Practitioner Reflections on Sex Offender Treatment in Remote Communities.

PURPOSE OF REVIEW: We offer reflections on practitioner service provision for sex offenders when working in remote communities. The social ecological model framework is used to capture the influence on practitioner working at an individual, relationship, community, and societal level. RECENT FINDINGS: The social construction and geographic conditions of sexual offending within remote communities present myriad challenges for professionals working in these isolative settings in which they are embedded. Challenges include being the sole expert in a community, unavoidable dual relationships, community anxieties, and restrictive guidelines and assessment measures. Despite the challenges presented to practitioners operating in remote communities, many opportunities are available for building local and international peer relationships, connecting with the community, individualized treatment for clients, and flexibility in the adaptation of best practice to fit the needs of remote communities while maintaining ethical integrity.

Research Ethics for Behavior Analysts in Practice.

Behavior analysts in practice have an advantage over many others in the helping professions-they have at their disposal a robust science of behavior change informed primarily by single-case experimental research designs. This is advantageous because the research literature is focused on individual behavior change and has direct relevance to behavior analysts who need to change the behavior of individuals in need. Also, the same experimental designs used to advance the basic and applied sciences can be used to evaluate and refine specific procedures as they are put into practice. Thus, behavior-analytic research and practice are often intertwined. However, when behavior analysts in practice conduct research and use their own clients as participants, several important ethical issues need to be considered. Research with human participants is subject to careful ethical oversight, but the ethical guidelines that have been developed are usually described in terms of research conducted by nonpractitioners working in universities or institutions. This article focuses on several areas of special concern when conducting research in practice settings, including dual relationships and conflicts of interest, obtaining informed consent, and using ethical review panels.

Examining dual roles in long-term-care homes in rural Alberta: a qualitative study.

INTRODUCTION: In rural settings, many healthcare professionals experience intersections of professional and personal relationships, often known as dual roles. Dual roles are traditionally studied in terms of their potential for ethical conflicts or negative effects on care. In the existing scholarship, there is little discussion of dual roles in long-term care (LTC) settings, which present distinct conditions for care. Unlike other forms of health care, LTC work is provided daily, over longer periods, in care recipients' home environments. This article outlines results from a case study of LTC in rural Alberta, Canada and provides evidence of some of the challenges and, more notably, the considerable benefits of dual roles in these settings. METHODS: The qualitative data discussed in this article come from a multi-site comparative case study of rural LTC that, among other questions, asked, 'How do personal and professional lives intersect in rural LTC settings across the province?' These data were collected through the use of rapid ethnographies at three rural LTC homes across the province of Alberta. The research team conducted semi-structured, in-depth interviews (n=90) and field observations (~200 hours). Participants were asked about care team dynamics, the organization of care work, the role of the LTC home in the community, and the intersections of public and private lives. The results were coded and critically analyzed using thematic analysis. RESULTS: Dual roles were primarily described as beneficial for care provision. In many cases, dual roles provided participants with opportunities for reciprocity, enhanced person-centered care, and increased perceptions of trust and community accountability. Similar to what has been documented in the extant literature, dual roles also presented some challenges regarding personal and professional boundaries for those in leadership. However, the negative examples were outweighed by positive accounts of how dual roles can serve as a potential asset of rural LTC. CONCLUSION: There is a need for more nuanced conversations around the implications of dual roles. Policies and care approaches need to emphasize and support the use of good judgment and the responsible navigation of dual roles, rather than taking either a permissive or prohibitive approach. Leaders in rural LTC can promote conversations among care providers, with an emphasis on the cultural context of care provision and how dual roles play out in their specific professional practice. Blanket policies or educational approaches that frame dual roles as necessarily problematic are not only insensitive to the unique nature of rural LTC, but prohibitive of relational elements that these results suggest are highly supportive of person-centered care.

Psychotherapists' attitudes to intimate and informal behaviour towards clients.

BACKGROUND: To avoid harming or exploiting a client, sexual and non-sexual dual relationship is generally considered as unacceptable in the psychotherapeutic relationship. However, little is known about what therapists themselves constitute as (un)acceptable intimate and informal behaviour (IIB). METHODS: A survey among psychotherapists in Flanders (Belgium) was conducted. Opinions about the acceptability of IIB were asked. Based on these opinions attitude groups could be determined. RESULTS: In total, 786 therapists completed and returned the questionnaire (response rate: 39.8%). Therapists could be divided into three attitude groups. Almost half of the therapists belonged to the 'rather restrictive group', a third to the 'rather socially permissive group' and a fifth to the 'rather sexually permissive group'. Being categorised as 'rather sexually permissive' is predominantly related to being male and non-heterosexual, whereas being 'rather restrictive' or 'rather socially permissive' is mainly due to the type of psychotherapy training. The 'rather sexually permissive' therapists more often found a client sexually attractive during the last year and fantasised more often about a romantic relationship with a client, but they did not more often started a sexual relationship. CONCLUSIONS: Most therapists in Flanders are rather restrictive in their attitude to IIB, pointing to a high sense of morality. Having a rather sexually permissive attitude is predominantly related to more personal characteristics of the therapists, but these therapists did not start a sexual relationship more often.

Ethical behaviour of physicians and psychologists: similarities and differences.

OBJECTIVE: To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas. POPULATION: 88 clinical psychologists and 149 family physicians in Israel. METHOD: Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical. The vignettes were presented to both family physicians and clinical psychologists. RESULTS: Psychologists' aggregated mean ethical intention score, as compared with the physicians, was found to be significantly higher (F(6, 232)=22.44, p<0.001, η2=0.37). Psychologists showed higher ethical intent for two dilemmas: issues of payment (they would continue treating a non-paying patient while physicians would not) and dual relationships (they would avoid treating the son of a colleague). In the other four vignettes, psychologists and physicians responded in much the same way. The highest ethical intent scores for both psychologists and physicians were for confidentiality and a colleague's inappropriate practice due to personal problems. CONCLUSIONS: Responses to the dilemmas by physicians and psychologists can be categorised into two groups: (1) similar behaviours on the part of both professions when confronting dilemmas concerning confidentiality, inappropriate practice due to personal problems, improper professional conduct and academic issues and (2) different behaviours when confronting either payment issues or dual relationships.

Ethical issues surrounding counselors' use of social media / 中国心理卫生杂志

Objective:To understand counselors' use of social media from the perspective of clients, and find the relevant ethical issues. Methods: The questionnaire of how clients regarding counselors'use of social media was made as evaluation tool. Totally 434 valid questionnaires were received, including 86 males and 348 females, aged (36 ±7) years. Results: Almost 51.6％ of the clients got information of counseling and counselors through social media, and 35.9％ received online counseling through social media. Several ethical issues existed. Counselors didn't make informed consent with clients, which included the confidentiality, security and real identity about online counseling issues. Clients and counselors added WeChat or QQ friends and interacted with each other outside the counseling process. This situation led to multiple relations. Counselors' personal exposure in their social media negatively impressed clients. Counselors had over propaganda or clients'privacy expose during advertising or training through social media. Conclusion: Counselors' using social media for counseling involve many ethical issues. The confidentiality and multiple relations are more complex and subtle due to Internet features. The ethical issue of counselors' self-exposure in personal social media particularly requires being noticed.

Ethical Issues Pertaining to Forensic Assessments in Mental Capacity Proceedings: Reflections from South Africa.

Within the context of South African criminal law, the defence of pathological criminal incapacity, or more commonly referred to as the insanity defence, is well established. Whenever the insanity defence is invoked, the Criminal Procedure Act 1977 ('CPA') provides that an accused shall be referred for observation at a mental institution. Such observation will essentially be conducted by three forensic psychiatrists and one clinical psychologist. Within this context various ethical issues come into play. One of the primary issues relates to the confidentiality of statements made by an accused during such observation. In terms of section 79(7) of the CPA, statements made by an accused during the enquiry into his or her criminal incapacity may be admissible during the subsequent trial, provided that they are relevant to the assessment and determination of the accused's mental state. The latter section necessarily raises various ethical and constitutional concerns. The focus of this article is on the ethical dilemma of confidentiality within the context of mental capacity proceedings. Dual relationships, bias and 'hired gun' experts are also discussed canvassed against the backdrop of the defence of pathological criminal incapacity. Recommendations for possible reform are provided in conjunction with a proposed ethical code of conduct for mental health professionals conducting forensic assessments during the course of mental capacity proceedings.

Counselors' and therapists' interpersonal personality and ethical behavior in dual relationship / 中国心理卫生杂志

Objective:To investigate the relation of counselors'and therapists'interpersonal personality on the ethical behavior of dual relationship.Methods:Totally 177 practitioners (21-65 years old) were investigated with 4 interpersonal personality subscales of the Chinese Personality Inventory (CPAI) and the Questionnaire of the attitude of counselors to the ethical behavior of dual relationship.Results:There were no differences of 4 dimension of interpersonal personality on the 6 items of professional relationship between higher and lower groups (Ps ＞ 0.05),but on the other 5 types of dual relations respectively,there were 6 (9％),10 (15％),12 (18％) and 21 items'(32％) score showing statistically difference (Ps ＜ 0.05).Furthermore,more items had score difference on social relationship.Conclusion:It suggests that the counselors'and therapists'interpersonal personality may be related to the ethical behavior in dual relationship.

A Multi-Center Survey on Dual Relationships and Associated Factors among Chinese Counselors and Psychotherapists / 中国医学伦理学

Objective: To explore the dual relationships and associated factors among Chinese counselors and psychotherapists.Methods: 1000 participants were investigated by a self-made questionnaire composed of ethical problems in psychotherapy and counseling.Results: The main dual relationships between counselors/psychotherapists and clients were the association of friends.Thirty-two percent of participants provided counseling or psychotherapy to their friends.To the item of "providing counseling or psychotherapy for their friends,students,supervisee,employees",the judges of ethical beliefs of participants were inconsistent,and forty-one percent of them thought that such behaviors were ethical.These items were the main associated factors,such as gender,the duration time of professional experience,the title of a technical post,the different experience of training,prescription,and medicine.Conclusion: The present state of nonsexual dual relationships between counselors/psychotherapists and clients are not rare,and the ethical beliefs of some participants in dual relationships were blurring.It is necessary to intensify the professional education,unify the ethical code,and accept the help of psychotherapy and supervision,in order to improve the current states of Chinese counselors and psychotherapists.