The inescapably ethical character of psychotherapy.

Abstract

Many psychologists are aware of the ethical and inescapably valueladen nature of psychotherapy (cf., Kurtines, Azmitia, & Gewirtz, 1992). Research has demonstrated that case conceptualization, treatment intervention decisions, and therapy goals are all grounded from the outset in a guiding framework of values and broader ethical assumptions. Despite this awareness about values, however, much confusion persists about the nature and management of values in practice. Alan Tjeltveit's (1999) seminal work, Ethics and Values in Psychotherapy, seeks to address such questions among many others. Tjeltveit's fine book is one of the first works to comprehensively integrate the research regarding values inescapability with broader ethical theory and philosophy and its potential impact on psychology.In his extensive review, Tjeltveit explores the meaning of "psychotherapist as ethicist," the varied definitions of values, the relationship between science and ethics, the ethical nature of therapy goals and practice, and implications of these issues for public philosophy and professional ethics (p. 18). Tjeltveit notes that the ethical nature of psychotherapy has long been marginalized, and hence, rarely discussed. He argues that one reason for this marginalization has been psychology's commitment to the ideals of natural science. Such a commitment encourages "objectivity" and a "sole focus on scientific knowledge (interpreted as ethically neutral)" (p. 113). In other words, psychologists are supposed to be led by scientific and objective "facts" that have been freed from the biasing influence of things like subjective values. Indeed, in the realm of psychotherapy, such values are often presumed to distort and cloud the therapist's view of the client. Hence, maintaining an objective, and therefore value-free stance toward clients is often considered superior.In addition to psychology's commitment to this vision of science, a second hindrance to the explicit discussion of psychology's ethical character concerns the language of personality and psychotherapy theory. According to the author, such language "masks" the inherently ethical dimensions of the theories (p. 33). Tjeltveit explains that therapists use words like "healthy, 'well adjusted,' 'appropriate,' 'mature,' and 'rational,' -words that are not only descriptive, but evaluative, and therefore ethical (p. 33). Such terms describe what psychothera-This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.