Registered Australian Psychologists' Responses to Ethical Dilemmas Regarding Medicare Funding of Their Services

Politis, Athena Natalie; Knowles, Ann

doi:10.1111/ap.12014

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…It is important to interpret the results of this study while considering its limitations. Firstly, although the present methods of data collection have been successful in recruiting psychologist samples in previous research (Duncan et al, 2013;Politis and Knowles, 2013), it is likely that the majority of individuals who were contacted to take part in the study declined to participate. Therefore, the extent to which results can be generalized to all therapists is unclear.…”

Section: Discussionmentioning

confidence: 96%

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Therapist beliefs about exposure therapy implementation

Meyer

Kelly

Deacon³

2020

tCBT

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Exposure therapy is consistently indicated as the first-line treatment for anxiety-related disorders. Unfortunately, therapists often deliver exposure therapy in an overly cautious, less effective manner, characterized by using their own ‘therapist safety behaviours’. Cognitive behavioural models postulate that beliefs about therapist safety behaviours are related to their use; however, little is known about the beliefs therapists hold regarding therapist safety behaviour use. The present study aimed to identify the beliefs exposure therapists have regarding the necessity of therapist safety behaviours and to examine the relationship between this construct and therapist safety behaviour use. Australian psychologists (n = 98) completed an online survey that included existing measures of therapist safety behaviour use, therapist negative beliefs about exposure therapy, likelihood to exclude anxious clients from exposure therapy, and use of intensifying exposure techniques. Participants also completed the Exposure Implementation Beliefs Scale (EIBS), a measure created for the present study which assesses beliefs regarding the necessity of therapist safety behaviours. Beliefs about the necessity of therapist safety behaviours – particularly in protecting the client – significantly predicted therapist safety behaviour use. Findings suggest that exposure therapy training media should aim to decrease therapist safety behaviour use by addressing beliefs about the necessity of therapist safety behaviours, especially in protecting the client. Key learning aims (1) To understand what therapist safety behaviours are in the context of exposure therapy. (2) To identify common beliefs about therapist safety behaviours. (3) To understand how beliefs about therapist safety behaviours relate to therapist safety behaviour use. (4) To consider how exposure therapy delivery may be improved by modifying beliefs about therapist safety behaviours. (5) To explore how beliefs about therapist safety behaviours may be modified to reduce therapist safety behaviour use.

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Section: Discussionmentioning

confidence: 96%

“…and so on. Previous studies have been successful in recruiting participants using both of these techniques simultaneously (Duncan et al, 2013;Politis and Knowles, 2013). Unfortunately, a response rate could not be calculated, as it is unknown how many individuals were notified of the survey.…”

Section: Methodsmentioning

confidence: 99%

Therapist beliefs about exposure therapy implementation

Meyer

Kelly

Deacon³

2020

tCBT

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“…The original questionnaire describing three exemplary clinical and ethical dilemmas (short case presentations) combined with a multiple-choice questionnaire containing recommended solutions to the presented dilemmas was used. Other authors have also used the short case study method in studies investigating ethical issues (Bhola et al, 2015;Coverdale et al, 1997;Politis and Knowles, 2013). The original version of the questionnaire survey was drawn up by Anna Bogatyńska-Kucharska.…”

Section: Questionnairementioning

confidence: 99%

Paternalism and autonomy: psychotherapists’ choices in dilemmas and their justifications as ethical aspects of the therapeutic relationship

Bogatyńska-Kucharska¹,

Kucharski²,

Jabłoński³

2023

Psychiatr Psychol Klin

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Aim: The aim of the study was to analyse solutions to ethical dilemmas based on the criterion of “paternalism-autonomism” in the context of psychotherapists’ professional experience and therapeutic modality. Another aim was to review the sources of choices of ethical decisions from the perspective of the “intuitiveness – ethical reflection” dichotomy, and to assess the percentage of ethical, ambiguous, and non-ethical justifications of solutions preferred in those ethical dilemmas. Method: It was a cross-sectional qualitative study. An original questionnaire describing three exemplary clinical and ethical dilemmas combined with a multiplechoice questionnaire containing recommended solutions to the presented dilemmas was employed in the study. The responses were correlated with the modality of psychotherapy (cognitive-behavioural, psychoanalytic-psychodynamic, psychodynamic-systemic, systemic, integrated) and the professional experience of therapists. The statistical analysis included questionnaires obtained from 191 respondents. Results: Statistical data indicate the general advantage of autonomous decisions in the entire group of therapists, regardless of their professional experience. A significant advantage of autonomic solutions over paternalistic solutions was demonstrated in all analysed therapeutic approaches with the exception of the cognitive-behavioural approach. Moreover, a statistically significant majority of psychotherapists reported the use of ethical reflection when choosing the solutions to the discussed dilemmas. A comparison of the total number of selected justifications revealed a significant advantage of ethical justifications over ambiguous and non-ethical ones, regardless of the professional experience of therapists and in all modalities except the psychoanalytic-psychodynamic and psychodynamic-systemic types. Conclusions: The principle of respect for autonomy plays an important role in the professional ethics of psychotherapists, and the preference for ethical considerations and justifications when choosing solutions to practical ethical dilemmas indicates a potential benefit of incorporating ethics into the professional training of therapists.

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“…Clinician ethical dilemmas regarding patients with suicidal thoughts are less discussed -most publications being practitioner opinion surveys (15,16). Prominent clinician dilemmas are confidentiality concerns, limited direct care of patients with suicidal thoughts, and clouding of personal and professional domains (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Ethical dilemmas encountered in suicide research and management: Experiences of young mental health professionals

Bhasin¹,

Bharadwaj²,

Beniwal³

et al. 2021

IJME

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This study aimed to explore ethical dilemmas and challenges faced by young mental healthcare researchers and professionals working with survivors of suicide (hereinafter suicide survivors). Two focus group discussions (FGDs) Researcher FGD (with those engaged in suicide research) and Clinician FGD (with those providing treatment to suicide survivors) – consisting of open-ended questions and lasting for 70-90 minutes were conducted and analysed using Thematic Analysis. Five themes were identified: i) struggling with the incongruity of harm within benefit, ii) difficulty in delineating boundaries, iii) self-doubt in one’s professional competence, iv) nature of suicide straining the limits of confidentiality, and v) working with structural limitations. The study helps to understand the obstacles and dilemmas encountered in adhering to ethical principles while working with vulnerable individuals.

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Registered Australian Psychologists' Responses to Ethical Dilemmas Regarding Medicare Funding of Their Services

Cited by 4 publications

References 33 publications

Therapist beliefs about exposure therapy implementation

Therapist beliefs about exposure therapy implementation

Paternalism and autonomy: psychotherapists’ choices in dilemmas and their justifications as ethical aspects of the therapeutic relationship

Ethical dilemmas encountered in suicide research and management: Experiences of young mental health professionals

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