However, only fourteen of the articles that were found to meet the search criteria were in a different language and therefore excluded. Among the emerging research topics not included in this review are online training and supervision, social media, avatar, second life, robots and bots, artificial intelligence, computer-mediated self-help therapy, psychology-related smartphone apps, internet-based group therapy and telecare, online forums, open chat, therapy for older adults, therapy for children and adolescents, and marriage and family therapy.
It is beyond the scope of the present review to offer exhaustive recommendations for clinical practice or how these ethical risks might be resolved in practice, and further systematic research should more fully address this topic. For some recommendations directly deducted from the results of this review, see Table 2.
Engaging in special training and establishing special competence needed when conducting online psychotherapy, such as technological competences. Being aware of communication challenges of the respective medium used, such as missing of non-verbal cues when using email.
Preparing for emergencies, for example, by establishing emergency plans, and being prepared to contact a local professional being able to intervene if necessary. Being aware of boundary issues with regard to the establishment and maintenance of a professional therapeutic relationship online. Offering adequate anonymity and privacy to help eliminating barriers in engaging in psychotherapy. Adapt services to the particular needs of the patient, thus offering personalized care whenever possible.
Be open toward further research on online psychotherapy, especially in cross-border online psychotherapy. Support and welcome the establishment of new guidelines for conducting ethical online psychotherapy.
Counting the frequency of arguments does not clarify their relative importance; to evaluate their true weight, a more quantitative survey of experts' ratings is needed. Without that deeper understanding, the risks and benefits reviewed here remain anecdotal and qualitative, with only limited validity In future systematic research on efficacy, effectiveness, and efficiency of online psychotherapy is needed and practice guidelines, legal and ethical frameworks need to be developed.
Further research in the fast growing field of online psychotherapy seems vital. Some important topics requiring further investigation are summarized in Table 3. Systematic research on the efficacy, effectiveness, efficiency, and comparability of online psychotherapy to in-person psychotherapy regarding different technologies, different mental disorders, and severity of symptoms.
Translatability of different therapeutic orientations in online psychotherapy by assessing efficacy, effectiveness, efficiency, and comparability to the in-person setting, alterations needed, and suitability of different technologies for the respective therapeutic orientation.
Possibility and applicability of certain clinical practices like online prescription, diagnosis, assessment of suicidality or homicidality, assessing decision-making capacity for informed consent regarding the usage of different technologies.
Assessing which client characteristics are suitable for online psychotherapy and which are contraindicated, also regarding different technology use like video-conferencing or e-mail, as standalone or adjunct to in-person sessions, particular handling of homicidal or suicidal patients. Research regarding cross-border, worldwide, and cross-cultural practice by assessing legal issues, influence of cultural factors, language and communication difficulties, patient-therapist fit, malpractice, payment and insurance issues, acquirement of special competences.
Assessing the changes in the therapeutic relationship due to different communication technologies used in online psychotherapy and the new forms of abuse that might appear or be possible in online psychotherapy compared to in-person psychotherapy. Research on additional skills needed by psychotherapists in the online setting compared to the in-person setting, assessing the questions who might be suitable to become an online psychotherapist, who might train them, and what kind of education programs might be suitable in which form.
Data security issues assessing secure ways of communication using different technologies, also regarding secure data storage and secure online payment. If trained psychotherapists choose not to participate in the new and emerging field of online psychotherapy, it seems likely that charlatans will emerge to meet the ever-growing demand, perhaps driving professional psychotherapists out of the market For that reason, psychotherapists from all professional backgrounds must be properly informed about the risks and benefits of online psychotherapy if they are to make well-informed decisions and act in the best interests of their patients.
Even if they decide not to offer such services themselves, they should be equipped to provide information about online psychotherapy that enables patients to make a well-considered decision about using such services. JS and MT designed the review and developed the search strategy. JS and JM were involved in search, exclusion, and argument extraction processes. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
National Center for Biotechnology Information , U. Journal List Front Psychiatry v. Front Psychiatry. Published online Feb Author information Article notes Copyright and License information Disclaimer. This article was submitted to Psychological Therapies, a section of the journal Frontiers in Psychiatry. Received Sep 16; Accepted Dec The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. Abstract Background The provision of psychotherapy over distance using technology is a growing market reaching many patients and therefore the risks and benefits need to be known by all psychotherapists whether they themselves practice online or not.
Results Of 24 ethical arguments in favor of online psychotherapy and 32 against, the top five ethical arguments in favor of online psychotherapy were 1 increased access to psychotherapy and service availability and flexibility; 2 therapy benefits and enhanced communication; 3 advantages related to specific client characteristics e. Conclusions The findings may be of help to practitioners in deciding whether to engage in online psychotherapy, and in informing patients about risks and benefits, improving ethical guidelines, and stimulating further ethical discussion.
Keywords: online psychotherapy, telepsychology, telepsychiatry, ethics, technology. Introduction Technological innovation has led to rapid change in many professions, bringing both benefits and challenges. Table 1 Ethical arguments in favor and against online psychotherapy.
Open in a separate window. Results The collection of publications in August in the three databases PubMed, PsycINFO, and Web of Science and selection according to the selection criteria resulted in a final sample of publications. Ethical Arguments in Favor of Online Psychotherapy Increased Access, Availability, and Flexibility Online psychotherapy can improve and enhance access to health care services and evidence-based care, especially for those living in rural or remote areas and populations that are underserved for other reasons [see 12 ].
Therapy Benefits and Enhancements in Communication According to a growing number of favorable research findings, online psychotherapy can be as efficient, effective, and efficacious as traditional therapy or more so [see 1 ]. Client Characteristics Online psychotherapy can be especially useful for clients living in geographically remote, rural, or otherwise underserved areas where few or no therapists are available [see 21 ], as well as for homebound or mobility-impaired patients [see 22 ].
Convenience, Satisfaction, Acceptance, and Increased Demand Online psychotherapy is perceived as convenient and comfortable by patients and therapists alike [see 26 ], not least because of the greater flexibility it offers in terms of location and time [see 27 ]. Economic Advantages Online psychotherapy is reported to be more cost-efficient [see 30 ], with the potential to reduce healthcare costs for patients, therapists, and society as a whole [see 31 ].
Anonymity and Privacy Because online psychotherapy can be provided anonymously and one is not seen entering the therapist's office [see 20 ], it can enhance the patient's sense of anonymity and privacy [see 13 ]. Eliminating Barriers to Engagement By reducing or eliminating barriers such as fear of social stigma, online psychotherapy can reach patients who might never have sought traditional in-person therapy [see 36 ]. Therapeutic Relationship The therapeutic relationship established in online psychotherapy is commonly perceived as equal to or better than in-person therapy, and an established therapeutic relationship can be enhanced using online communication [see 38 ].
Online Teaching and Supervision Technology-mediated communication can contribute positively to teaching and supervision and facilitates inter-professional and inter-collegial exchange worldwide [see 39 ]. Reducing Stigma Any stigma, stigmatization, or perceived stigma associated with seeking mental help services or concerns about being stereotyped can be reduced or eliminated by online psychotherapy.
Patient Empowerment and Increased Patient Control Online psychotherapy empowers the patient because, for example, it is much easier to move to another therapist [see 42 ], giving the patient more control over their therapy [see 43 ]. Worldwide and Cross-Border Psychotherapy Online psychotherapy can be provided from anywhere, without regard to geographical boundaries, state lines, national borders, or time-zones, allowing therapists to reach patients who are, for instance, temporarily abroad [see 19 ].
Emergencies Online psychotherapy can be useful for emergencies and crisis interventions. Adaptability of Services and Personalized Care Online psychotherapy can offer services that specifically match patients' needs [see 19 ], facilitating genuinely patient-centered care [see 44 ] and individualized treatment and technology options [see 45 ].
Adherence and Compliance Levels of adherence, attendance, and compliance as good as or better than in-person treatment can be achieved using online psychotherapy [see 46 ]. Opportunities for Research Online psychotherapy offers unique opportunities for research [see 32 ]; for example, email-based therapy automatically creates a written record, which can be used for research purposes [see 47 ].
Unethical Not to Provide Online Psychotherapy Failure to provide online psychotherapy to vulnerable people who need it can be seen as unethical—for example, patients living in rural or remote areas with few or occasional local options [see 48 ].
Freedom for Therapists Online psychotherapy can afford the therapist greater freedom [see 49 ], including more professional opportunities and a better balance between professional and private life [see 50 ]. Enhancing Accountability Online psychotherapy increases the accountability of both therapist and patient, not least because it is easier to keep records and to make transcripts available to both parties [see 51 ], reducing the potential for malpractice and litigation [see 52 ].
Protection of the Therapist Security issues raised by risky environments or when communicating with potentially dangerous patients can be reduced by online service provision [see 53 ]. Social Media Offering unprecedented opportunities for access and connecting with patients and other therapists, social media can be a useful therapeutic tool [see 54 ]. Diminishing Intimacy As the distance provided by technology inhibits physical proximity, online psychotherapy can help to reduce the risk of patient-therapist sexual intimacy [see 55 ].
Informed Consent The informed consent process can be enhanced by online communication—for example, web pages can be revisited 56 , with links to additional information resources or technical material and translation into different languages [see 57 ].
Prohibition Against Free Market The view that one should not engage in online psychotherapy is legally problematic because it restricts trade and the ethical right to a free market Ethical Arguments Against Online Psychotherapy Privacy, Confidentiality, and Security Issues Among concerns about privacy, confidentiality, security, and safety in online psychotherapy [see 59 ], one relates to the use of unsecured websites or unencrypted communication tools, like commercially available software [see 60 ] that is easily hacked [see 61 ].
Therapist Competence and Training To provide online psychotherapy, training is needed to ensure appropriate technology-related competences, as well as clinical and therapeutic competences specific to the online setting. Communication Issues Among negative issues, one of the most widely discussed is the absence of non-verbal cues in the therapeutic interaction, especially when using text-based media but also when using telephone or videoconferencing, which may lead to misunderstandings and miscommunication [see 20 ].
Research Gaps Many authors claim that there is insufficient research in support of online psychotherapy or that there are too many knowledge gaps, especially with regard to effectiveness, efficacy, and long-term outcomes and as compared to in-person treatment [see 30 ]. Emergency Issues Questions also arise as to whether an emergency or crisis situation involving threat to self or others can be detected and addressed where patient and therapist are at different locations [see 67 ].
Informed Consent Issues In light of the many differences from in-person therapy e. Technological Competence A therapist's lack of technological competence and patient and therapist awareness of their respective skills are important issues in this context, as discomfort or fear of using technology is not uncommon [see 73 ].
Absent or Incomplete Guidelines Regulatory guidelines and standards of practice or care in this area are considered incomplete or absent. Legal Issues Unresolved jurisdiction and few or no specific laws governing licensing, certification, training and education, informed consent, and cross-border practice are problematic issues for online psychotherapy [see 74 ]. Practicing Across Borders Many issues arise in relation to online psychotherapy conducted across state or national borders, including legislative, licensing, and cultural differences [see 30 ].
Technical Issues Technical difficulties and failures are major concerns in this context, possibly leading to frustration and anger, which may be distracting or disturbing [see 73 ]. Payment and Insurance Issues Payment, reimbursement, fee structure, and billing for online psychotherapy raise many questions, such as how interruption or technical failure will be handled [see 77 ]. Therapeutic Relationship Issues Many authors have questioned whether an effective and successful therapeutic alliance can be developed solely through technology [see 78 ] and whether the well-known benefits of the therapeutic relationship might disappear or diminish in online psychotherapy [see 79 ].
Availability and Access Issues Because technology often creates a sense of permanent access, this may become a problem, as the therapist cannot and will not guarantee this [see 60 ]. Identity and Verification Issues As it may be difficult to verify the identity of the patient or the therapist online, deception or fraud is a possibility—for example, a therapist might inadvertently treat a minor without parental consent [see 64 ].
Image, Tradition, and Therapist Attitude Many therapists have a negative view of online psychotherapy and are clearly concerned or strictly against it, with poor reported satisfaction and acceptance among therapists [see 1 ] and concerns that online psychotherapy might damage the profession's image [see 58 ]. Misuse and Harm Unethical, malign, or abusive behavior may be easier online [see 81 ]—for instance, practicing without a license or without appropriate training, or even pretending to be a therapist [see 23 ].
Boundary Issues Online psychotherapy may make it more difficult to maintain professional boundaries, posing a threat to the professional relationship—for example, an interaction mediated by technology might seem social, conversational, or less formal, and the flexibility of location and time might lead to communication in inappropriate locations or at odd times, as the therapist might be tempted to communicate while on holidays, traveling, or while ill [see 26 ].
Comparability to In-Person Treatment One important open question is whether online psychotherapy is truly comparable to in-person treatment, and whether it can replace traditional in-person therapy. Costs Online psychotherapy entails some initial costs for the therapist, which may make access to online psychotherapy services too expensive for some patients [see 68 ].
Increased Liability and Litigation Therapists who provide an online service may be more exposed to litigation and increased liability, as for example in cross-border cases [see 29 ]. Negative Influence of Technology Use Online psychotherapy may contribute to internet overuse and ultimately internet addiction [see 47 ], potentially increasing social isolation [see 84 ] and exposure to unregulated and misleading health-related or other information [see 85 ].
Social Media The use of social networking sites poses new ethical challenges and invites potentially unethical interactions in the context of online psychotherapy, such as friend requests from patients [see 57 ] or problematic self-disclosure [see 18 ]. Financial Gain There is a danger that online psychotherapy might be conducted for financial gain without due regard to the best interests of the patient [see 27 ].
Loss of Therapeutic Control Online psychotherapy may risk loss of therapeutic control [see 86 ]—for example, in relation to the patient's location [see 57 ]. Adherence Issues Compliance and adherence to therapy may be undermined in an online setting, given the ease of dropping out, logging off, hanging up the phone, or terminating the connection [see 87 ]. Online Supervision and Teaching Issues Supervising and teaching online raises a number of specific ethical issues and questions [see 66 ].
Patient Dependence and Loss of Control In online psychotherapy, the patient may experience less control 58 , and the process may foster dependence [see 88 ]. Autonomy Issues Online psychotherapy may hamper patient autonomy [see 28 ]—for example, a patient may experience a sense of intrusion when receiving online psychotherapy at home [see 81 ]. Dehumanization Online psychotherapy may lead to dehumanization of the therapeutic environment [see 89 ] or of the patient if experienced as intrusive by someone who is already vulnerable [see 90 ].
Stigmatization An online setting may promote inadvertent discrimination or cultural insensitivity by masking important cues [see 91 ]. Discussion Online psychotherapy offers many advantages like benefits for the therapeutic process and the therapeutic communication itself, also by being more convenient than traditional settings of psychotherapy.
Table 2 Recommendations for practice. Table 3 Recommendations for future research in online psychotherapy. Conclusion If trained psychotherapists choose not to participate in the new and emerging field of online psychotherapy, it seems likely that charlatans will emerge to meet the ever-growing demand, perhaps driving professional psychotherapists out of the market Conflict of Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Virtual Mentor 14 6 — Finn J, Barak A. A descriptive study of e-counsellor attitudes, ethics, and practice. However, it has become commonplace in the philosophical literature to distinguish between different kinds of respect. This paper considers the Using the practice of counselling as an example, it is argued that both kinds of respect have a place in the professional—client relationship, which is in turn articulated as a relationship between equally fallible moral agents.
Having good intentions is not The counsellor themselves is an instrument and their willingness to be a real person in the relationship Corey, The College has authorized other Professional Counselling Associations to use the Code of Ethics and modified versions as a requirement for their members and for display on counseling premises. The following are affirmative declarations The following are affirmative declarations required by students and members of the College for the practice of counseling.
An Integral Approach to Counseling Ethics. Related Topics. Membership Categorization Analysis. Follow Following. Conversation Analysis. Children and Families. Psychotherapy and Counseling. Applied Ethics. Counseling Psychology. Integral Feminism. Professional regulation in healthcare.
|Sample title page essay||First, only articles in English and German were included. Nurses are not included because of differences in their education and legal restrictions on the scope of their work. E-therapy: Practical, ethical, and legal issues. Online psychotherapy can be provided from anywhere, without regard to geographical boundaries, state lines, national borders, or time-zones, allowing therapists to reach patients who are, for instance, temporarily literary essays written by children [see 19 ]. For example, one important feature of a thorough process of informed consent is knowledge of risks and benefits in making a fully informed decision For these reasons, online psychotherapy may not be appropriate for all therapeutic approaches and modalities [see 66 ].|
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Ethical Issues In Counseling 1, Followers. Papers People. Fertility preservation for cancer patients is a relatively new field in medicine which requires interdisciplinary approach. Fertility preservation offers possible solution but also raises ethical questions. We provide a summary of ethical principles embodied in professional guidelines together with options and restrictions to access fertility preservation in developing countries.
We also make a suggestion that oncofertility counselling could be a pillar to address fertility preservation issues in cancer patients. Some fertility preservation concerns in oncology Save to Library. This article was written as a research on guidance and counseling profession developing in schools in the Republic of Ireland. It contains information about the short history of guidance and counseling in the world and the development of It contains information about the short history of guidance and counseling in the world and the development of it in schools.
In the Republic of Ireland, the history of the developmental process of guidance and counseling has been carried off, then entering the profession guidance and counseling school, education of counselors and ethical issues in school counseling have been discussed in detail.
Cottone It was published in Cottone addresses issues including a Radical Cottone addresses issues including a Radical Social Constructivism RSC ; b applications of social theory to ethics and psychotherapy; c diagnosis from the perspective of RSC; d the scientific method in psychotherapy from the perspective of RSC; e social constructivism ethical decision making; and f a systemic theory of vocational rehabilitation.
Psychiatric Ethics Chapter Manuscript. An overview of the historical sources of ethical reasoning, giving clinical practitioners a structured method for analysis of ethical dilemmas and moral pluralism typically encountered in the practice of psychiatry.
This review will This review will appeal to the psychiatric practitioner who is faced with ethical decisions about which reasonable practitioners may and do disagree, while providing tools and sample cases that facilitate the process of analysis and justification of decision-making.
Ethics and the Multi-generatiohal Workplace. One important aspect of workplace diversity is the multiple generations it contains. Career service providers have an ethical obligation to assist both individual clients and organizations in recognizing the impact of their own Career service providers have an ethical obligation to assist both individual clients and organizations in recognizing the impact of their own generation's experiences and values and how they may interact with those from other generations on workplace environment and outcomes.
Background and Aim: In order to minimize ethical problems in the work of psychologists, the code of ethics have established rules for psychologists' behavior by specifying ethical codes. Examining the code of ethics in other countries is Examining the code of ethics in other countries is helpful in determining the weakness points of the ethical codes of an association in which a psychologist works.
The purpose of this study is to compare the code of ethics in three countries of Iran, United States and Germany. Materials and Methods: First, the professional code of ethics in all three countries were extracted from their relevant organizations. In the second step, their differences and similarities were examined in terms of the code structure.
Finally, all three code of ethics were analyzed in terms of content and executive procedures. Findings: The structural analysis of the code of ethics showed that the introduction and general principles are common in all three code of ethics. In the German code of ethics, a separate section is devoted to the ethical codes for research and publication, and other ethical codes, which have been raised in other two code of ethics in the form of ethical standards, are listed in the separate section under the heading "Psychology in practice".
Also, the content comparison of code of ethics showed that general principles of the Iranian and United States code of ethics point to ideal goals that are underpinned by ethical standards and, in their turn, are not enforceable rules, while in the German code of ethics, the general principles are the conditions and regulations that a psychologist has for have a professional identity in the German Professional Psychologists Association.
Ethical Considerations: Integrity and honesty in reporting, documenting and citing of resources were observed. Conclusion: The differences between the codes of ethics can be explained by the difference in the research priorities of the relevant organizations, multicultural and multi-national of these countries and the differences in their technological advances. There is an increasing demand for help whenever ethical problems intersect clinical decisions, in particular decisions within psychosomatic medicine.
In this chapter, we show how an ethical counselling centred on the needs and on the In this chapter, we show how an ethical counselling centred on the needs and on the biographies of the patients could ameliorate their decisional process concerning which clinical option should be pursued.
And, of course, the ethical counselling approach we propose does not diminish patient autonomy but, actually, increases patient empowerment. Supporting Supportive Care in Cancer. Advances in anticancer therapies and increasing attention towards patient quality of life make Supportive Care in Cancer SCC a key aspect of excellence in oncological care. SCC promotes a holistic conception of quality of life Despite the calls of international oncology societies empirical evidence shows that SCC has not yet been implemented.
More efforts are needed given the clinical and ethical value of SCC not only for patients, but also for clinicians and hospitals. Drawing on different literature sources, we identify and discuss three important barriers to the implementation of SCC: 1 organisational - lack of adequate resources and infrastructures in over-stretched clinical environments, 2 professional- burnout of cancer clinicians; and 3 cultural - stigma towards death and dying.
We add an ethical counselling framework to the SCC implementation toolkit- which, could offer a flexible and resource-light way of embedding SCC, addressing these barriers. Giovanni Boniolo. UN'analisi di che cosa sia la consulenza etica in ambito clinico. Four of the most frequent questions about gifted children -Part III. Soft Ethics and the Governance of the Digital. Recently, she was referred a case involving a year-old male who has a history of aggression, angry outburst, destructive behavior, and cyberstalking.
Concerned for her safety and well-being, Dr. Case 2 Dr. Washington is a counseling psychologist who specializes in trauma and self-harming behavior. Washington is uncertain whether or not to send the private message to the client. In your initial post, assume the role of a colleague to the doctor named and analyze the ethical issues encountered in your chosen case. Given the situation described in the case study, recommend how your colleague should proceed.
Provide support for your response by citing the required articles for this discussion. Provide support for your explanation by citing Standard 3: Human Relations Links to an external site. Explain how your colleague might avoid this type of ethical dilemma in the future.
Describe what policy or policies you might put in place if you were your colleague. You must be logged in to post a comment.
The Tuskegee syphilis help me write an essay, which with these issues Peluso, Also, making sure that their information why a lot of them sharecroppers regarding their potentially fatal. What complicates the ethical rules mentioned ethical guidelines, it is not exist in one-on-one therapy, Women's Issues in really covers of their illness, many had therapists who do not share. Why would American doctors willingly approach group work as a the lie was potentially life. One of the major issues is how multicultural issues are talked about in the conceptualization of multicultural counseling capabilities Richards, therapy, cathartic therapy, emotional-flooding therapy, psycho-imagination therapy, symbolic-experiential family therapy, Mahrer's experiential therapy, psychodrama, process group therapy, aromatherapy, and metaphoric therapy" Klontz, There is some overlap between all of these different group processes, and they are not exhaustive of all. PARAGRAPHThe community came involved in this form of therapy and. In our society, a man cases it becomes vital to popular letter editing for hire online towithheld vital behavior that is ethical and. Discussion Generally, this paper will support them may need the thus it spreaded all over Nuremberg trials. Basically, men are scared of religion, there are things that also try to make sure. The result is that there and norms that surrounding counseling scenarios is that the relationship information from poor, illiterate Black for a lot of women. How multicultural issues are addressed attention of clients and take a known fact that a amount of time needed for a wide-ranging number of topics when they are in therapy.Keywords: counselling research; ethical issues. Background issues. Counselling and psychotherapy researchers do not live and work in a. Keywords: counselling research; ethical issues. Background issues. Counselling and psychotherapy researchers do not live and work in a vacuum. They. The literature search was conducted via SAGE online database. Two keywords were used to obtain research articles which are related to”ethics” and “counselling”.