Ethics for Psychologists sets out to provide a background to ethics at teaching and practice level. It has a practical orientation and an easy to follow format. Each chapter is summarised briefly at the beginning and important points are highlighted at the end. There is also a quick reference compendium comprising the third section of the book which allows ethical issues to be easily accessed. Its advantage is that it is not a specialist book, it has a clear structure and a comprehensive feel to it. Well written, it gives life to a potentially dry subject. However the scope of the book is such that it merely offers tasters to the subject matter, perhaps trying to do a little too much. Although covering a wide range of issues, problematic areas tend to be skimmed over and simplified. Ethics for Psychologists is aimed at the psychologist working both in private practice and for institutions such as the NHS and business and voluntary sectors. It covers every area of psychology embracing the needs of clinical, counselling and organisational psychologists. Again there is an admirable amount of ground covered, yet at times it feels as though important issues are simplified or alternative perspectives are not given because of the breadth of material. Fewer issues given greater depth may have been preferable.
Francis describes ethics as enlightened self-interest, a form of risk management. This sets the tone for the book. Although the needs of the client are addressed (he takes time to determine who the client is, when the client ceases to be a client etc.), the author frequently refers to the rights of the psychologist. This is useful inasmuch they can often be overlooked, ethical dilemmas are addressed and a positive spin is placed on solving them rather than defending or blaming one party or the other. He seeks to promote fairness and balance.
The intention of ethics is noted, the need to act in an ethical spirit is conveyed and the value of self-regulating bodies are summed up. The book delves into the problems of achieving a wide, i.e. European, standard when so many differences abound. He notes the problems with chartership, the difficulties of protecting the title rather than the practice, and the parallels between other professions.
In the latter half of the book clear advice is given about the disclosure of information regarding clients. He groups together a number of topics such as releasing information that has been gleaned from psychometric testing to disclosure of intent to harm self and/or others. He pays lip service to the issue of privacy versus the need to protect. The advice fails to note the complexity or the disparity between certain examples like disclosure of childhood sexual abuse and disclosure of test results. Although there are statutory guidelines and most professional bodies offer an ethical code on disclosure it is rarely straightforward. It is difficult to differentiate the rights and privacy of the client while honouring Duty of Care, a conflict of interest can occur. He does note the need to be aware of due process and offers ways of solving difficult ethical issues such as seeking advice from other professionals. However the grey areas are not explored in a substantial way.
In van Deurzen's book Existential Counselling in Practice (1988) a good example for the potential of conflict of interest is raised when she worked with a client who was hitting her child. The client was in therapy prior to the Children Act (1989). Under the Children Act (1989) she would have been bound to report such action, however will the knowledge of the investigating social worker she was able to maintain full confidentiality. It is rare that confidentiality and legal duty can be easily balanced, difficult decisions may have to be made alone by the practitioner in private practice. The conflict of interest between protecting the client and other vulnerable parties is not an easy matter for anyone. There is considerable literature and policy documents available to all Health Care Professionals (including psychologists), confidential helplines and substantial peer supervision. Psychotherapists in private practice do not always have this level of support which can lead to the individual making very difficult decisions alone or with limited access to supervision.
The topic is somewhat glossed over in the book. It would have been valuable to have a greater debate on the issue of privacy versus the need to protect. A clear comment on the legal position of one's Duty of Care would also have been desirable. This issue is complex and is somewhat simplified by the book indicating that protection of the vulnerable party is always advisable. However determining the level of risk is crucial and often very difficult to do. It stresses the need to act honourably, "do no harm" yet the complexity of the issues are not adequately debated. To do no harm to one party may involve jeopardising the safety of another. By choosing not to disclose the therapist may inadvertently become an accessory to abuse or a crime. By informing the client of one's Duty of Care the therapist may find that the client restricts information which would otherwise have been crucial to the therapy. The book fails to acknowledge how grey this area can be.
As a teaching aid the book is invaluable, offering a number of other references and further reading. It also highlights the most contentious areas, offers solutions to dilemmas and notes the need of any ethical code to evolve. It is useful for providing initial instances for debate, a wealth of pertinent references and pays attention for the need for due process when attempting to solve ethical dilemmas.
It will be extremely useful to assist the experienced therapist, but it is not a definitive text. To be fair it did not set itself up as such, although the Compendium of Ethical Issues can be read to offer advice and detail on solving ethical issues and dilemmas. Its limits need to be made more explicit. It is one approach not a definitive guide to solving ethical problems. It does however give a well written, readable account of many of the ethical dilemmas that face psychologists, much of which can be transferred to psychotherapists of any orientation working either privately or for an organisation.
Claire John
Children Act (1989). HMSO.
Deurzen, E. van. (1988). Existential Counselling in Practice. Sage Publications.