In my last blog, I touched on the relationship between practitioners in any psychological or talking therapy—this includes CBT, NLP, other talking therapies, and hypnotherapy—and their clients.
Perhaps the most important task a therapist has is to handle this relationship with care and take into account the vulnerability of the client. A client will often disclose things to their therapist that they have never shared with anyone before. The process of therapy can take the client to places where they experience great emotional pain and require support. There is also the well-known phenomenon of transference, where a client may develop strong and inappropriate feelings towards their therapist.
I do not intend to go through a checklist of dos and don’ts regarding ethics, as these can be easily found online. The British Psychological Society provides an extensive and clear list, for example: BPS Ethical Guidelines. If you are looking for a therapist, this guide can be helpful in choosing someone to assist you. It also offers insight into the psychological concepts and principles underpinning the practice of psychological therapies.
What I want to do here is to delve deeper and explore what underpins these ethical guidelines. This takes us to the heart of how the relationship between a client and their therapist should function for a positive and successful outcome.
Power Imbalance in Therapy
At the core of much of the ethical guidance is an acknowledgment of the power imbalance between the client and the therapist. The client typically has less knowledge of the therapeutic process, is grappling with their own challenges, and is investing their hard-earned money in seeking help. This creates significant responsibility for the therapist, who must ensure their knowledge is both extensive and sound while recognising the unique characteristics of each client—whether cultural, psychological, behavioural, financial, or something else.
The therapist must also work within the ethical guidelines of their profession. Every profession has an ethical code which should be publicly accessible.
Transparency and Flexibility
Therapists must be transparent about what influences their approach. For instance, they should disclose the methodologies and theories they are using. Being open to adapting or changing methods to better support the client is equally important. For example, if a particular method proves ineffective for a client, the therapist may need to adjust their approach or even recommend another professional if they feel they cannot help.
Confidentiality and Its Limits
Clients have a right to confidentiality from their therapist. However, there are challenging areas here. Ethical considerations may require therapists to disclose certain issues—for example, if a client is suicidal or self-harming, or if they pose a threat to others. It is crucial that these broad exceptions are clearly communicated to clients before therapy begins.
Striving for Ethical Practice
It might seem that being ethically sound requires therapists to be perfect—but of course, no one is flawless. However, therapists can aim for—and clients have a right to expect—an open, critical, and reflective attitude where biases are recognised and limitations acknowledged. Experienced therapists are often accustomed to this process but may still find it challenging at times. Many believe that constant updating, ongoing training and good supervision are essential for maintaining ethical practice.
The Role of Supervision
The importance of supervision cannot be overstated in a therapist’s professional life. Supervision involves meeting with another professional in the same field to discuss and reflect on practice. It serves as a safeguard for ethical and safe practice, facilitates skill development and knowledge acquisition, protects therapists from burnout, and helps them avoid working beyond their competencies or qualifications.
Supervision also addresses countertransference—a phenomenon where therapists confuse their own emotions with those of their clients—which can otherwise compromise therapy outcomes.
Ethical Decision-Making Models
A robust ethical decision-making process is essential for practitioners. Effective models should include:
- A clear description of the problem
- Allocation of responsibility for solutions
- A critique of possible solutions
This critique should evaluate how solutions align with professional ethical codes, public perception, fairness, and protection for vulnerable clients. Finally, it should incorporate processes for assessing the success of solutions and learning from outcomes—whether successful or not.
Documentation: A Tool for Learning
Though documentation may sound dull, it is invaluable—not only as protection against complaints but also as a learning tool for therapists themselves. Documentation can highlight areas of success or failure by revealing which client interactions were effective and which were not.
While such records must remain confidential, clients may feel reassured knowing that their therapist keeps clear, honest, and complete records of interventions—indicating professionalism.
We will be returning to this area later in the series. If you are following the series please keep what I have said here in mind, and search out more if you feel inclined. I do aim to make sure that ethical principles underpin everything I write and everything I do.
Contact Me
I hope this overview has clarified some key ethical issues in psychological practice. Feel free to reach out with any questions or let me know if there are topics you’d like me to explore further.
Coming Next
Next time I will begin a short series on Cognitive Processes and Hypnosis; we’ll start with an in-depth examination of attention, focus, and suggestibility. See you then!