Ethical Dilemmas in the Treatment of Battered Women in Individual Psychotherapy: Analysis of the Beneficence Versus Autonomy Polemic

Abstract

The purpo.se of this article is (o explore the ethical dilemmas inherent in the Ireatment of women currently in abusive relationships. Utilizing ethical decision-making models, the conflicting principles of beneficence and autonomy are discussed with regards to whether a therapist should encourage a client to leave an abusive relationship. Given that most ethical decision-making models stress the importance of contextual factors that are relevant to a given ethical situation, this article discusses the importance of evaluating, considering, and weighing certain factors, such as abuse severity and competency/rationality, in cases involving intimate partner violence,. Following this discussion, recommendations and implications for research and policy are delineated.

Leaving an Abusive Dating Relationship

“…For example, given that attitudes toward leaving one’s partner were the strongest correlate of intentions to leave one’s partner (which subsequently predicted actual leaving behavior), it may be important for a therapist to explore with women the factors that shape their attitudes toward leaving or not leaving an abusive partner. However, the extent to which a therapist directly or indirectly encourages a client to terminate an abusive relationship is a controversial topic (Edwards, Merrill, Desai, & McNamara, 2008). In addition, given that greater perceived social pressure to leave one’s partner was positively associated with intentions to leave one’s partner, it is important to educate others—especially other college students as they are the most likely source of their friends’ disclosures (Edwards et al, 2012)—on how to respond to the disclosure of IPV.…”

College Women’s Stay/Leave Decisions in Abusive Dating Relationships: A Prospective Analysis of an Expanded Investment Model

“…When discussing the clinical implications of women's stay/leave decisions, it is important to note that therapists' encouragement regarding the stay/leave process with abused women is a controversial topic (see Edwards, Merrill, Desai, & MacNamara, 2008, for a discussion). Whereas therapists consider many variables in their conceptualization and treatment of women in abusive relationships, ultimately it is the client's decision whether she stays or leaves.…”

Ethical decision making in mental health contexts: Representative models and an organizational framework.

“…These publications are found not only in psychology journals, but also in social work, marriage and family therapy, behavioral science, and counseling journals. A number of publications address specifi c challenges when serving clients who have faced such issues as (a) domestic violence or battered women (e.g., Edwards, Merrill, Desai, & McNamara, 2008 ;Koenig, Rinfrette, & Lutz, 2006 ), (b) end-of-life care (e.g., Werth, 2002 ), (c) geriatric neuropsychology (e.g., Martin & Bush, 2008 ), and (d) HIV and AIDS. There also have been models or guidelines developed for serving clients within specifi c contexts, such as (a) religious communities (e.g., Hill & Mamalakis, 2001 ), (b) managed care (e.g., Belar, 2000 ;Tjelveit, 2000 ;Younggren, 2000 ), (c) child clinical psychology (e.g., Mannheim et al, 2002 ), (d) outpatient care ( Truscott, Evans, & Mansell, 1995 ), and (e) play therapy ( Seymour & Rubin, 2006 ).…”