Morality in Psychotherapy John D. Gavazzi, PsyD ABPP Samuel Knapp, EdD, ABPP ndividuals rarely, i!

ever, enter psychotherapy "ith the e#plicit $oals o! understandin$ the ori$ins o! their morality, their moral reasonin$ s%ills, or matchin$ their e#pressed moral ideals "ith their everyday &ehavior. 'onetheless, clients and psycholo$ists al"ays &rin$ their moral values into the psychotherapy session. Althou$h morality and moral values may not &e an overt part o! the therapeutic dialo$ue, many psychotherapy sessions are ri!e "ith moral issues, value(laden comments, ethical con!licts, and moral reasonin$. ! morality is seldom overtly addressed in psychotherapy, "hat ma%es morality so important to the practicin$ psycholo$ist) *ne reason !or this lac% o! emphasis stems !rom the idea that morality simply re!ers to +immoral,, +&ad,, or other inappropriate !orms o! &ehavior, "ithout considerin$ the &readth and depth o! morality "ithin the psychotherapeutic relationship. -his emphasis on the harm!ul aspects o! morality parallels the level o! ne$ativity and an#iety related to the "ord +ethics, in psychotherapy. .rom our perspective, psychotherapy is a moral enterprise, meanin$ that moral values run throu$h the avera$e, everyday interactions and discussions "ithin the psychotherapy session. -his article is the !irst in a !our(part series hi$hli$htin$ moral issues as a component o! psychotherapy. /hile these articles are not callin$ !or a novel or radical means o! conductin$ psychotherapy, "e hope that psycholo$ists providin$ psychotherapy "ill have a more re!ined lens to vie" "hat happens &et"een them and their patients. -his article "ill !ocus on some $eneral issues related to morality and psychotherapy.

Psychologists as Moral Agents with Moral Responsibilities The Pennsylvania Professional Psychologists Practice Act 0Act 123 re4uires applicant psycholo$ists to su&mit proo! that she5he is +o! accepta&le moral character., Althou$h Act 12 does not de!ine +accepta&le moral character,, the $eneral interpretation is the applicant demonstrates the &asic capacity to understand ri$ht !rom "ron$ in order to practice psycholo$y competently. Althou$h the State Board o! Psycholo$y may &e a&le to screen out applicants "ith serious character !la"s, the optimal practice o! psycholo$y re4uires more care!ul consideration o! moral issues. t is easy !or practicin$ psycholo$ists, "ith &usy lives and demandin$ practices, to !or$et the amount o! moral responsi&ility they have "hen treatin$ a patient in psychotherapy. Psychotherapy is !ounded on a !iduciary moral and ethical !rame"or% &et"een the psycholo$ist 0"ho is learned, s%illed and e#perienced in emotional su!!erin$3 and the patient 0"ho ordinarily %no"s less a&out psycholo$ical distress and treatment3. Based on this po"er im&alance, a psycholo$ist6s moral &elie!s can in!luence the course o! psychotherapy as "ell as the tra7ectory o! a patient6s li!e. -here!ore, psycholo$ists have an o&li$ation to &e a"are o! their moral values so that these do not unnecessarily inter!ere "ith a patient6s autonomy. Alon$ "ith respect !or patient autonomy, moral values in psychotherapy can &e !ound &roadly in the ethical principles o! &ene!icence, nonmale!icence, !idelity, and 7ustice. Psychotherapy as a Moral Enterprise At its most &asic level, psychotherapy can &e considered a moral activity &ecause it alleviates human su!!erin$ and promotes human "el!are. 8o"ever, the moral dynamics in psychotherapy move &eyond the psycholo$ist en$a$in$ in immoral or irresponsi&le &ehavior

"ith patients. Because o! the po"er im&alance inherent in the psychotherapy relationship, psycholo$ists remain responsi&le to evaluate their moral &elie! systems and to re!rain !rom imposin$ these moral values onto the patient6s thou$hts, &elie!s, stru$$les and con!licts 0e#cept in very limited circumstances such as "hen the li!e or sa!ety o! a third party is at ris%3. n other "ords, it is important !or psycholo$ists to help patients "or% throu$h their motivated moral reasonin$ or stru$$le "ith moral dilemmas rather than un"ittin$ly !oistin$ their +e#pert, value( laden opinion onto the patient6s li!e. /ithin the psychotherapy session, patients may as% their treatin$ psycholo$ists directly "hat they should do "ith a moral 4uandary. /hen this situation arises in psychotherapy, the treatin$ psycholo$ist ordinarily needs to avoid any type o! moral persuasion and to re!rain !rom $ivin$ a simple response to comple# moral dilemmas. A treatin$ psycholo$ist, "ho $ives the solution to a moral impasse, may decrease the tension in the room and temporarily reduce the patient6s su!!erin$. 'onetheless, &y actin$ as the patient6s moral compass, the psycholo$ist may also, un"ittin$ly, !oster dependence and hamper the patient6s sense o! autonomy, independence, and moral responsi&ility !or that decision and may potentially ta%e valua&le moral a$ency a"ay !rom the patient. /hen individuals ma%e the commitment to &ecome a psycholo$ist, they a$ree to en$a$e in moral &ehavior !or the &ene!it o! the patient. Moreover, the optimal practice o! psychotherapy re4uires psycholo$ists to understand their moral &elie! systems and to reco$nize that the process o! psychotherapy may involve helpin$ patients "or% throu$h moral predicaments themselves, rather than havin$ the psycholo$ists assume that role !or their patients. n this article, "e ar$ued that psycholo$ists operate "ithin a moral "orld "hen conductin$ psychotherapy. -he theme o! morality is not al"ays o&vious in the therapeutic

relationship. n order to &e e!!ective in psychotherapy, the psycholo$ists should not only &e !ree o! serious character !la"s 0have an +accepta&le moral character,3, they also need to %no" their moral &elie! systems and permit their patients to "or% throu$h moral challen$es. n !uture articles, "e "ill address more speci!ic areas o! morality in psychotherapy.