Further, they utilize case law and provide practice recommendation so that each
client’s confidentiality may be optimally preserved.
Gerald Koocher, in his article entitled ‘‘Ethical Challenges in Mental Health
Services to Children and Families,’’ expands on consent and confidentiality as they
specifically apply to clinical work with minors and their families. Koocher applies the
4-C model—competence, consent, confidentiality, and congruence of interests—
when children and their parents participate in or set goals for psychotherapy. His
article addresses the unique challenges that confront psychotherapists who must
balance competing interests of children and their parents. Koocher provides
thoughtful analyses of these most frequent dilemmas and offers practical
recommendations to help prevent ethical lapses.
Samuel Knapp and Leon VandeCreek then address the ‘‘business’’ of psychother-
apy in their article, ‘‘The Ethics of Advertising, Billing, and Finances in
Psychotherapy.’’ They tackle the sticky topics of advertising, billing, and finances,
which may adversely impact the psychotherapy process and relationship if not
properly addressed. They do so through realistic case examples and by applying
virtues to assist psychotherapists in achieving the highest ideals in business practices.
In her article, ‘‘Competence and Scope of Practice: Ethics and Professional
Development,’’ Erica Wise addresses the complexities and challenges of establishing
clinical competence. Through case examples, she emphasizes a comprehensive and
proactive approach to competence that utilizes self-reflection and self-care along
with ongoing professional development.
Next, Kenneth Pope and Patricia Keith-Spiegel provide a thoughtful approach
for managing boundary concerns and nonsexual multiple relationships in
psychotherapy in their article, ‘‘A Practical Approach to Boundaries in
Psychotherapy: Making Decisions, Bypassing Blunders, and Mending Fences.’’
Their realism is sensitive to clients’ treatment needs, individual differences, and the
potential of negative client reactions. Importantly, they provide psychotherapists
with a detailed review of frequently occurring cognitive errors that may lead to
In the final article, ‘‘Psychotherapy Termination: Clinical and Ethical Responsi-
bilities,’’ Melba Vasquez, Rosie Bingham, and Jeffrey Barnett address the final phase
of psychotherapy: termination. They highlight differences between termination and
abandonment, discuss the many ways that a psychotherapy relationship may end
(both planned and unplanned), and recommend practical steps to help ensure a
successful outcome to the psychotherapy process.
In the end, our hope is that this compilation will provide psychotherapists with a
solid foundation for ethical practice. These articles provide practical strategies for
addressing the most common ethical challenges. Learning how to prevent these
challenges when possible, and how to respond to them thoughtfully and effectively
when they arise, will serve the best interests of all psychotherapists, and even more
importantly, the best interests of our clients.
American Psychological Association. (2002). Ethical principles of psychologists and code of
conduct. American Psychologist, 57, 1060–1073.
American Psychological Association, Ethics Committee. (2004). Report of the Ethics
Committee, 2003. American Psychologist, 59, 434–441.
Journal of Clinical Psychology: In Session, May 2008
Journal of Clinical Psychology: In Session