Ethics and Values in Psychotherapy – 1

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In our Ethics course this spring we are reading Ethics and Values in Psychotherapy by Alan Tjeltveit. We recently discussed the first couple of chapters. Here’s a brief summary.

Tjeltveit’s thesis is that psychotherapy is value-laden; that it is invariably value-laden. In the opening two chapters he lays this out and in chapter one, especially, identifies competing views. Here they are:

  • Psychotherapy is inconsequentially value-laden
  • Psychotherapy involves only mental health values
  • Clients alone should choose therapy values
  • Psychotherapy ought to be based on science, not values
  • It is meaningless to claim that values or ethical assertions in psychotherapy can be true or correct
  • Psychotherapy is not value-free. So what?

He unpacks the meaning of each competing claim and then points out the difficulties inherent in that claim. For instance, the claim that Psychotherapy is inconsequentially value-laden makes the assertion that, yes, the psychotherapist could say to a client, “You should honor your marriage vow and return to your spouse and fulfill your responsibilities to your children” (p. 3). But what do most psychotherapists actually do? They say something like, “Sounds like you’re really feeling sad. How long has this been going on?” (p. 4). Tjeltveit’s response is to say is such a response really neutral? Or are their implicit values in responses we commonly identify as neutral?

His thesis is that psychotherapy is value-laden and that therapy – all therapy – necessarily involves goals that are value-laden. Goals reflect commitments to values and an ethical theory (at least an implicit one), and Tjeltveit reasons that  it can be helpful to reflect on ethical convictions and theories.

For reflection: What do you make of Tjeltveit’s thesis? What are your thougths about the competing views? More Tjeltveit to come!

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