Mbroh, H., Najjab, A., et al. (2020).
Professional Psychology: Research and
Practice, 51(3), 284–290.
Abstract
Psychologists will often encounter patients who make prejudiced comments during psychotherapy. Some psychologists may argue that the obligations to social justice require them to address these comments. Others may argue that the obligation to promote the psychotherapeutic process requires them to ignore such comments. The authors present a decision-making strategy and an intervention based on principle-based ethics for thinking through such dilemmas.
Public Significance Statement—
This article identifies ethical principles psychologists should consider when deciding whether to address their patients’ prejudicial comments in psychotherapy. It also provides an intervention strategy for addressing patients’ prejudicial comments.
Here are some thoughts:
The article explores how psychologists should ethically respond when clients express prejudicial views during therapy. The authors highlight a tension between two key obligations: the duty to promote the well-being of the patient (beneficence) and the broader responsibility to challenge social injustice (general beneficence). Using principle-based ethics, the article presents multiple real-life scenarios in which clients make discriminatory remarks—whether racist, ageist, sexist, or homophobic—and examines the ethical dilemmas that arise. In each case, psychologists must consider the context, potential harm, and therapeutic alliance before choosing whether or how to intervene. The authors emphasize that while tolerance for clients' values is important, it should not extend to condoning harmful biases. They propose a structured approach to addressing prejudice in session: show empathy, create cognitive dissonance by highlighting harm, and invite the client to explore the issue further. Recommendations include ongoing education, self-reflection, consultation, and thoughtful, non-punitive interventions. Ultimately, the article argues that addressing patient prejudice is ethically justifiable when done skillfully, and doing so can improve both individual therapy outcomes and societal well-being.
