Ethics in Psychotherapy and Counseling: A Practical Guide, 3rd ed.

December 1, 2007
David H. Brendel, MD, PhD
Volume 24, Issue 14

It is notoriously difficult to capture in writing the essence of what constitutes ethical practice in contemporary psychotherapy. Authors who take on this daunting task face the potential pit-falls of presenting their ideas in an abstract manner that bores the reader and is clinically irrelevant or risks coming across as overly moralistic and preachy.

by Kenneth S. Pope and Melba J. T. Vasquez;
San Francisco: Jossey-Bass, 2007
458 pages • $50.00 (hardcover)

It is notoriously difficult to capture in writing the essence of what constitutes ethical practice in contemporary psychotherapy. Authors who take on this daunting task face the potential pit-falls of presenting their ideas in an abstract manner that bores the reader and is clinically irrelevant or risks coming across as overly moralistic and preachy. It is little wonder that there are so few texts to which experienced therapists or trainees can turn when they seek reasonable and straightforward guidance about the values that underpin their practice. One such text is the third edition of Ethics in Psychotherapy and Counseling: A Practical Guide, which is authored by clinical psychologists Kenneth S. Pope and Melba J. T. Vasquez. Its message is as pertinent to practicing psychiatrists as it is to clinicians in the authors' discipline of psychology.

Pope and Vasquez present 7 fundamental assumptions that ground their well-reasoned, pragmatic approach: (1) they regard ethical reflection as an active and continuous process for therapists; (2) while acknowledging a legitimate role for ethical codes, they do not regard such codes as a substitute for clinicians' own creative and open-minded deliberation about cases; (3) they call on clinicians to avoid simple-mindedly adopting received wisdom and published findings and instead to ask hard questions about how general claims apply to specific patients; (4) they emphasize the need for clinicians to acknowledge and manage the inevitable fallibility they bring to their work; (5) they caution against questioning the ethics of others and judging them, urging us instead to continuously look within ourselves to clarify our values and how we are applying them clinically; (6) they encourage clinicians to reflect on and question values and assumptions they most take for granted; (7) they normalize therapists' experiences of finding themselves in ethical dilemmas, stating plainly that such dilemmas are an expected and manageable part of the work.

Armed with these 7 useful background assumptions, Pope and Vas-quez take the reader on an engaging and fascinating tour of the most pressing ethical challenges that confront professional therapists today. Among the concerns they address are consent, confidentiality, treatment of suicidal patients, and sexual and nonsexual boundary issues. They also consider how self-care, "emotional competence," and informal networks of professional colleagues can promote ethical practice. While the language in some of the text is overly colloquial and repetitive, in general, the writing is forthright, accessible, and jargon-free. The third edition of this admirable book fills a vital niche in clinical ethics for professional therapists, merits reading and rereading by practicing clinicians, and can serve as an excellent introduction to clinical ethics for therapists in training.