ETHICS COMMITTEE COMMON ISSUES IN COUPLES THERAPYEthics Committee Common Issues in Couples Therapy Alfredo E. Crespo, Ph.D.
In offering couples therapy, psychologists are routinely challenged by ethical issues for which a careful review of the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (2002) (hereinafter “Ethics Code”) proves especially pertinent. Section 10.02 of the Ethics Code specifically concerns providing therapy to couples and families. This section provides that psychologists “take reasonable steps to clarify at the outset (1) which of the individuals are clients/patients and (2) the relationship the psychologist will have with each person.” In couples therapy, it needs to be emphasized that although both participants are clients/patients, the issues to be addressed in the therapy will primarily concern the relationship between those two clients/patients. Further, the psychologist, pursuant to Section 4.02(b) of the Ethics Code, which is entitled ”Discussing the Limits of Confidentiality,” also comes into play with couples therapy. This section provides that psychologists will discuss with their clients/patients “(1) the relevant limits of confidentiality and (2) the foreseeable uses of the information generated” through the therapy sessions. In particular, the psychologist should discuss his or her policy concerning secrets a partner may want to keep from the absent partner. Though secrets couples keep from another are often benign and do not invite collusion by the therapist with one partner, especially troubling disclosures in individual meetings, for example, a secret marital affair, especially if it is current, may place the therapist in a difficult position and impede neutrality that the couples therapist role requires. See also Principle C regarding the integrity of psychologists’ activities. An unfortunately too common and very “real world” ethical problem that is often minimized is the potential of couples therapy sessions to increase the risk of Domestic Violence among partners. In oversimplified terms, the emotions and thoughts that may be “stirred up” by the couples therapy could lead one or both partners to become angry or even to act violently. This possibility is resolved by invoking Code Section 10.01 concerning Informed Consent. This section requires psychologists to discuss “as early as is feasible in the therapeutic relationship” the proposed course of therapy, as well as the potential risks involved and the alternatives that are available. Though couples therapy may pose ethical challenges beyond those encountered in rendering individual therapy, and which may be more complicated by the nature of the difficult presenting problems that bring couples into therapy, clinicians who apply the Ethics Code not only model but also ensure the integrity of the process. Such ethical practices can by themselves be of benefit to distressed couples seeking to improve the quality of their relationship. |