Psychotherapy is most commonly conceptualized as one therapist and one client. However, the ethical challenges of multiperson therapies, such as couple, family, and group treatments, differ from those found in individual therapy. The multiplicity of relationships with the therapist and with each other is just one reason for this complexity. Often, the very processes that are the most powerful to create change in therapy with groups or families are also the most ethically risky ( Lakin, 1994 ).The most recent revision of the Ethical Principles and Code of Conduct (the Ethics Code; American Psychological Association [APA], 2010 ) has two standards specifi c to multiperson therapy, Standard 10.02, Therapy Involving Couples and Families, and Standard 10.03, Group Therapy. Standard 10.02 requires psychologists to identify which member(s) of a couple or family are the identifi ed client(s), as well as clarify the relationship and role the psychologist will have with each person. This standard also requires psychologists to modify or withdraw from potentially confl icting roles. Standard 10.03 states: "When psychologists provide services to several persons in a group setting, they describe at the outset the roles and responsibilities of all parties and the limits of confi dentiality" ( APA, 2010, p. 13 ). Thus, both group and family therapy place the therapist and the client in a unique role with a special set of responsibilities.However, the Ethics Code does not specifi cally address several areas that are especially problematic in family and group therapy. As a consequence, psychologists need to take the general standards of the Ethics Code and interpret them in light of overarching general principles to determine how to optimize ethical behavior in multiperson therapy. The emphasis on overarching ethical principals compels psychologists to focus on doing the very best they can to promote patient welfare and respect decision making. This chapter will focus on both the most common as well as the more subtle ethical problems in multiperson therapy including the following: competence, informed consent, collaterals, confi dentiality, domestic abuse, boundaries, combined individual and group therapy, record keeping, billing, and ethical issues with high-confl ict families.
COMPETENCECompetence is an important principle of ethically responsible practice, and competence in general is covered in detail in Volume 1, Chapter 6, this handbook. However, many practitioners tend to add group and/ or family therapy to other modalities for which they have been more adequately trained ( Lakin, 1994 ). This lack of training can lead to numerous problems related to the unique aspects of group therapy or using specifi c techniques in family therapy.
Family TherapyVarious theories and perspectives have developed specifi c to family therapy, such as systems theory, which practitioners should have mastered. In addition, certain techniques in family therapy require specialized training to use competently, such as family sculpting, communicat...