Catherine O’Dea is Chairperson of the Ethics Committee of the IAHIP. Here she looks at the work already achieved and what lies ahead in the future.
I have been asked to write a short piece on the work of the IAHIP Ethics Committee of which I am currently a member. I shall address two general questions first: why do we need an Ethics Committee and what are the issues it has to consider, and what do we think is the most important aspect of our work?
It is interesting to note that one of the first bodies to be set up by the newly formed IAHIP in 1991 was a working party on ethics. As a result of its deliberations, the first Ethics Committee was elected at the first AGM in 1992.
This indicates that, right from the start, the subject of Ethics was considered of great importance in the setting up of a professional association. So, what were the ethical issues to be considered? There were two. First, a Code of Ethics and Practice and, following on from, and arising out of that, a Complaints Procedure.
The Code of Ethics and Practice was essential for two reasons. The first was to set standards of behaviour right away for the practising psychotherapists, even though they were, at that stage, not full members as the first accreditations did not take place until 1993. The second was that, when a body sets itself up as a professional one dealing with the public, then it must be seen openly as protecting the public through adopting these standards of behaviour.
Why the need for all this codifying, you may ask? Surely we all know about respect and confidentiality and an empowering non-judgmental, empathic attitude in our relationship with the client, our equal fellow human being? Yes, that is indeed what I am sure we all subscribe to, but there are factors in the psychotherapeutic relationship that can bring problems and need rules and reminders to help to keep us on the straight and narrow path. Consider the most common example of a psychotherapeutic structure: the one to one situation. In the relationship between these two people, one of whom is generally being paid for their professional skills, there is an inherent inequality and imbalance of power. Added to that, there is the fact that, as John Rowan puts it ‘inequality does not depend on mystification or expertise or money – it simply depends of the fact that the client is the one who is working on problems and the therapist is the one assisting the process.¹
So that even though you, the therapist, are clear that you are ‘not necessarily any healthier than the client in some absolute overall sense’² that is not the way it may very well be perceived by the client who may feel in an inferior position. Also, the psychotherapeutic relationship is often an intense one in which, given the above mentioned factors, there is plenty of room for, at the very least, misunderstandings and, at worst, abuse of power. In section three of the Code of Ethics and Practice 3.5 states that ‘psychotherapists must not exploit their clients either financially, sexually, emotionally or in any other way.’
However, to write only about setting standards for psychotherapists and protecting the public, would be to present an incomplete picture from the point of view of the Ethics Committee. Their field of vision has to be wider than that. Clients may misunderstand a therapist’s words or actions or, even worse, maliciously misinterpret them, albeit from a transferential position.
This leads logically to our second major issue: the Complaints Procedure. Here again, work began early with the first draft ready by July 1992. The main work took two years until the completed document was ratified by the AGM in 1997.
This sets out, and I quote from the section entitled Aims, ‘to provide a structure whereby any complaint against a member of IAHIP regarding a breach of the Code of Ethics can be dealt with’ and ‘to put in place a process which seeks to resolve where possible all formal complaints concerning members received by the Ethics Committee’. It has two processes for this; an informal conciliatory one and, if necessary, a formal and possibly more adversarial one. But, given my previous remarks on the problems which can arise in the psychotherapeutic relationship I should point out that the document seeks to be both supportive and fair to both parties involved. In case it looks as if it leans on the side of the complainant, there is an accompanying document to assist any psychotherapist who has a complaint lodged against him or her.
To sum up: the main work of the Ethics Committee to date has been to put in place two documents which set down clear standards for all members of IAHIP in a manner befitting a properly constituted professional body dealing with the public. If these standards are not adhered to by members then we now have in place a mechanism which enables us to deal openly with ethical issues and complaints when they arise.
Even though these standards are now in place, our work continues and we have two main duties. One is continuously to monitor the two documents as fresh issues arise. We do not see them as being set in tablets of stone, but rather as evolving to meet the demands of our profession. Our second duty is to operate the Complaints Procedure as, and when, necessary.
All of this involves thinking about words and meanings, and making judgments to the best of our ability. But we have to remember the people behind the words. We constantly struggle to see the wood and the trees. We feel the tension between the need to protect vulnerable clients and the need to protect our colleagues, who work in an isolated and often stressful profession. It is a continuous balancing act.
(1) John Rowan, The Reality Game, p.36 Routledge 1983