Ethical Dilemmas in Psychotherapy: Positive Approaches to Decision Making

The authors outline a clear decision-making process that is based on three practical strategies: the ethics acculturation model to help therapists incorporate personal ethics into their professional roles; the quality enhancement model for dealing with high-risk patients who are potentially harmful; and ethical choice-making strategies to make the most ethical decision in a situation where two ethical principles conflict. Throughout the decision-making process, psychotherapists are encouraged to follow four basic guidelines: focus on overarching ethical principles; consider intuitive, emotional, and other nonrational factors; accept that some problems have elusive solutions; solicit input from colleagues and consultation groups. Numerous vignettes illustrate how to apply positive ethics to many different ethical challenges that psychotherapists will likely encounter in practice.