Bhola Poornima, Sinha Ananya, Sonkar Suruchi, Raguram Ahalya
Associate Professor, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore 560 029 INDIA,.
Senior Research Fellow, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore 560 029 INDIA,.
Indian J Med Ethics. 2015 Oct-Dec;12(4):206-12. doi: 10.20529/IJME.2015.055. Epub 2015 Aug 12.
Ethical dilemmas are inevitable during psychotherapeutic interactions, and these complexities and challenges may be magnified during the training phase. The experience of ethical dilemmas in the arena of therapy and the methods of resolving these dilemmas were examined among 35 clinical psychologists in training, through an anonymous and confidential online survey. The trainees' responses to four open-ended questions on any one ethical dilemma encountered during therapy were analysed, using thematic content analysis. The results highlighted that the salient ethical dilemmas related to confidentiality and boundary issues. The trainees also raised ethical questions regarding therapist competence, the beneficence and non-maleficence of therapeutic actions, and client autonomy. Fifty-seven per cent of the trainees reported that the dilemmas were resolved adequately, the prominent methods of resolution being supervision or consultation and guidance from professional ethical guidelines. The trainees felt that the professional codes had certain limitations as far as the effective resolution of ethical dilemmas was concerned. The findings indicate the need to strengthen training and supervision methodologies and professional ethics codes for psychotherapists and counsellors in India.
在心理治疗互动过程中，伦理困境不可避免，而且在培训阶段，这些复杂性和挑战可能会被放大。通过一项匿名且保密的在线调查，对35名临床心理学实习生在治疗领域遇到伦理困境的经历以及解决这些困境的方法进行了研究。采用主题内容分析法，分析了实习生对关于治疗期间遇到的任何一个伦理困境的四个开放式问题的回答。结果突出表明，突出的伦理困境与保密和边界问题有关。实习生还提出了有关治疗师能力、治疗行为的善举和不伤害原则以及来访者自主权的伦理问题。57%的实习生报告称，这些困境得到了充分解决，主要的解决方法是督导或咨询以及专业伦理准则的指导。实习生们认为，就有效解决伦理困境而言，专业准则存在一定局限性。研究结果表明，有必要加强印度心理治疗师和咨询师的培训及督导方法以及职业道德准则。
