Gerger Heike, Nascimento Antje Frey, Locher Cosima, Gaab Jens, Trachsel Manuel
Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
Department of General Practice, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Front Psychiatry. 2020 Jun 2;11:406. doi: 10.3389/fpsyt.2020.00406. eCollection 2020.
The evidence-based practice movement clearly defines the relevant components of a good treatment. In the present article, we elaborate on how the active involvement of patients within psychotherapy can and should be increased in order to respect ethical considerations. Our arguments complement the requirements of evidence-based practice, and are independent of the actual psychotherapeutic treatment approach being used.
Theoretical and ethical analysis.
In order to respect patient autonomy, psychotherapy needs to be transparent and honest when it comes to disclosing the relevant factors for promoting therapeutic change. It has been argued that ethical informed consent needs to include empirically supported patient information. In this paper we go one step further: we outline that fully respecting ethical considerations in psychotherapeutic treatment necessarily calls for acknowledging and strengthening the active role of patients in the course of psychotherapy. Accordingly, patients need not only to be informed openly and transparently about the planned treatment, the treatment rationale, and the expected prognosis of improvement in the course of psychotherapy, but they also need to be actively involved in the decision-making process and during the entire process of psychotherapeutic treatment.
Our arguments support the tendency that can be observed in health care in recent years towards more active patient involvement across different health-care domains, but also in clinical research. This article offers an ethical perspective on the question what defines a 'good psychotherapy', which, hopefully, will help to leave behind some of the ongoing psychotherapy debates and move the field forward.
循证实践运动明确界定了良好治疗的相关组成部分。在本文中,我们阐述了如何能够且应该增加患者在心理治疗中的积极参与度,以尊重伦理考量。我们的观点补充了循证实践的要求,且独立于所采用的实际心理治疗方法。
理论与伦理分析。
为尊重患者自主权,心理治疗在披露促进治疗改变的相关因素时需要保持透明和诚实。有人认为,符合伦理的知情同意需要包含经实证支持的患者信息。在本文中,我们更进一步:我们概述了在心理治疗中充分尊重伦理考量必然要求承认并加强患者在心理治疗过程中的积极作用。因此,患者不仅需要被公开透明地告知心理治疗过程中的计划治疗、治疗原理以及预期的改善预后,而且他们还需要积极参与决策过程以及整个心理治疗过程。
我们的观点支持近年来在医疗保健领域可以观察到的一种趋势,即患者在不同医疗保健领域以及临床研究中都有更积极的参与。本文就“什么是良好的心理治疗”这一问题提供了一种伦理视角,希望这将有助于摒弃一些正在进行的心理治疗辩论,并推动该领域向前发展。