *Greatest risk of harm
*Lack appreciation for ethics
*Motivated by self-interest
*Less concern for patients

18. Matrix: Higher on professional ethics
Lower on personal ethics
Risks: Developing an overly legalistic
stance
Rigidly conforming to certain
rules while missing broader
issues

19. Matrix: Lower on professional ethics
Higher on personal ethics
Risks: Compassion overrides good
professional judgment
Fail to recognize the unique
role of treatment

20. Matrix: Higher on professional ethics
Higher on personal ethics
Reward: Implement values in context
of professional roles
Reaching for the ethical ceiling
Aspirational ethics

21. Autonomy
Beneficence
Nonmaleficence
Fidelity
Justice

22. Does not mean promoting autonomy
(individuation or separation)
Means respecting the autonomous decision
making ability of the patient

23. It encompasses freedom of thought and
action.
Individuals are at liberty to behave as they
chose.
- Determining goals in therapy
- Making life decisions (e.g., marriage, divorce)
- Scheduling appointments and terminating
treatment

24. The principle of benefiting others and
accepting the responsibility to do good
underlies the profession.
- Providing the best treatment possible
- Competency
- Referring when needed

25. The principle is doing no harm.
- Demonstrating competence
- Maintaining appropriate boundaries
- Not using an experimental technique as the
first line of treatment
- Providing benefits, risks, and costs

26. This principle refers to being faithful to
commitments. Fidelity includes promise
keeping, trustworthiness, and loyalty.
- Avoiding conflicts of interests that could
compromise therapy
- Keeping information confidential
- Adhering to therapeutic contract (e.g.,
session length, time, phone contacts,
etc.)

27. Justice primarily refers to treating people fairly
and equally.
Become aware of our biases/judgments to avoid
negative countertransference and inequality.
Concepts of justice may included “social justice”
and advocacy outside of our offices. Example
include legislative and advocacy work.

28. Part of the Code of Ethics
Do no harm
Competence
Promote Welfare of
others
Communicate
Truthfully
Integrity of the
profession, avoid
damaging public trust
Collaboration &
positive working
relationships

29. The Counseling Relationship
Avoid harm
Multiple relationships
Informed Consent
Managing Boundaries
Documentation
Cultural Sensitivity
Careful with imposing
your values on others
Advocacy work

30. Confidentiality and Privacy
Respecting rights and
privacy
Couples/Family
Treatment
Informed Consent
Client access to records
Document/Records
Case Consultation
Storage and Disposal
of Records
Community
Beneficence -Danger

31. Professional Responsibility
Competence
Specialization/CE
Advertisement to
public
Media Presentations
Professional
Impairment
No Sexual Harassment
Nondiscrimination

32. Evaluation, Assessment & Interpretation
Client Welfare
Competence
Informed Consent
Diagnosis
Cultural Sensitivity
Prejudice/Pathology
Appropriate
instruments
Forensic Issues

33. Supervision, Training and Teaching
Client Welfare
Competence
Informed Consent
Multicultural
Competence
Conflict of Interest
Boundary Issues
Sexual Issues
Teaching Ethics

34. Studies show that individuals who teach
ethics and philosophy are not any more
ethical or moral than others
The most ineffective way to teach ethics is
learning ethical codes. Thoughts on this?

35. From real life ethical dilemmas in the mental
health field

36. Older patient dies in car accident. The patient
was not suicidal.
Adult child goes through papers and wants to
find out what was discussed in treatment.
What should you do?

37. Vignette Warehouse on Ethics and Psychology
site
www.ethicalpsychology.com

38. Complete course evaluations