Ethical Issues and the IAHIP

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

(2) Ibid