Ethical Therapy

When people are seeking therapy, it is often because they are feeling vulnerable in some way; they are struggling with anxiety, loss, confusion or a persistent difficulty managing their emotions. When you are feeling like this, you want to be able to trust that your therapist will do the right thing by you, and give you the help that you need. In Australia (and many other countries) psychologists must adhere to high ethical standards in their professional work, and they can lose their right to practice if they breach the Australian Psychological Society's Code of Ethics.

You can read the code of ethics in full here, so I have not reproduced it in detail, but instead have highlighted some of its provisions that may be relevant to people who are accessing therapy and feeling vulnerable.

The Code of Ethics is based on three broad principles that govern how psychologists must act professionally.

1. Respect for the rights and dignity of people and peoples; meaning that psychologists must ensure that people are treated justly, and with respect for their autonomy and independence.

This principle addresses a psychologist's obligation to be respectful of all individuals, provide informed consent when offering treatment, respect the privacy of clients and trainees, and honour reasonable requests by clients for release of information. Any personal information that is collected during psychological therapy remains confidential, unless the psychologist has concerns about harm to the person being treated or somebody else, or if the disclosure of that information is required by a legal process.

2. Propriety; meaning that psychologists must act to improve wellbeing and refrain from causing any harm to their clients, their profession and society as a whole.

This principle requires psychologists to practice within their areas of expertise and know the limits of their expertise, to accurately reflect the current state of research, and to use interventions appropriately. It also requires psychologists to maintain written records for 7 years following the completion of treatment, and until a minor is 25 years of age.

3. Integrity; meaning that psychologists must be of good character, and be worthy of the trust given to them in their professional roles.

This principle requires psychologists to be honest, and conduct themselves in a reputable manner in all their dealings, including how they advertise their services. Advertising must not include testimonials or be misleading in any way. There are specific provisions prohibiting the exploitation of employees or clients, and requiring honesty in financial dealings.

The binding guidelines of the APS Code of Ethics are designed to ensure that people who access psychological help in a state of vulnerability are offered effective treatment that improves their wellbeing.

Maintaining Healthy Boundaries

There is a concept of observing appropriate boundaries that is central to ethical therapy. As I have described in some detail when considering the therapeutic relationship, there are specific aspects of a person's relationship with their therapist that can make it seem like a personal relationship; we disclose a lot of personal information in therapy, that information is often the most emotionally intimate information we have. However, a therapeutic relationship is not a personal relationship, it is a relationship that is governed by very strict boundaries: you will have a contract, written or otherwise, that specifies:

  • where you meet your therapist
  • when your therapist is available to meet
  • how your therapist is available to meet (in person, by phone, email or video conference, etc...)
  • what specifically your therapist will be doing with you in your sessions
  • how your therapist is paid for their contact with you
  • what your therapist may do with the information they have about you

If your therapist proposes an intervention that involves physically touching you, you must provide written permission to be touched, and the form you sign should specify the means of touch and its specific purpose in your therapy.

These boundaries would feel constraining and unusual in a personal relationship, and they are there to maintain the difference between a personal and professional relationship. By observing these boundaries, the public's safety is maintained, despite the inevitable vulnerability of the person who is seeking assistance with their mental health.

If you notice that these boundaries are not being observed, you may need to consider your safety within the therapeutic relationship.

If you have concerns about the conduct of a psychologist, you may report it here: http://www.ahpra.gov.au/Notifications/Make-a-complaint.aspx