Ethics in the practice of psychotherapy: A survey

This survey was designed to obtain systematic data concerning the attitudes of psychotherapists toward various ethical issues. A 103-item questionnaire was developed and mailed to 203 practicing psychotherapists; 101 responded. Items focused on six areas: sexual contact, socialization, confidentiality, harm to third parties and patients themselves, encouraging life changes during therapy, and use of the media. Respondents were asked to indicate whether they considered the behaviors described to be Acceptable practice, Inappropriate, Unethical, or Grounds for Malpractice. Opinions about ethical standards varied greatly. Some clear differences emerged when respondents were divided by orientation into strictly psychoanalytic and 'other'. Psychoanalysis were more conservative in response to items concerning sexuality; the nonpsychoanalytic therapists were more conservative in other areas. When divided by years of experience, more experienced therapists tended to be more conservative regarding therapist-patient confidentiality than their less experienced colleagues. Lack of consensus over what constitutes ethical practice is interpreted in terms of lack of knowledge as well as in terms of disagreement over inherently complex and ambiguous issues.