In Chapter 6 Tjeltveit discusses “the intellectual contexts of psychotherapy.” He argues that psychotherapy is necessarily rooted in ethics precisely because the goals of therapy involve aiding clients in living better lives. The implicit (if not explicit) assumption is that some ways of living are better than other ways of living. This is a similar critique to those who have addressed this concern from an explicitly Christian worldview, such as Jones and Butman’s Modern Psychotherapies and Robert Roberts’ Taking the Word to Heart. In other words, it has been argued that each model of therapy provides a “map” for getting from one place (disorder, dysfunction, etc.) to another (health, improved functioning, etc.). But these are more than just ways to get from “here” to “there”; they are theories with assumptions about what is wrong and what is right – including assumptions about what better ways to live and relate to others and understand oneself.
In any case, Tjeltveit goes on to discuss “old” and “new” psychology and the contributions of each to ethical contours in therapy. He then discusses the perspective of those who think psychotherapists essentially strive to base decisions on science alone in responding to ethical issues. He has a great quote from Beutler (1989, p. 4):
Our mentors have implied, if not overtly said, that if it only were possible surgically to remove the therapist’s values, he or she would be a more effective clinician. In the greatest of therapeutic paradoxes, a valueless clinician is valued. (p. 111)
Tjeltveit unpacks a number of issues, and he reasons that “The scientific context of psychotherapy has both shaped and obscured psychotherapy’s ethical dimensions in a variety of ways” (p. 130). But we have erred on the side of avoiding “ethical discourse” based upon our current “understandings of science” (p. 130). Tjeltveit sees both science and ethics as interrelated in part because scientists themselves necessarily rely upon ethics in so many facets of their work. For the author the ability to reflect on ethics is helpful in part because scientists can then either decide to reduce the influence of those values or recognize and use specific values more intentionally (or “wisely”) as he puts it (p. 128).
For reflection: In what ways is your approach to (or practice of) psychotherapy based upon science? In what ways is your approach to (or practice of) psychotherapy based upon ethics? How do you experience these as related?