By John Gavazzi
Originally published in The Pennsylvania Psychologist
During workshops on ethical decision-making, I typically take time to highlight cognitive and emotional factors that adversely affect clinical judgment and impede high quality psychotherapy. In terms of cognitive heuristics that hamper effective treatment, the list includes the Fundamental Attribution Error, Trait Negativity Bias, the Availability Heuristic, and the Dunning-Krueger Effect. Emotionally, a psychologist’s fear, anxiety, or disgust (also known as countertransference) can obstruct competent clinical judgment. A PowerPoint presentation providing more details on these topics is on my SlideShare account found here.
Research from cognitive science and moral psychology demonstrates many of these heuristics and emotional reactions are automatic, intuitive, and unconscious. The cognitive heuristics and emotional responses are shortcuts intended to evaluate and respond to environmental demands quickly and efficiently, which is not always conducive for optimal clinical judgment and ethical decision-making. For better or worse, these cognitive and affective strategies are part of what makes us human. It is incumbent upon psychologists to be aware of these limitations and work hard to remediate them in our professional roles.
Recent research by Lebowitz and Ahn (2014) provides insight into another cognitive bias that leads to potentially detrimental emotional responses. Their research illustrates how a clinician’s perception as to the causes of mental health problems can undesirably influence his or her perceptions of patients. The authors chose to investigate clinicians’ perceptions of patients when using a biological model of mental disorders. The biological model supports the belief that genetics play an important role in the creation of mental distress; that central nervous system dysfunction is the most important component of the mental health disorder; and, because of these biological origins, a patient’s thoughts and behaviors are largely outside of the patient’s control.
The entire article is here.
