Positive Ethics for Mental Health Professionals. Sharon K. Anderson
how you relate to it. Although not as formal as journal entries, these reflections can really contribute to your learning. You might think of them as extra consideration of the next step on the staircase, whereas the journal entries involve building handrails or sanding down rough edges on the steps.
The third type of activity we call Red Flag and Green Flag stories, which we introduce in Chapter 4. This is where we articulate some of the tripping points (red flags) and ways to prevent, mitigate, or transcend tripping points and achieve ethical excellence (green flags). The flag stories contain specific examples of behaviors and attitudes that you can think about, react to, and expand upon.
If you are reading this book for a class, your professor may ask you to do some additional entries or exercises, or ask you to share your work as part of a class discussion. The purpose of every activity is to facilitate the development of your professional/ethical identity and ethical acculturation—to explore yourself, the culture of psychotherapy, and/or the relationship between the two. As you respond to our prompts, remember that there are very few clearly right or wrong answers; we’ve left most of the questions open-ended to facilitate your exploration.
A note about the process of activities: We encourage you to take your time and reflect on what is being asked or what we offer through one of the flag stories. You don’t want to feel like it is absolutely necessary to answer every question in every activity or even to do every activity. You choose what is most meaningful at this time, knowing that you may come back to the chapter at a later time to do some additional reflection. However, we believe the more you do, the more you will benefit from this book. Think of these activities as walking up some stairs on the staircase or entering and exploring one of the rooms in the mansion. We intend the exercises to have multiple benefits, including growing self-understanding about who you are and who you want to be as an ethical professional.
Awareness
We ask you to keep an open mind and to continue expanding your awareness. For example, in our activities we sometimes ask you to take different perspectives. We ask you to respond as a therapist, but we will also ask you to put yourself in different positions or roles like that of a client, a colleague, a member of an ethics committee, a member of the public, and so forth. These perspectives will help you understand the complexity and uniqueness of psychotherapy and build your ethical sensitivity. Another example: We ask you to be aware of your potential tripping points—realizing that all human beings have them.
Most of our suggestions will be worded in such a way as to apply primarily to beginning therapists. However, we think practicing psychotherapists would do well to revisit this book on a regular basis. If you are an experienced therapist you can easily adapt the activities by thinking about the next stage of your career as a renewal or re-entry into a changing professional culture. But do not modify the activities too much! There is much to be gained from moving back a few steps and casting fresh eyes upon steps that we believe we have already covered.
Aspiration
In spite of the difficulties inherent in navigating your new mansion, we hope you see developing your ethical identity as a positive and personal venture rather than an alienating attempt to follow a disembodied set of rules (Handelsman et al., 2009). For example, it is important for psychotherapists to include the informed consent process in the first session and it is an unethical choice not to do so. However, sometimes new psychotherapists skip the informed consent process because they aren’t comfortable with talking about confidentiality and its limits. Other therapists skip it because they believe it detracts from building the relationship with clients. Although we understand these concerns, a more positive and aspirational perspective is honoring the client and their right to be truly informed and addressing the difficult questions that might come with limits to confidentiality. Avoidance of confidentiality issues and upfront conversations about the limits work against our desire to produce beneficial therapeutic outcomes and to act in clients’ best interests. Clients need to know what is promised and what is not promised in the therapy relationship.
Journal Entry: Chapter Reflections
Here is your first journal entry. We have posed some questions to help you reflect on this chapter:
How did you react to this first chapter?
What surprised you about what we said?
What parts of the chapter/discussion seemed to make the most sense and what parts were counterintuitive?
Did you find yourself getting defensive at anything we said? If yes, what?
What are you most looking forward to about this book: the mansion and its rooms, the spiral staircase? What are you least looking forward to?
This is a journal entry that you can repeat at the end of every chapter!
Food for Thought: Big Questions
Right now, take a few minutes and reflect on these big questions, which we will return to at various points in the book:
What do you see as important when it comes to ethics?
What do you think of when you think of “professional ethics”?
What you think professional ethics includes?
What is the relationship, as you think of it, between your personal morality and your professional ethics?
How do you see yourself in relationship to professional ethics?
What part does ethics play in your current and future professional identity?
What might be your ethical weak spots in your profession? What kind of mistakes might you make?
When are you—or might you be—not at your best when making ethical decisions? What happens at those times?
Coming Attractions
In Chapters 1 and 2 we ask you to think more about you and your background and how it might prepare you for your professional roles. In Chapter 3 we will discuss in more detail the process of acculturation and how to develop your professional identity. Readers who want a broad overview before getting into specifics may want to read Chapter 3 first.
1 Basics of Awareness Knowing Yourself and Your Core
Our dialogue with you in this chapter is about you. What have you noticed about you in the community comprising the mansion? What do you notice about you in the elegant mansion itself? What have you noticed about your curiosity regarding the many rooms? And what have you noticed about you and your climb up the spiral staircase thus far?
Our own ethics students are often surprised when they begin our courses by exploring (by writing and discussing) the question, “Who are you?” Some students initially respond with some variation of, “Well, I’m a student, a partner, a parent, a server at a restaurant, a retired service person.” These responses are about roles in life. They are important aspects of identity; however, they aren’t really about the students at their core. Then we push a little harder: “Who are you really?” Students begin to describe aspects of their character. For example, “I’m a nice person,” or I’m a curious person,” or “I’m a fixer.” Now we’re