Author
Jeffrey E. Barnett, Psy.D., ABPP
44 articles
Personal Psychotherapy as a Self-Care Strategy for Psychotherapists-in-Training
Numerous authors have highlighted the many challenges and stressors experienced by graduate students in clinical and counseling psychology throughout their training (e.g., Harder, 2024; Prakash et al., 2023; Sosoo & Wise, 2021) and that “given the multiple demands and expectations for students in professional psychology programs” some level of stress is an inevitable part of […]
Alana N. Levine, B.S. + 1 more
April 9, 2024
Personal Psychotherapy as an Essential Self-Care Strategy
Numerous authors have emphasized the importance of the ongoing practice of self-care for psychotherapists (e.g. Baker, 2003; Barnett et al., 2007; Norcross & VandenBos, 2018; Wise & Reuman, 2019). Support for this focus on self-care by all psychotherapists is found in the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (Ethics Code, […]
Jeffrey E. Barnett, Psy.D., ABPP + 1 more
January 14, 2024
Being Informed About Informed Consent
Part One: Foundational Issues The informed consent process is an essential component of ethical, legal, and clinically effective practice by psychotherapists. Yet, how we engage in this process can have significant implications for the unfolding professional relationship and for the assessment, treatment, or other professional services provided. This is the first of four consecutive articles […]
Jeffrey E. Barnett, Psy.D., ABPP
November 22, 2023
Ethical Decision-Making for Psychologists
As licensed professionals, psychologists are obligated to serve in their professional roles and to carry out their professional duties and responsibilities in an ethical manner. We have a fiduciary duty to our clients that requires that all decisions made, and all actions taken, are motivated by and in keeping with our clients’ best interests (Jorgenson […]
Jeffrey E. Barnett, Psy.D., ABPP
October 27, 2023
Risk Management and Clinical Excellence for Psychotherapists
No psychotherapist wants a licensing board complaint or malpractice suit filed against them. While the overall risk of such events happening during the course of one’s career can be fairly low, their consequences may be quite significant for the psychotherapist. Even just the threat of such actions being taken can be stressful and may be […]
Jeffrey E. Barnett, Psy.D., ABPP + 1 more
October 27, 2023
与儿童青少年工作时，怎么做知情同意？
知情同意为治疗关系和心理治疗奠定了基础它体现了治疗师尊重当事人的合法权利，并为当事人提供机会就所参与的治疗做出知情决定。Barnett, Wise, Johnson-Greene和Bucky(2007)强调了适当实施知情同意程序的潜在好处： 这是一个协作过程，为心理治疗关系定下基调，促进治疗同盟。 它促进了治疗关系中的共同决策权。 它促进了当事人的自主性，并授权当事人在治疗中发挥积极作用。 通过这种信息共享和协作决策过程，它最大程度降低了对当事人的剥削和伤害的风险。 伦理守则和每一个心理健康专业在许可的法律法规中，也要求知情同意的程序是必须的，且许可的法律法规也明确了知情同意的法律要求和义务。其中一项要求是该司法管辖区的法定年龄，以及未成年人在何种情况下享有与成年人相同的权利来表示自己的同意。在每个司法管辖区的许可法律和法规中，对法定成年人同意治疗的要求有多种例外情况，在开始与未成年人进行临床工作之前，必须了解并理解其中的每一项。 Snyder和Barnett(2006)表示，要使知情同意有效，必须满足四个标准： 必须自愿给予同意。 当事人必须有能力(在法律上以及认知/情感上)给予同意。 我们必须积极地确保当事人理解她/他同意的内容。 共享的信息和所有同意的内容必须记录在案。 在未成年人的治疗中想要获得他们的知情同意时，这些标准中的前三项具有特殊意义。 当事人是谁？ 儿童和青少年可能会在多种情况下接受治疗。他们可能会被父母带去治疗，他们可能会被监护人(个人或儿童保护服务或社会服务部等机构)带去治疗，或者他们可能会自行寻求治疗。重要的第一步是确定心理治疗师对每一方应承担的义务(Fisher, 2009)。我们通常认为当事人是接受心理治疗的人。但是，情况并非总是如此。《心理学家的伦理守则和行为准则》(APA伦理守则; APA, 2010)在标准3.07条《第三方服务要求》中解决了这一问题。正如本标准所述，“心理学家应试图在服务开始时澄清与所有相关个人或组织的关系性质”(第六页)。 在这些情况下，“当事人”实际上可能是接受心理治疗的儿童或青少年以外的组织或个人。因此，知情同意过程对于澄清角色、责任和期望非常重要，并且在提供治疗前一开始就达成了协议。 这些协议包括关于保密性及其限制的决定、第三方在儿童或青少年治疗中可能扮演的角色(如有)、谁将参与制定治疗目标以及谁将同意治疗计划。 知情同意 除非在符合某一管辖范围内的法律允许的某些例外情况下(例如，未成年人结婚或参军，已获得自由的未成年人)，未成年人通常不得自主决定接受治疗。但是，这并不意味着他们不应该在知情同意过程中发挥任何作用。根据未成年人的年龄和发展水平，未成年人在知情同意过程中的参与程度可能各不相同。 即使在父母或监护人法律上是“当事人”的情况下，出于临床和伦理原因，将未成年人(我们服务的直接接受者)纳入信息共享和决策过程也很重要。对于非常年幼的孩子来说，获得他们对治疗的同意是很重要的。 同意与知情同意的不同之处在于，同意涉及与孩子共享信息，以便她/他了解要提供的服务、过程的性质、心理治疗师的角色和孩子的角色以及其他相关信息。目标是在孩子可能理解的水平上与孩子分享基本信息。这样做可能有助于鼓励未成年人参与治疗的建议过程，并促进更加合作和有效的治疗关系。 随着未成年人的年龄和发展水平的提高，他们理解心理治疗过程的性质和变迁、各方的角色、责任和义务的能力通常也会增强，因此，正如McCabe(2006)所表明的那样，将同意和知情同意视为一个连续统一体是有帮助的。随着未成年人参与信息共享和决策过程的能力提高，在父母同意的情况下，他们应该在这个过程中发挥更大的作用。 将未成年人纳入知情同意程序 即使他们还没有合法权利同意接受治疗，研究表明，许多未成年人具有认知和情感能力来理解他们决定(包括医疗保健决定)的后果。事实上，年仅12岁的未成年人经常具备这种能力(Redding, 1993)。虽然他们可能没有合法权利对自己的治疗提供知情同意，但许多未成年人可能能够在决策过程中成为积极的合作伙伴。而且，他们的发展水平随着时间的推移而提高，应重新审视信息共享和决策过程，以便为未成年当事人提供机会尽可能充分参与这一过程。 此外，将发展程度更高的未成年人纳入这一过程有许多临床原因： 表现出对未成年人及其自主权的尊重。 有助于促进治疗同盟和治疗关系 有助于为未成年人赋能，并且 它传达的信息是，未成年人将会积极参与她/他自己的治疗(Lind, Anderson, Oberle, 2003) 在此过程中协商父母的权利 父母或监护人有合法权利同意其未成年子女或青少年的治疗，决定治疗过程的相关事项，并有可能完全获得心理治疗过程中的所有信息；但是，我们必须在实践层面上考虑这样做是否合适。 心理治疗师应该考虑，在临床上这是否是进行心理治疗的可行方法。 心理治疗师应根据目前的临床情况仔细考虑未成年人的意愿和偏好。此外，我们应该考虑什么最合适实现心理治疗的目标。例如，如果一个15岁的孩子知道在治疗中分享和讨论的所有内容，每周都会向她/他的父母详细披露，那么，心理治疗的效果会如何？这种安排对分享的程度以及未成年人对心理治疗师的信任程度会产生什么影响？ 因此，虽然父母和监护人对其未成年子女确实拥有某些法律权利，但这些权利可以在知情同意过程中协商。可以告知父母，为了使治疗有效，必须为未成年人提供一定程度的保密性。正如Koocher解释的那样：“我们通常可以说服父母同意尊重治疗关系的隐私，尤其是如果他们觉得心理治疗师和他们一样关心并重视孩子的安全。”(Barnett, Behnke, Rosenthal, & Koocher, 2007, p.12) 治疗师可以向各方解释，某些主题和问题将在心理治疗关系的范围内得到解决，并且只有在超过某些阈值时，才会与父母或监护人共享这些机密信息。治疗师可以向父母或监护人分享这些情况的例子，以说明何时会发生这种情况，例如对未成年人或其他人的安全造成重大风险时。 实践建议 了解您所在司法管辖区，有关同意在什么年龄以及未成年人何时有权同意接受自己治疗的法律。 从一开始就明确法律义务，确定谁有权同意治疗。 确定各方参与知情同意过程的意愿和能力。 当未成年当事人未获得法律授权提供她/他自己的知情同意时，请寻求他们的同意，并以符合其智力和发展水平的方式向他们解释与治疗相关的信息。 […]
Caroline Coffman + 3 more
September 12, 2023
Addressing Religion and Spirituality in Psychotherapy: Ethical and Clinical Perspectives
Psychotherapists strive to provide their clients with the best treatment possible, something highly dependent on our ability to achieve high standards of competence. An important aspect of one’s clinical competence that has received increasing attention in recent years is multicultural competence. It is recognized that a psychotherapist cannot be clinically competent without being multicultural competent […]
Jeffrey E. Barnett, Psy.D., ABPP
April 9, 2023
Self-care in the Age of Telepsychology
Self-Care in the Age of Telepsychology The practice of psychotherapy has changed dramatically in response to the COVID-19 pandemic. Some changes may be seen as positive for both psychotherapists and their clients. For clients there is the convenience of online psychotherapy, such as no longer needing to take as much time off from work due […]
Jeffrey E. Barnett, Psy.D., ABPP + 1 more
January 5, 2023
The Practice of Telepsychology
The use of telepsychology by psychotherapists has increased in recent decades (Glueckauf et al., 2018). It provides greater access to psychotherapy, such as for those who live in areas where needed treatment services are not available and for those who are homebound or who lack access to adequate transportation. It also can be more cost-effective […]
Jeffrey E. Barnett, Psy.D., ABPP + 1 more
September 1, 2022
Ethics and Values in Psychotherapy
Ethical practice is essential for all psychotherapists. As licensed professionals, we are obligated to ensure that we meet the minimal expectations set in our state’s licensing law, the regulations that accompany it, other laws relevant to the practice of our profession, and our profession’s code of ethics. Yet, our goal should be to go far […]
Jeffrey E. Barnett, Psy.D., ABPP + 1 more
June 1, 2022
Self-Care for Graduate Students
You don’t need us to tell you this, but graduate school is a very challenging, demanding, and stressful time. While it hopefully is one of the most exciting, stimulating, and invigorating times of your life, you also must contend with stressors associated with being a graduate student as well as those in your personal life, […]
Jeffrey E. Barnett, Psy.D., ABPP + 1 more
March 24, 2022
The Evolving Nature of the Ethical Practice of Psychotherapy
While all psychotherapists aspire to practice ethically, this can at times prove challenging. It may seem at first glance that practicing ethically means simply following the ethics code of one’s profession. While this is a good place to start, unfortunately this is not sufficient for ensuring ethical practice. There are several reasons for this: 1. […]
Jeffrey E. Barnett, Psy.D., ABPP
March 1, 2020