Specialist Department for the Prevention of Eating Disorders, University Hospital Bern, Bern, Switzerland.
Department of Psychology, University of Bern, Bern, Switzerland.
BMC Med Ethics. 2021 Nov 12;22(1):150. doi: 10.1186/s12910-021-00718-z.
The legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists' attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.
155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent.
Among the surveyed psychotherapists, there was a high consensus on important information that should be communicated to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists' age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.
The present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective.
心理专业协会的法律和伦理准则规定，患者的知情同意是心理治疗的一个基本前提。尽管人们已经意识到知情同意的重要性，但关于心理治疗师对知情同意的态度以及知情同意在心理治疗实践中是如何实施的，实证证据却很少。
瑞士的 155 名心理治疗师完成了一项在线调查，评估他们对知情同意的态度。
在所调查的心理治疗师中，对于知情同意背景下应向患者传达的重要信息，存在高度共识。几乎所有的心理治疗师都认为保密性及其豁免（95%）和自主决策（97%）很重要。披露有关费用的信息以及所提供治疗的经验有效性，被超过 80%的参与者视为重要。披露关于治疗师个人信息的重要性，也被 60%的人认为是重要的。其他方面，虽然不是知情同意的直接组成部分，但也是全面的目标，也得到了相当一致的评价：患者的自主决策几乎被所有接受调查的心理治疗师（97%）视为重要。以下几个方面也被大多数参与者认为是重要的：促进希望（80%）和讨论治疗目标（93%）。大多数心理治疗师将知情同意的实施描述为一个持续的过程，而不是治疗的第一次会谈中的一次性事件。治疗师的年龄、研究生培训、治疗的患者群体和治疗环境影响了他们对知情同意的态度。
本研究表明，知情同意被心理治疗师视为既是一种挑战，也是一种资源。从临床和伦理的角度来看，心理治疗中的知情同意实施需要进一步研究。
