Informed Consent as a Framework for Treatment: Ethical and Therapeutic Considerations

Abstract

Significant changes in the nature of doctor-patient relationships have required more patient involvement in decision making and the therapeutic use of informed consent. Particularly in family therapy, open acknowledgment and discussion of potential hazards of psychotherapy not only establish trust, but also can deflect patients' resistance to therapy and strengthen their commitment to the therapeutic work. Three case reports of the successful use of "informed consent as a treatment strategy" are described.

Client Preferences for Informed Consent Information

“…Although some have expressed concern that consent procedures may hinder the therapeutic relationship (Faustrnan & Miller, 1987;Handelsman, Kemper, Kesson-Craig, McLain, & Johnsmd, 1986;Haut & Muehleman, 1986), decrease clients' confidence in therapists' potential helpfulness, and potentially cause a loss of clientele (Lewis, Davis, & Lesmeister, 1983), the promotion of autonomy and rational decision making is thought to enhance (Coyne & Widiger, 1978;Everstine et al, 1980;P. S. Jensen, Josephson, & Frey, 1989) and help define the relationship between client and therapist (Birch, 1990).…”

“…The client population may also indicate the need for a variability of disclosure. For example, the ethical problems, particularly in regard to confidentiality, that are posed in family therapy can affect multiple levels of individuals and families (P. S. Jensen et al, 1989;Miller, Scott, & Searight, 1990) and are different from those posed by inpatients (Lidz et al, 1984). The problems posed by minor clients, whose concerns about therapy are influenced by their developmental needs (Croxton, Churchill, & Fellin, 1988;Gustafson & McNamara, 1987;Kaser-Boyd, Adelman, & Taylor, 1984), are unique.…”

Informed consent bij psychotherapie

“…In (voornamelijk Amerikaanse) publicaties over psychotherapie en informed consent wordt het bereiken van informed consent dringend aanbevolen, niet alleen als ethische of wettelijke verplichting, maar vooral als middel om een betere patient involvement te verkrijgen (Coyne & Widiger, 1978;Everstine, Everstine, Heymann, True, Frey, Johnson & Seiden, 1980;Handelsman, Kemper, Kesson-Craig, McLain & Johnsrud, 1986;Jensen, Josephson & Frey, 1989;Jensen, McNamara & Gustafson, 1991). Deze aanbevelingen zijn echter nauwelijks wetenschappelijk onderbouwd.…”

Factors to consider in assessing adult litigants' complaints of childhood sexual abuse

“…Often, where novel and unvalidated therapeutic methods have been used to elicit memories, the therapist has not provided adequate informed consent for treatment procedures and/or did not exercise appropriate precautions in order to prevent possible harm (Hamilton & Ondrovik, 1993;Jensen, Josephson, & Frey, 1989).…”