In Chapter Eight, which is titled “Ethical Dimensions of the Techniques, Strategies, and Processes of Therapy: Which Means to Therapeutic Ends?” Tjeltveit explores the ethical contours of what actually happens during the “50-minute hour.” These include the therapeutic relationship, specific techniques and methods, diagnosis, ways in which people change, and so on. Tjeltveit says each of these components of therapy have an ethical dimension and should be explored.
Do the ends justify the means? If so, you might be an ethical teleologist. Do you prefer to look at the means themselves? If so, you may be an ethical deontologist. Do you focus on therapist/client ethical characteristics, such as prudence? Then you may be a virtue ethicist when it comes to therapy processes. Tjeltveit then looks at five change processes: education, corrective emotional experiences, self-liberation, counterconditioning, and reevaluation. He wants psychotherapists to evaluate each of these five common change processes for their ethical dimensions. He turns his attention to overlapping aspects of the psychotherapy process, including preserving client autonomy, a non-manipulative therapist-client relationship, choice of therapy goals, and recognizing the potential influence on the client by the therapist. He distinguishes inappropriate from appropriate ethical influence, seeing a kind of paternalism as inappropriate, while informing clients of the ethical dimensions of not only therapy but also of their presenting concerns, so that they are making truly informed and autonomous decisions.
For reflection: How ought psychotherapists communicate their ethical views to clients? Do both psychotherapists and clients function as ethicists?