Transcript Ethical Issues in Psychotherapy

Ethical Issues in Psychotherapy
Punishment
Informed consent
Transference
Abreaction
Value systems
Psychoanalysis an hedonism
Punishment
• Reject psychotherapy as punishment
• Some neurotic px may perceive it as such
Punishment
• Penological reform by the court
– Decide first on the facts of criminal action
– Secondly: moral responsibility of the person
– * Moral freedom can be destroyed by mental
confusion
• Based on expert testimony from psychiatrist
– Should be directed to determining the defendant’s freedom
limited by the psychological factors
– Why the accused chronic or temporary psychological condition
did or did not render him so unfree
– Whether he cant be held responsible for the act
– If he is partially responsible, in what degree or in what respect
• It is unjust to punish someone for acts for
which he or she was not MORALLY responsible
• Role of the psychiatrist in the process of
punishment
– Limited to 2:
1. diagnose inmates who develop mental illness and thus
treatment
2. As consultants to penologists in setting up routines
that make good for mental health and discipline
Informed consent
• Issue of comptency
• Mentall disturbed pxs:
– Unable to understand the risk or purpose of
treament
– May not be truly free to make a decision
• Fear
• Masochistic tendecies (desire to suffer or to be
humiliated)
• Narcississm
Informed consent
• If impossible for the patients: patient’s
guardian with observance of legal process
• Treatment without consent:
– Must have the objective to bring the patient as as
soon as possible to the level of mental integration
• Use of drugs or psychosurgery
transference
• Primarily in therapy
• Termination of therapy: patient is sufficiently
autonomous and under self control
• Issue of responsibility by the therapist
– Must be trustworthy
– Maintain secrecy
– True concern for the px
– Prompt in appoinments
*avoid manipulating the patient for personal
gratification