Ethics in Psychotherapy and Counseling. Kenneth S. Pope

Nonsexual physical abuse 13.14 9.15 At least one of the above 26.28 39.22 Abuse during adulthood Sexual harassment 1.46 37.91 Attempted rape 0.73 13.07 Acquaintance rape 0.0 6.54 Stranger rape 0.73 1.31 Nonsexual physical abuse by a spouse or partner 6.57 12.42 Nonsexual physical abuse by an acquaintance 0.0 2.61 Nonsexual physical abuse by a stranger 4.38 7.19 Sexual involvement with a therapist 2.19 4.58 Sexual involvement with a physician 0.0 1.96 At least one of the above 13.87 56.86 Abuse during childhood, adolescence, or adulthood 32.85 69.93 Source: From “National survey of psychologists’ sexual and physical abuse history and their evaluation of training and competence in these areas,” By K.S. Pope and S. Feldman-Summers, 1992, Professional Psychology: Research and Practice, 23, pp. 353–361. Copyright 1992 by the American Psychological Association. Adapted with permission.

While these experiences may—or may not—affect emotional competence for any of us as individuals, it is important not to assume a one-size-fits-all theory about how forms of abuse (or any other experience) may affect an individual therapist. No research supports the notion that all those who have a history of abuse are more competent or less competent as therapists, or that those who have no history of abuse are more or less competent as therapists. Each instance must be evaluated on an individual basis, with the full range of available information and without stereotypes. What is key is for us to be aware of how such events affect us and what role, if any, they play in our emotional competence and our ability to respond effectively to clients.

      Our work requires continuous awareness to prevent compromised performance, especially when we go through hard or challenging personal times. Chapter 17 discusses common consequences when a therapist or counselor is distressed, drained, or demoralized. These common consequences include disrespecting clients, disrespecting work, making more mistakes, lacking energy, using work to block out unhappiness, pain, and discontent, and losing interest.

      Emotional competence includes the process of constantly questioning ourselves. Consider the following: Do the demands of the work we do as therapists, or other factors, suggest that the we need therapy in order to maintain or restore emotional competence? For many of us, creating self-care strategies that fit us as unique individuals and that sustain, replenish, and give meaning are an essential part of our work to maintain competence (see Chapter 17), particularly to maintain “emotional competence for therapy” (Pope & Brown, 1996; Pope, Sonne et al., 2006).

      The psychology profession emphasizes the ethical aspects of self-care. General Principle A, Beneficence and Nonmaleficence, and Standard 2.06 of the APA Ethics Code (APA, 2017a) encourage psychologists to be aware of the possible effects of their own physical and mental health on their ability to help those with whom they work. The new proposed General Principle of Beneficence and Nonmaleficence also encourages psychologists to safeguard, protect, and contribute to the well-being, welfare, and rights of Persons and Peoples. Psychologists are also encouraged to maximize benefit and avoid or minimize harm in ways that respect the dignity of Persons and Peoples (APA Ethics Code Task Force, 2020, July 31).

      The Canadian Code of Ethics for Psychologists, Standard II.11 (CPA, 2017a), states that psychologists “seek appropriate help and/or discontinue scientific or professional activity for an appropriate period of time, if a physical or psychological condition reduces their ability to benefit and not harm others.” Standard II.12 states that psychologists “engage in self-care activities that help to avoid conditions (e.g., burnout, addictions) that could result in impaired judgment and interfere with their ability to benefit and not harm others.”

      The National Association of Social Workers (2017) and the American Counseling Association (2014) are among the other major mental health professions whose ethics codes highlight the role of self-care in supporting competence and preventing impairment.

Table 6.3 presents the results of a national study of therapists as therapy patients (Pope & Tabachnick, 1994). Eighty-four percent of the therapists in this study reported that they had been in personal therapy. Only two respondents indicated that the therapy was not helpful, but 22% reported that their own therapy included what they believed to be harmful aspects (regardless of whether it also included positive aspects).

Table 6.3. Therapists’ Experiences as Therapy Patients.

Item	Never	Once	Rarely	Sometimes	Often
In your own personal therapy, how often (if at all) did your therapist (N = 400):
Cradle or hold you in a nonsexual way	73.2	2.7	8.0	8.8	6.0
Touch you in a sexual way	93.7	2.5	1.8	0.3	1.0
Talk about sexual issues in a way that you believe to be inappropriate	91.2	2.7	3.2	0.5	1.3
Seem to be sexually attracted to