Ethical decision-making models: a taxonomy of models and review of issues

Johnson, M. K., Weeks, S. N.,  et al. (2021).

Ethics & Behavior, 32(3), 195–209.

https://doi.org/10.1080/10508422.2021.1913593

Abstract

A discussion of ethical decision-making literature is overdue. In this article, we summarize the current literature of ethical decision-making models used in mental health professions. Of 1,520 articles published between 2001 and 2020 that met initial search criteria, 38 articles were included. We report on the status of empirical evidence for the use of these models along with comparisons, limitations, and considerations. Ethical decision-making models were synthesized into eight core procedural components and presented based on the composition of steps present in each model. This taxonomy provides practitioners, trainers, students, and supervisors relevant information regarding ethical decision-making models.

A pdf can be downloaded here.

Here are some thoughts:

This article reviews ethical decision-making models used in mental health professions and introduces a taxonomy of these models, defined by eight core procedural components. The study analyzed 38 articles published between 2001 and 2020 to identify these components. The eight core components are:   

1. Framing the Dilemma: This involves identifying and describing the ethical dilemma.
2. Considering Codes: This includes reviewing relevant ethical codes and legal standards.
3. Consultation: Seeking advice from supervisors, colleagues, or ethics experts.
4. Identifying Stakeholders: Recognizing all individuals and parties affected by the decision.
5. Generating Alternatives: Developing various potential courses of action.
6. Assessing Consequences: Evaluating the potential outcomes of each alternative.
7. Making a Decision: Choosing the best course of action.
8. Evaluating the Outcome: Reflecting on the decision-making process and its results.    

The paper discusses the empirical evidence for the use of these models, their limitations, and other important considerations for practitioners, trainers, students, and supervisors. 

AI Anxiety: a comprehensive analysis of psychological factors and interventions

Kim, J. J. H., Soh, J., et al. (2025).

AI And Ethics.

https://doi.org/10.1007/s43681-025-00686-9

Abstract

The rapid advancement of artificial intelligence (AI) has raised significant concerns regarding its impact on human psychology, leading to a phenomenon termed AI Anxiety—feelings of apprehension or fear stemming from the accelerated development of AI technologies. Although AI Anxiety is a critical concern, the current literature lacks a comprehensive analysis addressing this issue. This paper aims to fill that gap by thoroughly examining the psychological factors underlying AI Anxiety and proposing effective solutions to tackle the problem. We begin by comparing AI Anxiety with Automation Anxiety, highlighting the distinct psychological impacts associated with AI-specific advancements. We delve into the primary contributor to AI Anxiety—the fear of replacement by AI—and explore secondary causes such as uncontrolled AI growth, privacy concerns, AI-generated misinformation, and AI biases. To address these challenges, we propose multidisciplinary solutions, offering insights into educational, technological, regulatory, and ethical guidelines. Understanding the root causes of AI Anxiety and implementing strategic interventions are critical steps for mitigating its rise as society enters the era of pervasive AI.

A pdf can be downloaded here.

Here are some thoughts:

The rapid advancement of artificial intelligence (AI) has led to a growing concern termed "AI Anxiety," which is the apprehension or fear individuals experience due to the fast-paced development of AI technologies.  This anxiety is multifaceted, encompassing fears about job security, privacy infringements, the loss of control over AI systems, and the potential for AI to generate misinformation and exhibit biases.  While AI Anxiety shares similarities with Automation Anxiety, which arose during the Industrial Revolution with the introduction of machinery, it presents unique challenges.  Unlike Automation Anxiety, which was primarily focused on the replacement of manual labor, AI Anxiety extends to the replacement of cognitive and creative skills across various sectors, including healthcare, finance, and education.  The pervasive nature of AI, its integration into personal lives, and the ethical dilemmas it raises contribute to a deeper and more complex form of anxiety. 

The Illusion of Thinking: Understanding the Strengths and Limitations of Reasoning Models via the Lens of Problem Complexity

Parshin, S.,  et al. (n.d.).

Apple.

Abstract

Recent generations of frontier language models have introduced Large Reasoning Models (LRMs) that generate detailed thinking processes before providing answers. While these models demonstrate improved performance on reasoning benchmarks, their fundamental capabilities, scaling properties, and limitations remain insufficiently understood. Current evaluations primarily focus on established mathematical and coding benchmarks, emphasizing final answer accuracy. However, this evaluation paradigm often suffers from data contamination and does not provide insights into the reasoning traces’ structure and quality. In this work, we systematically investigate these gaps with the help of controllable puzzle environments that allow precise manipulation of compositional complexity while maintaining consistent logical structures. This setup enables the analysis of not only final answers but also the internal reasoning traces, offering insights into how LRMs “think”. Through extensive experimentation across diverse puzzles, we show that frontier LRMs face a complete accuracy collapse beyond certain complexities. Moreover, they exhibit a counterintuitive scaling limit: their reasoning effort increases with problem complexity up to a point, then declines despite having an adequate token budget. By comparing LRMs with their standard LLM counterparts under equivalent inference compute, we identify three performance regimes: (1) low-complexity tasks where standard models surprisingly outperform LRMs, (2) medium-complexity tasks where additional thinking in LRMs demonstrates advantage, and (3) high-complexity tasks where both models experience complete collapse. We found that LRMs have limitations in exact computation: they fail to use explicit algorithms and reason inconsistently across puzzles. We also investigate the reasoning traces in more depth, studying the patterns of explored solutions and analyzing the models’ computational behavior, shedding light on their strengths, limitations, and ultimately raising crucial questions about their true reasoning capabilities.

The paper can be located here.

Here are some thoughts:

This paper is important to psychologists because it explores how Large Reasoning Models (LRMs) generate reasoning processes that appear human-like but may lack true understanding—an illusion that mirrors aspects of human cognition. By analyzing LRMs’ step-by-step reasoning traces, the study reveals striking parallels to human reasoning heuristics, biases, and limitations, such as inconsistent logic, computational failures under complexity, and a collapse in effort beyond a certain threshold. These findings offer psychologists a novel framework to compare AI and human reasoning, particularly in domains like problem-solving, metacognition, and cognitive overload. Additionally, the paper raises urgent questions about human-AI interaction: if people overtrust AI-generated reasoning (despite its flaws), this could influence reliance on AI in therapeutic, educational, or decision-making contexts. The study’s methods—using controlled puzzles to dissect reasoning—also provide psychologists with tools to test human cognition with similar precision. Ultimately, this work challenges assumptions about what constitutes "genuine" reasoning, bridging AI research and psychological theories of intelligence, bias, and the boundaries of human and artificial thought.

Communitarianism revisited

Etzioni, A. (2014).

Journal of Political Ideologies, 19(3), 241–260.

https://doi.org/10.1080/13569317.2014.951142

Abstract

This article provides a retrospective account and analysis of communitarianism. Drawing upon the author's involvement with the political branch of communitarianism, it attempts to summarize both the history of the school of thought as well as its most prominent ideas. These include the communitarian emphasis on the common good; the effort to find an acceptable balance between individual rights and social responsibilities; the basis of social order; and the need to engage in substantive moral dialogues. The article closes with a discussion of cultural relativism according to which communities ought to be the ultimate arbitrators of the good and a universalistic position.

A pdf of this article is here.

Here are some thoughts:

This article offers a comprehensive overview and critical reflection on the evolution of communitarian thought, particularly as it relates to political philosophy and public life. Etzioni traces the historical roots of communitarianism, highlighting its emphasis on the common good, the balance between individual rights and social responsibilities, and the necessity of substantive moral dialogue within communities. He notes that while communitarianism is a relatively small school in academic philosophy, its core ideas-such as prioritizing the welfare of the community alongside individual freedoms-are deeply embedded in various religious, political, and cultural traditions across the world.

The article explores the resurgence of communitarian ideas in the 1980s and 1990s as a response to the perceived excesses of individualism promoted by liberalism and laissez-faire conservatism. Etzioni discusses the tension between individual autonomy and communal obligations, arguing for a nuanced approach that seeks equilibrium between these often competing values, adapting as societal conditions change. He also addresses critiques of communitarianism, including concerns about its potential association with authoritarianism and the vagueness of the concept of "community."

For practicing psychologists, this article is significant because it underscores the importance of considering both individual and collective dimensions in understanding human behavior, ethical decision-making, and therapeutic practice. Recognizing the interplay between personal autonomy and social context can enhance psychologists’ ability to support clients in navigating moral dilemmas, fostering social connectedness, and promoting well-being within diverse communities.

Prejudiced patients: Ethical considerations for addressing patients’ prejudicial comments in psychotherapy.

Mbroh, H., Najjab, A., et al. (2020).

Professional Psychology: Research and

Practice, 51(3), 284–290.

https://doi.org/10.1037/pro0000280

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.

A pdf is here.

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.

No Change? A Grounded Theory Analysis of Depressed Patients' Perspectives on Non-improvement in Psychotherapy

De Smet, M. M., et al. (2019).

Frontiers in Psychology, 10.

https://doi.org/10.3389/fpsyg.2019.00588

Aim: Understanding the effects of psychotherapy is a crucial concern for both research and clinical practice, especially when outcome tends to be negative. Yet, while outcome is predominantly evaluated by means of quantitative pre-post outcome questionnaires, it remains unclear what this actually means for patients in their daily lives. To explore this meaning, it is imperative to combine treatment evaluation with quantitative and qualitative outcome measures. This study investigates the phenomenon of non-improvement in psychotherapy, by complementing quantitative pre-post outcome scores that indicate no reliable change in depression symptoms with a qualitative inquiry of patients' perspectives.

Methods: The study took place in the context of a Randomised Controlled Trial evaluating time-limited psychodynamic and cognitive behavioral therapy for major depression. A mixed methods study was conducted including patients' pre-post outcome scores on the BDI-II-NL and post treatment Client Change Interviews. Nineteen patients whose data showed no reliable change in depression symptoms were selected. A grounded theory analysis was conducted on the transcripts of patients' interviews.

Findings: From the patients' perspective, non-improvement can be understood as being stuck between knowing versus doing, resulting in a stalemate. Positive changes (mental stability, personal strength, and insight) were stimulated by therapy offering moments of self-reflection and guidance, the benevolent therapist approach and the context as important motivations. Remaining issues (ambition to change but inability to do so) were attributed to the therapy hitting its limits, patients' resistance and impossibility and the context as a source of distress. “No change” in outcome scores therefore seems to involve a “partial change” when considering the patients' perspectives.

Conclusion: The study shows the value of integrating qualitative first-person analyses into standard quantitative outcome evaluation and particularly for understanding the phenomenon of non-improvement. It argues for more multi-method and multi-perspective research to gain a better understanding of (negative) outcome and treatment effects. Implications for both research and practice are discussed.

Here are some thoughts:

This study explores the perspectives of depressed patients who experienced no improvement in psychotherapy. While quantitative measures often assess therapy outcomes, the reasons behind a lack of progress from the patients' viewpoint remain unclear. Through a grounded theory analysis, the researchers aimed to understand this phenomenon. The study highlights the importance of considering the patient's subjective experience when evaluating the effectiveness of psychotherapy, particularly in cases where standard outcome measures might not capture the nuances of non-improvement.

Promoting competent and flourishing life-long practice for psychologists: A communitarian perspective

Wise, E. H., & Reuman, L. (2019).

Professional Psychology Research 

and Practice, 50(2), 129–135.

https://doi.org/10.1037/pro0000226

Abstract

Based on awareness of the challenges inherent in the practice of psychology there is a burgeoning interest in ensuring that psychologists who serve the public remain competent. These challenges include remaining current in our technical skills and maintaining sufficient personal wellness over the course of our careers. However, beyond merely maintaining competence, we encourage psychologists to envision flourishing lifelong practice that incorporates positive relationships, enhancement of meaning, and positive engagement. In this article we provide an overview of the foundational competencies related to professionalism including ethics, reflective practice, self-assessment, and self-care that underlie our ability to effectively apply technical skills in often complex and emotionally challenging relational contexts. Building on these foundational competencies that were initially defined and promulgated for academic training in health service psychology, we provide an initial framework for conceptualizing psychologist well-being and flourishing lifelong practice that incorporates tenets of applied positive psychology, values-based practice, and a communitarian-oriented approach into the following categories: fostering relationships, meaning making and value-based practice, and enhancing engagement. Finally, we propose broad strategies and specific examples intended to leverage current continuing education mandates into a broadly conceived vision of continuing professional development to support enhanced psychologist functioning for lifelong practice.

Here are some thoughts:

Wise and Reuman highlight the importance of lifelong learning for psychologists, emphasizing that competence involves maintaining both technical skills and personal wellness.  The authors introduce a framework that integrates positive psychology, values-based practice, and a communitarian approach, focusing on fostering relationships, enhancing meaning, and promoting engagement.  They stress the significance of foundational competencies such as ethics, reflective practice, self-assessment, and self-care, and advocate for leveraging continuing education mandates to support psychologists' ongoing development and well-being throughout their careers.

Preventing Veteran Suicide: a landscape analysis of existing programs, their evidence, and what the next generation of programs may look like.

Ramchand, R. et al. (2025, April 16).

RAND.

https://www.rand.org/pubs/research_reports/RRA3635-1.html

Preventing veteran suicide is a national priority for government, veteran advocacy groups, and the private sector. This attention has led many individuals and organizations to leverage their expertise to create, expand, or promote activities that they hope will prevent future deaths. While the number and array of diverse approaches reflect a nation committed to a common goal, they also can create confusion. Advances in technology also generate questions about the future of veteran suicide prevention.

In this report, the authors analyze current and emerging activities to prevent veteran suicide. They introduce the RAND Suicide Prevention Activity Matrix, a framework that organizes current approaches, how they complement each other, how they might change, their evidence for preventing veteran suicide, and why they might (or might not) work. This framework places 26 categories of activities in a matrix based on whom the activity targets (the veteran directly, those who regularly interact with the veteran, or social influences) and what the activity is intended to accomplish (address social conditions, promote general well-being, address mental health symptoms, provide mental health supports, and prevent suicide crises). Entities committed to preventing veteran suicide and seeking to design evidence-informed, comprehensive suicide prevention strategies will benefit from the framework and evidence reviewed in this report, in addition to the recommendations the authors developed from these data.

Key Findings

• The authors identified 307 suicide prevention programs, 156 of which were currently operating and 226 that were proposed to expand existing services or initiate new programs.
• These organizations' suicide prevention activities were categorized across 26 suicide prevention activity categories and organized into the RAND Suicide Prevention Activity Matrix.
• Among the 156 current programs, there is a strong focus on those that aim to build social connections and those that offer case management or noncrisis psychological counseling.
• Veterans are the primary focus of most current programs, but many programs are also offered to family members and friends — often in addition to serving veterans directly.
• Nonprofit organizations operate most current programs, and just under half of the programs are accessed virtually or via a combination of in-person and virtual access.
• Among the 226 proposed programs, the most common types are multifunctional digital health platforms (mobile health applications), suicide risk assessment tools, and real-time monitoring.
• The following activity types have a robust evidence base for preventing suicide: community-based suicide prevention initiatives, suicide risk assessment, noncrisis psychological treatment, crisis psychological clinical services, and pharmacotherapy (for those with mental health conditions).

Recommendations

• Organizations charged with developing, investing in, implementing, or evaluating comprehensive suicide prevention strategies should prioritize implementation of evidence-based prevention activities.
• When implementing a suicide prevention activity, organizations should consider the context in which the activity is intended to be delivered.
• Organizations should conduct a needs assessment to identify gaps in suicide prevention activities.
• Organizations should apply different thresholds of evidence when considering different suicide prevention activities.
• Organizations should invest strategically in research that can fill notable gaps in knowledge.

The myth of harmless wrongs in moral cognition: Automatic dyadic completion from sin to suffering

Gray, K., Schein, C., & Ward, A. F. (2014).

Journal of experimental psychology.

General, 143(4), 1600–1615.

https://doi.org/10.1037/a0036149

Abstract

When something is wrong, someone is harmed. This hypothesis derives from the theory of dyadic morality, which suggests a moral cognitive template of wrongdoing agent and suffering patient (i.e., victim). This dyadic template means that victimless wrongs (e.g., masturbation) are psychologically incomplete, compelling the mind to perceive victims even when they are objectively absent. Five studies reveal that dyadic completion occurs automatically and implicitly: Ostensibly harmless wrongs are perceived to have victims (Study 1), activate concepts of harm (Studies 2 and 3), and increase perceptions of suffering (Studies 4 and 5). These results suggest that perceiving harm in immorality is intuitive and does not require effortful rationalization. This interpretation argues against both standard interpretations of moral dumbfounding and domain-specific theories of morality that assume the psychological existence of harmless wrongs. Dyadic completion also suggests that moral dilemmas in which wrongness (deontology) and harm (utilitarianism) conflict are unrepresentative of typical moral cognition.

A pdf is here.

Here are some thoughts:

This research paper explores the psychological theory of dyadic morality, which posits that our moral cognition is structured around a template of a wrongdoing agent and a suffering patient (victim). The authors argue that this dyadic template leads to an automatic and implicit process called "dyadic completion," where individuals perceive victims and harm even in situations considered objectively harmless wrongs. Across five studies, the researchers found that ostensibly harmless immoral acts are indeed perceived as having victims, activate concepts related to harm, and increase perceptions of suffering. This suggests that the perception of harm is fundamental to our intuitive understanding of immorality and challenges theories that assume the psychological reality of victimless wrongs, as well as standard interpretations of moral dumbfounding. The concept of dyadic completion also implies that moral dilemmas contrasting wrongness and harm might not reflect typical moral cognition.

How peer influence shapes value computation in moral decision-making

Yu, H., Siegel, J. et al. (2021).

Cognition, 211, 104641.

https://doi.org/10.1016/j.cognition.2021.104641

Abstract

Moral behavior is susceptible to peer influence. How does information from peers influence moral preferences? We used drift-diffusion modeling to show that peer influence changes the value of moral behavior by prioritizing the choice attributes that align with peers' goals. Study 1 (N = 100; preregistered) showed that participants accurately inferred the goals of prosocial and antisocial peers when observing their moral decisions. In Study 2 (N = 68), participants made moral decisions before and after observing the decisions of a prosocial or antisocial peer. Peer observation caused participants' own preferences to resemble those of their peers. This peer influence effect on value computation manifested as an increased weight on choice attributes promoting the peers' goals that occurred independently from peer influence on initial choice bias. Participants' self-reported awareness of influence tracked more closely with computational measures of prosocial than antisocial influence. Our findings have implications for bolstering and blocking the effects of prosocial and antisocial influence on moral behavior.

Here are some thoughts:

Peer influence plays a significant role in shaping how people make moral decisions. Rather than simply copying others, individuals tend to adjust the way they value different aspects of a moral choice to align with the goals and preferences of their peers. This means that observing others’ moral behavior-whether prosocial or antisocial-can shift the importance people place on certain outcomes, such as helping others or personal gain, during their own decision-making process. Computational models, like the drift diffusion model, show that these changes occur at the level of value computation, not just as a surface-level bias. Interestingly, people are generally more aware of being influenced by positive (prosocial) peers than by negative (antisocial) ones. Overall, the findings highlight that social context can subtly and powerfully shape moral values and behavior.

Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track.

Waller, G., & Turner, H. (2015).

Behaviour Research and Therapy, 77, 129–137.

https://doi.org/10.1016/j.brat.2015.12.005

Abstract

Therapist drift occurs when clinicians fail to deliver the optimum evidence-based treatment despite having the necessary tools, and is an important factor in why those therapies are commonly less effective than they should be in routine clinical practice. The research into this phenomenon has increased substantially over the past five years. This review considers the growing evidence of therapist drift. The reasons that we fail to implement evidence-based psychotherapies are considered, including our personalities, knowledge, emotions, beliefs, behaviours and social milieus. Finally, ideas are offered regarding how therapist drift might be halted, including a cognitive-behavioural approach for therapists that addresses the cognitions, emotions and behaviours that drive and maintain our avoidance of evidence-based treatments.

Highlights

• We consider the recent evidence that therapist drift is a common phenomenon in psychological therapies.

• We consider the reasons that therapist drift takes place.

• A cognitive-behavioural approach to overcoming therapist drift is outlined.

Here are some thoughts:

Therapist drift is when clinicians fail to deliver evidence-based treatments effectively, despite having the training and resources to do so.  This drift can occur consciously or unconsciously and results in patients receiving suboptimal care, reducing their chances of recovery.  Factors contributing to therapist drift include the therapist's knowledge, beliefs, emotions, personality, behaviors, and social environment.  Research indicates that therapist drift is a significant issue in delivering cognitive-behavioral therapy (CBT).  To address therapist drift, strategies incorporating a cognitive-behavioral approach may be beneficial, targeting the beliefs, emotions, and behaviors that lead therapists away from evidence-based practices. 

Bounded ethicality and ethical fading in negotiations: Understanding unintended unethical behavior.

Rees, M., Tenbrunsel, A., & Bazerman, M. (2018).

Academy of Management Perspectives, 33(1), 26–42.

https://doi.org/10.5465/amp.2017.0055

Abstract

The business scandals of the past several decades have led to the rising importance of ethics as a topic central to management scholarship. Behavioral scientists in particular have been attracted to the topic in far greater numbers, and the study of ethical decision making has emerged as a core subfield (Messick & Tenbrunsel, 1996). This paper draws on that framework and applies it to negotiations, arguing that not all unethical behavior is intentional; rather, negotiators fall prey to bounded ethicality, engaging in behavior that is contradictory to their values without realizing that they are doing so. We further argue that ethical fading—when individuals do not see the ethical implications of the situation or their action—is central to explaining why this occurs. Relying on past empirical research, we identify negotiation cues that have been linked to unethical behavior, and explore how they make a negotiator particularly vulnerable to ethical fading, resulting in subsequent unethical behavior. We discuss several opportunities for future research in the negotiation discipline and other disciplines that draw on motivated social exchange or assume intentionality, and conclude with a call for scholars to define normative standards as they pertain to negotiator ethics.

A pdf of the article is here.

Here are some thoughts:

The article explores how ethical failures in organizations often result not from intentional wrongdoing, but from cognitive limitations and unconscious biases that restrict individuals’ ability to act ethically. The authors argue that even well-intentioned people routinely engage in unethical behavior without realizing it due to bounded awareness—where individuals fail to see or act on all relevant ethical information. Factors such as implicit biases, motivated blindness, and outcome bias distort judgment and decision-making, making unethical actions seem acceptable. The article calls for greater structural and organizational changes, rather than solely relying on individual character or compliance efforts, to address these hidden ethical failures and promote more ethical behavior.

Religion, Spirituality, and Suicide

Knapp, S. (2024, September 25).

Society for the Advancement of Psychotherapy.

Article Link is here.

When evaluating suicidal patients, it is often indicated to ask them about their religious beliefs about suicide because many patients believe that their spiritual or religious beliefs1 are closely linked to their mental health (Yamada et al., 2020). For example, some patients in significant emotional distress say they would not kill themselves because their religion strongly condemns it. For them, religion includes a life-protecting belief that prohibits them from attempting suicide.  

Nonetheless, the relationship between religion, spirituality, and suicide goes deeper than just prohibitions against suicide. Instead, religious and spiritual beliefs influence how people care for themselves, interact with others, think about themselves, and interpret their life histories. For example, some people have religious or spiritual beliefs that command them to live their lives productively, express their talents and abilities, and show love for others while experiencing joy. For them, religion includes life-promoting beliefs that encourage them to flourish and thrive. 

The goals for treating suicidal patients are to keep them alive and to help them create lives worth living. While life-protecting beliefs may help keep many patients alive (at least temporarily), life-promoting beliefs help keep patients alive and also help them to create lives worth living. This article suggests ways psychologists can encourage life-promoting beliefs when working with suicidal patients.

The entire article is here.

Here are some thoughts:

The article explores the complex relationship between religious and spiritual beliefs and suicide risk. It highlights that while religious affiliation and spiritual practices can offer protective benefits against suicidal ideation and behavior, the impact varies based on individual experiences and contexts. Positive religious coping mechanisms—such as finding meaning, community support, and hope—are associated with reduced suicide risk. Conversely, negative religious coping, including feelings of punishment or abandonment by a higher power, may exacerbate distress and increase risk. The article emphasizes the importance for mental health professionals to assess and integrate clients' spiritual and religious dimensions into therapy, tailoring interventions to support each individual's unique belief system.

Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults

Levine, S. B., Abbruzzese, E., & Mason, J. W. (2022).

Journal of Sex & Marital Therapy, 48(7), 706–727.

https://doi.org/10.1080/0092623x.2022.2046221

Abstract

In less than a decade, the western world has witnessed an unprecedented rise in the numbers of children and adolescents seeking gender transition. Despite the precedent of years of gender-affirmative care, the social, medical and surgical interventions are still based on very low-quality evidence. The many risks of these interventions, including medicalizing a temporary adolescent identity, have come into a clearer focus through an awareness of detransitioners. The risks of gender-affirmative care are ethically managed through a properly conducted informed consent process. Its elements—deliberate sharing of the hoped-for benefits, known risks and long-term outcomes, and alternative treatments—must be delivered in a manner that promotes comprehension. The process is limited by: erroneous professional assumptions; poor quality of the initial evaluations; and inaccurate and incomplete information shared with patients and their parents. We discuss data on suicide and present the limitations of the Dutch studies that have been the basis for interventions. Beliefs about gender-affirmative care need to be separated from the established facts. A proper informed consent process can both prepare parents and patients for the difficult choices that they must make and can ease professionals’ ethical tensions. Even when properly accomplished, however, some clinical circumstances exist that remain quite uncertain.

Here are some thoughts:

The article critiques the prevailing standards for obtaining informed consent in the context of gender-affirming medical interventions for minors and young adults. It argues that current practices often fail to adequately ensure that patients—and in many cases, their guardians—fully understand the long-term risks, uncertainties, and implications of puberty blockers, cross-sex hormones, and surgeries. The authors contend that the developmental immaturity of children and adolescents, combined with social pressures and sometimes incomplete psychological evaluations, undermines the ethical validity of consent. They advocate for a more cautious, evidence-informed, and ethically rigorous approach that prioritizes psychological exploration and long-term outcomes over immediate affirmation and medical intervention.

Core communitarian values for community practice: human development, empowerment, and social justice

James Anderson. (2024).

Technology Journal of Management,

Accounting and Economics, 12(4).

Link Here.

Abstract

Values are conceptions of good which enlighten and guide human analysis and action. Discounting noteworthy exceptions, community psychology has neglected making explicit and openly discussing its ethical and value dimensions. My aim in this paper to partially remedy such neglect by posing new sustantive values and approaches suitable for community practice. I suggest first changes in the deontological values to adapt them to the complexity and dynamism of community work. So I put forward shared or collective autonomy, that extends self-direction to the whole community, to substitue for individual disolving autonomy. I also introduce self-care (legitimate self-beneficence) to guarantee psychological and moral integrity of the practitioner as well as long term sustainability of communiy action. I describe, secondly, some core communitarian values. Human development which includes interaction and social bonding besides self-direction. Empowerment, an instrumental value, made of subjective consciousness, communication, and effective social action. Social justice, the main socio-communitarian value, consist of three components: a vital universal minimum, fair distribution of material and psychosocial goods and resources produced by society, and igualitarian personal treatment and relationship.

Here are some thoughts: 

The article explores core communitarian values essential for effective community psychology practice, emphasizing the need to move beyond traditional deontological ethics toward a more socially grounded framework. It argues that community psychology has historically neglected explicit ethical discourse despite its intrinsic moral dimensions. To address this gap, the author proposes redefining autonomy as shared or collective autonomy , extending self-direction to the entire community rather than focusing solely on individuals. Additionally, self-care is introduced as a crucial value to sustain practitioners' psychological and moral integrity. The paper outlines three central socio-community values: human development , empowerment , and social justice . Human development integrates personal growth with social bonding, empowerment focuses on increasing individual and group capacity through awareness and action, and social justice is framed around three pillars—ensuring a vital minimum for all, equitable distribution of resources, and relational fairness. These values are intended to guide both ethical reflection and practical interventions in community settings.

How Does Therapy Harm? A Model of Adverse Process Using Task Analysis in the Meta-Synthesis of Service Users' Experience

Curran, J., Parry, G. D.,  et al. (2019).

Frontiers in Psychology, 10.

https://doi.org/10.3389/fpsyg.2019.00347

Abstract

Background: Despite repeated discussion of treatment safety, there remains little quantitative research directly addressing the potential of therapy to harm. In contrast, there are numerous sources of qualitative evidence on clients' negative experience of psychotherapy, which they report as harmful.

Objective: To derive a model of process factors potentially leading to negative or harmful effects of therapy, from the clients' perspective, based on a systematic narrative synthesis of evidence on negative experiences and effects of psychotherapy from (a) qualitative research findings and (b) participants' testimony.

Method: We adapted Greenberg (2007) task analysis as a discovery-oriented method for the systematic synthesis of qualitative research and service user testimony. A rational model of adverse processes in psychotherapy was empirically refined in two separate analyses, which were then compared and incorporated into a rational-empirical model. This was then validated against an independent qualitative study of negative effects.

Results: Over 90% of the themes in the rational-empirical model were supported in the validation study. Contextual issues, such as lack of cultural validity and therapy options together with unmet client expectations fed into negative therapeutic processes (e.g., unresolved alliance ruptures). These involved a range of unhelpful therapist behaviors (e.g., rigidity, over-control, lack of knowledge) associated with clients feeling disempowered, silenced, or devalued. These were coupled with issues of power and blame.

Conclusions: Task analysis can be adapted to extract meaning from large quantities of qualitative data, in different formats. The service user perspective reveals there are potentially harmful factors at each stage of the therapy journey which require remedial action. Implications of these findings for practice improvement are discussed.

Here are some thoughts:

The article offers important insights for psychologists into the often-overlooked negative impacts of psychotherapy. It emphasizes that, while therapy generally leads to positive outcomes, it can sometimes result in unintended harm such as increased emotional distress, symptom deterioration, or damage to self-concept and relationships. These adverse effects often arise from ruptures in the therapeutic alliance, misattunement, or a lack of responsiveness to clients’ feedback. The study highlights the importance of maintaining a strong, collaborative therapeutic relationship and recommends that therapists actively seek client input throughout the process. Regular supervision and training are also essential for helping clinicians recognize and address early signs of harm. Informed consent should include discussion of potential risks, and routine outcome monitoring can serve as an early detection system for negative therapy responses. Ultimately, this research underscores the ethical responsibility of psychologists to remain vigilant, self-reflective, and client-centered in order to prevent harm and ensure therapy remains a safe and effective intervention.

Relationship between empathy and burnout as well as potential affecting and mediating factors from the perspective of clinical nurses: a systematic review

Zhou H. (2025).

BMC nursing, 24(1), 38.

https://doi.org/10.1186/s12912-025-02701-0

Abstract

Background

Burnout is prevalent in healthcare professionals, especially among nurses. This review aims to examine the correlation between empathy and burnout as well as the variables that influence and mediate them.

Methods

This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, to present a systematic evaluation of literature. A literature search of four electronic databases including CINAHL (EBSCO), EMBASE, PubMed, and Google Scholar was conducted from 2014 to 2024. A total of 1081 articles were identified in the initial search. After screening the title, abstract, and context of these articles, 16 eligible articles were finally included in this review.

Results

This review identified a number of factors related to empathy and burnout levels. The included studies showed consistent results that empathy and burnout were generally negatively related. When considering the different components of empathy or burnout independently, as well as the mediating factors involved, relations between empathy and burnout may alter.

Conclusions

This study provided an excellent summary of some important research on the mediating and affecting factors associated with burnout and empathy. These results can facilitate further

Here are some thoughts:

This systematic review found that higher empathy levels among clinical nurses are generally associated with lower burnout, although specific subcomponents of empathy influenced burnout dimensions differently.

While greater empathic concern and perspective-taking were linked to reduced depersonalization and increased personal accomplishment, high personal distress was correlated with greater emotional exhaustion.

Burnout prevalence varied across settings, with moderate levels common among Chinese nurses and high burnout rates observed in trauma and emergency care units in the U.S. and Spain. Factors such as female gender, specialty area, permanent employment, and fixed shifts were associated with higher empathy and lower burnout, whereas longer working hours and rural practice environments contributed to increased burnout. Organizational climate, coping strategies, job commitment, secondary traumatic stress, and workplace spirituality were important mediators. Overall, the findings emphasize the protective role of empathy against burnout and support interventions targeting workplace environment and personal coping to enhance nurse well-being.

Moral reasoning in a digital age: blaming artificial intelligence for incorrect high-risk decisions

Leichtmann, B., et al. (2024).

Current Psychology.

https://doi.org/10.1007/s12144-024-06658-2

Abstract

The increasing involvement of Artificial Intelligence (AI) in moral decision situations raises the possibility of users attributing blame to AI-based systems for negative outcomes. In two experimental studies with a total of N=911 participants, we explored the attribution of blame and underlying moral reasoning. Participants had to classify mushrooms in pictures as edible or poisonous with support of an AI-based app. Afterwards, participants read a fictitious scenario in which a misclassification due to an erroneous AI recommendation led to the poisoning of a person. In the first study, increased system transparency through explainable AI techniques reduced blaming of AI. A follow-up study showed that attribution of blame to each actor in the scenario depends on their perceived obligation and capacity to prevent such an event. Thus, blaming AI is indirectly associated with mind attribution and blaming oneself is associated with the capability to recognize a wrong classification. We discuss implications for future research on moral cognition in the context of human–AI interaction.

Here are some thoughts:

This research explores how people assign blame in situations where AI systems make mistakes that lead to harmful outcomes.    

In two experiments with a total of 911 participants, the study examined blame attribution and the underlying moral reasoning involved when AI is used in decision-making.  Participants were asked to use an AI-based app to classify mushrooms in pictures as edible or poisonous.  They then read a scenario where a person was poisoned due to a misclassification by the AI.    

The study's key findings include:

• In the first study, providing explanations for the AI's decisions (using explainable AI techniques) reduced the amount of blame attributed to the AI.    

• The second study showed that blame attribution depends on the perceived obligation and capacity of those involved (AI, user, etc.) to prevent the harmful event.    

• Blaming AI is linked to the degree to which the AI is perceived as having a mind of its own, while blaming oneself is associated with the individual's capability to recognize the AI's errors. 

This research is important for psychologists for several reasons:

• It provides insights into how people perceive AI as a moral agent and how they incorporate AI into their moral decision-making processes.

• The findings highlight the complexities of blame attribution in human-AI interaction, which is crucial for understanding responsibility, accountability, and trust in AI systems.

• Understanding the factors that influence blame attribution, such as perceived agency, mind attribution, and the availability of explanations, can inform the design of AI systems that promote trust and appropriate accountability.    

The research also has implications for legal and ethical considerations surrounding AI, particularly in cases where AI systems are involved in accidents or errors that cause harm. 

Delaware Becomes 12th U.S. Jurisdiction to Authorize Medical Aid in Dying, First Since 2021

Compassion & Choices (2025)

20 May 2025

Delaware Governor Matt Meyer today signed the Ron Silverio/Heather Block Delaware End-of-Life Options Act into law in a public signing ceremony, ending a decade of dedicated advocacy led by Compassion & Choices Action Network and fulfilling his September 2024 promise to authorize the option of medical aid in dying for terminally ill Delawareans. 

The new law will grant a terminally ill, mentally capable adult with six months or less to live the option to request a prescription from their healthcare provider for medication they can choose to self-ingest and die on their own terms. Delaware is the 12th U.S. jurisdiction to authorize medical aid in dying (10 other states plus Washington, D.C.) and the first to do so since New Mexico in April 2021. The law takes effect on January 1, 2026 or once the final regulations are formed to support the law, whichever is sooner. 

“Today I’m going to sign a bill that speaks to compassion, dignity, and respect for personal choice,” said Governor Meyer in an emotional speech before the signing. “This signing today is about relieving suffering and giving families the comfort of knowing that their loved one was able to pass on their own terms, without unnecessary pain, and surrounded by the people they love most.”

The info is here.

Here is a brief summary.

On May 20, 2025, Delaware Governor Matt Meyer signed the Ron Silverio/Heather Block Delaware End-of-Life Options Act into law, making Delaware the 12th U.S. jurisdiction to authorize medical aid in dying. This legislation allows mentally capable adults diagnosed with a terminal illness and a prognosis of six months or less to request a prescription for medication they can choose to self-administer to end their lives peacefully. 

Key Provisions:

Eligibility Criteria: Patients must be at least 18 years old, residents of Delaware, diagnosed with a terminal illness with a prognosis of six months or less, mentally capable of making healthcare decisions, and able to self-ingest the prescribed medication. 

Compassion & Choices

Safeguards: The law includes multiple safeguards, such as requiring two healthcare providers to confirm the diagnosis and prognosis, two waiting periods, and ensuring that patients are informed about all end-of-life care options, including palliative care and hospice. 

The law is set to take effect on January 1, 2026, or upon the completion of necessary regulations, whichever comes first.

States & districts permitting MAiD.

Oregon (1997); Washington (2008); Montana (2009) – Legalized through a state Supreme Court ruling; 

Vermont (2013); California (2015); Colorado (2016); District of Columbia (2017); Hawai‘i (2018); New Jersey (2019); Maine (2019); New Mexico (2021); Delaware (2025)

The Benefits of Adopting a Positive Perspective in Ethics Education

Knapp, S., Gottlieb, M. C., & 

Handelsman, M. M. (2018).

Training and Education in Professional Psychology,

12(3), 196–202.

https://doi.org/10.1037/tep0000195

Abstract

Positive ethics is a perspective that encourages psychologists to see professional ethics as an effort to adhere to overarching ethical principles that are integrated with personal values, as opposed to efforts that focus primarily on avoiding punishment for violating the ethics codes, rules, and regulations. This article reviews the foundations of positive ethics, argues for the benefits of adopting a positive approach in ethics education, and considers recent findings from psychological science that support the value of a positive perspective by improving moral sensitivity, setting high standards for conduct, and increasing motivation to act ethically.

Here are some thoughts:

The article argues that traditional ethics training often focuses narrowly on rules and punishments—a “floor” approach that teaches students simply what they must not do—while neglecting the broader, aspirational ideals that give ethics its vitality. In contrast, a positive ethics perspective invites psychologists to anchor their professional conduct in overarching principles and personal values, framing ethics as an opportunity to excel rather than a set of minimum requirements. Drawing on concepts from positive psychology and decision science (such as approach versus avoidance motivation and prescriptive versus proscriptive morality), the authors show how a positive approach deepens moral sensitivity, elevates standards of care beyond mere compliance, and taps into intrinsic motivations that make ethical practice more meaningful and less anxiety-provoking.

This perspective matters for psychologists because it reshapes how we learn, teach, and model ethical behavior. By broadening ethical reflection to include everyday decisions—from informed consent to collegial interactions—a positive ethics framework equips practitioners to recognize and respond to moral dimensions they might otherwise overlook. Training that highlights internal motivations and the connection between personal values and professional standards not only reduces the fear and cognitive narrowing associated with punishment-focused teaching, but also fosters stronger professional identity, better decision making under stress, and higher-quality care for clients and communities.

Ethical drift: when good people do bad things

Kleinman C. S. (2006).

JONA'S healthcare law, ethics and regulation, 

8(3), 72–76. 

https://doi.org/10.1097/00128488-200607000-00004

 Abstract

There are many factors in today’s healthcare environment which challenge nurses and nursing administration in adhering to ethical values. This article discusses the phenomenon of ethical drift, a gradual erosion of ethical behavior that occurs in individuals below their level of awareness. It is imperative for nurse managers and executives to be aware of the danger that workplace pressures pose in encouraging ethical drift at all levels of nursing, and to take steps to prevent this phenomena from occurring in their facilities.

Here is a summary and some thoughts:

The article explores how well-intentioned nurses and healthcare leaders can gradually erode their own ethical standards without realizing it. Under pressures such as staffing shortages, budget constraints, and competing organizational demands, small justifications for bending the rules accumulate until significant breaches become normalized. Kleinman illustrates this phenomenon through scenarios in which nurse managers unconsciously override physicians’ orders or skew performance appraisals to meet immediate needs, ultimately exposing themselves and their institutions to liability, moral distress, and burnout. She traces ethical drift to broader shifts in moral philosophy—where diverse, and sometimes conflicting, theories of right action make it easier to rationalize incremental deviations—and emphasizes that its insidious nature lies in occurring below conscious awareness until serious harm has already been done.

For psychologists, understanding ethical drift is vital because it mirrors key concepts in social and cognitive psychology, such as moral disengagement, obedience to authority, and the slippery-slope effect of incremental rationalization. Industrial-organizational psychologists can apply these insights to design training, support groups, and leadership practices that reinforce core values and ethical vigilance in high-pressure environments. Clinical psychologists and supervisors working with healthcare professionals must recognize how stress and systemic demands can undermine personal integrity and patient care, integrating strategies like values clarification, reflective practice, and peer feedback into interventions. By bringing psychological theory to bear on the gradual erosion of ethical behavior, psychologists help ensure that individuals and organizations remain aligned with the foundational principles of care and professional integrity.

Ethical Fading: The Role of Self-Deception in Unethical Behavior

Tenbrunsel, A. E., & Messick, D. M. (2004).

Social Justice Research, 17(2), 223–236.

https://doi.org/10.1023/b:sore.0000027411.35832.53

Abstract

This paper examines the root of unethical dicisions by identifying the psychological forces that promote self-deception. Self-deception allows one to behave self-interestedly while, at the same time, falsely believing that one's moral principles were upheld. The end result of this internal con game is that the ethical aspects of the decision “fade” into the background, the moral implications obscured. In this paper we identify four enablers of self-deception, including language euphemisms, the slippery slope of decision-making, errors in perceptual causation, and constraints induced by representations of the self. We argue that current solutions to unethical behaviors in organizations, such as ethics training, do not consider the important role of these enablers and hence will be constrained in their potential, producing only limited effectiveness. Amendments to these solutions, which do consider the powerful role of self-deception in unethical decisions, are offered.

Here are some thoughts:

For psychologists, the concept of ethical fading is vital because it reveals the unconscious cognitive and emotional processes that allow otherwise principled individuals to act unethically. Tenbrunsel and Messick’s identification of four self-deception enablers—euphemistic language that obscures harm, the slippery-slope effect that numbs moral sensitivity, biased causal attributions that deflect blame, and self-serving self-representations—aligns closely with established constructs in social and cognitive psychology such as motivated reasoning, framing effects, and defense mechanisms . By understanding how moral considerations “fade” from awareness, psychologists can refine theories of moral cognition and affect, deepening insight into how people justify or conceal unethical behavior.

This framework also carries significant practical and research implications. In organizational and clinical settings, psychologists can design interventions that counteract ethical fading—reshaping decision frames, interrupting incremental justifications, and exposing hidden biases—rather than relying solely on traditional ethics education. Moreover, it opens new avenues for empirical study, from measuring the conditions under which moral colors dim to testing strategies that re-salientize ethical concerns, thereby advancing both applied and theoretical knowledge in the psychology of morality and self-deception.

Different judgment frameworks for moral compliance and moral violation

Shirai, R., & Watanabe, K. (2024).

Scientific Reports, 14(1).

https://doi.org/10.1038/s41598-024-66862-9

Abstract

In recent decades, the field of moral psychology has focused on moral judgments based on some moral foundations/categories (e.g., harm/care, fairness/reciprocity, ingroup/loyalty, authority/respect, and purity/sanctity). When discussing the moral categories, however, whether a person judges moral compliance or moral violation has been rarely considered. We examined the extent to which moral judgments are influenced by each other across moral categories and explored whether the framework of judgments for moral violation and compliance would be different. For this purpose, we developed the episodes set for moral and affective behaviors. For each episode, participants evaluated valence, arousal, morality, and the degree of relevance to each of the Haidt's 5 moral foundations. The cluster analysis showed that the moral compliance episodes were divided into three clusters, whereas the moral violation episodes were divided into two clusters. Also, the additional experiment indicated that the clusters might not be stable in time. These findings suggest that people have different framework of judgments for moral compliance and moral violation.

Here are some thoughts:

This study investigates the nuances of moral judgment by examining whether people employ distinct frameworks when evaluating moral compliance versus moral violation. Researchers designed a series of scenarios encompassing moral and affective dimensions, and participants rated these scenarios across valence, arousal, morality, and relevance to Haidt's five moral foundations. The findings revealed that moral compliance and moral violation appear to be judged using different frameworks, as evidenced by the cluster analysis which showed different cluster divisions for compliance and violation episodes. 

This research carries significant implications for psychologists, deepening our understanding of the complexities inherent in moral decision-making and extending the insights of theories like Moral Foundations Theory. Furthermore, the study provides valuable tools, such as the developed set of moral and affective scenarios, for future investigations in moral psychology. Ultimately, a more refined grasp of moral judgment processes can inform efforts to mediate conflicts and foster enhanced social understanding.

On bullshit, large language models, and the need to curb your enthusiasm

Tigard, D. W. (2025).

AI And Ethics.

https://doi.org/10.1007/s43681-025-00743-3

Abstract

Amidst all the hype around artificial intelligence (AI), particularly regarding large language models (LLMs), generative AI and chatbots like ChatGPT, a surge of headlines is instilling caution and even explicitly calling “bullshit” on such technologies. Should we follow suit? What exactly does it mean to call bullshit on an AI program? When is doing so a good idea, and when might it not be? With this paper, I aim to provide a brief guide on how to call bullshit on ChatGPT and related systems. In short, one must understand the basic nature of LLMs, how they function and what they produce, and one must recognize bullshit. I appeal to the prominent work of the late Harry Frankfurt and suggest that recent accounts jump too quickly to the conclusion that LLMs are bullshitting. In doing so, I offer a more level-headed approach to calling bullshit, and accordingly, a way of navigating some of the recent critiques of generative AI systems.

Here are some thoughts:

This paper examines the application of Harry Frankfurt's theory of "bullshit" to large language models (LLMs) like ChatGPT. It discusses the controversy around labeling AI-generated content as "bullshit," arguing for a more nuanced approach. The author suggests that while LLM outputs might resemble bullshit due to their lack of concern for truth, LLMs themselves don't fit the definition of a "bullshitter" because they lack the intentions and aims that Frankfurt attributes to human bullshitters.

For psychologists, this distinction is important because it asks for a reconsideration of how we interpret and evaluate AI-generated content and its impact on human users. The paper further argues that if AI interactions provide tangible benefits to users without causing harm, then thwarting these interactions may not be necessary. This perspective encourages psychologists to weigh the ethical considerations of AI's influence on individuals, balancing concerns about authenticity and integrity with the potential for AI to enhance human experiences and productivity.

Optimized Informed Consent for Psychotherapy: Protocol for a Randomized Controlled Trial

Gerke, L. et al. (2022).

JMIR Research Protocols, 11(9), e39843.

https://doi.org/10.2196/39843

Abstract

Background:

Informed consent is a legal and ethical prerequisite for psychotherapy. However, in clinical practice, consistent strategies to obtain informed consent are scarce. Inconsistencies exist regarding the overall validity of informed consent for psychotherapy as well as the disclosure of potential mechanisms and negative effects, the latter posing a moral dilemma between patient autonomy and nonmaleficence.

Objective:

This protocol describes a randomized controlled web-based trial aiming to investigate the efficacy of a one-session optimized informed consent consultation.

Methods:

The optimized informed consent consultation was developed to provide information on the setting, efficacy, mechanisms, and negative effects via expectation management and shared decision-making techniques. A total of 122 participants with an indication for psychotherapy will be recruited. Participants will take part in a baseline assessment, including a structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) disorders. Eligible participants will be randomly assigned either to a control group receiving an information brochure about psychotherapy as treatment as usual (n=61) or to an intervention group receiving treatment as usual and the optimized informed consent consultation (n=61). Potential treatment effects will be measured after the treatment via interview and patient self-report and at 2 weeks and 3 months follow-up via web-based questionnaires. Treatment expectation is the primary outcome. Secondary outcomes include the capacity to consent, decisional conflict, autonomous treatment motivation, adherence intention, and side-effect expectations.

Results:

This trial received a positive ethics vote by the local ethics committee of the Center for Psychosocial Medicine, University-Medical Center Hamburg-Eppendorf, Hamburg, Germany on April 1, 2021, and was prospectively registered on June 17, 2021. The first participant was enrolled in the study on August 5, 2021. We expect to complete data collection in December 2022. After data analysis within the first quarter of 2023, the results will be submitted for publication in peer-reviewed journals in summer 2023.

Conclusions:

If effective, the optimized informed consent consultation might not only constitute an innovative clinical tool to meet the ethical and legal obligations of informed consent but also strengthen the contributing factors of psychotherapy outcome, while minimizing nocebo effects and fostering shared decision-making.

Here are some thoughts:

This research study investigated an optimized informed consent process in psychotherapy. Recognizing inconsistencies in standard practices, the study tested an enhanced consultation method designed to improve patients' understanding of treatment, manage their expectations, and promote shared decision-making. By comparing this enhanced approach to standard practice with a cohort of 122 participants, the researchers aimed to demonstrate the benefits of a more comprehensive and collaborative informed consent process in fostering positive treatment expectations and related outcomes. The findings were anticipated to provide evidence for a more effective and ethical approach to initiating psychotherapy.

Avoiding the road to ethical disaster: Overcoming vulnerabilities and developing resilience

Tjeltveit, A. C., & Gottlieb, M. C. (2010).

Psychotherapy: Theory, Research, Practice, 

Training, 47(1), 98–110.

https://doi.org/10.1037/a0018843

Abstract

Psychotherapists may, despite their best intentions, find themselves engaging in ethically problematic behaviors that could have been prevented. Drawing on recent research in moral psychology and longstanding community mental health approaches to prevention, we suggest that psychotherapists can reduce the likelihood of committing ethical infractions (and move in the direction of ethical excellence) by attending carefully to 4 general dimensions: the desire to facilitate positive (good) outcomes, the powerful opportunities given to professionals to effect change, personal values, and education. Each dimension can foster enhanced ethical behavior and personal resilience, but each can also contribute to ethical vulnerability. By recognizing and effectively addressing these dimensions, psychotherapists can reduce their vulnerabilities, enhance their resilience, reduce the risk of ethical infractions, and improve the quality of their work.

The article is paywalled, unfortunately.

Here are some thoughts:

The authors argue that psychotherapists, despite their good intentions, can engage in unethical behaviors that could be prevented. Drawing on moral psychology research, they suggest that ethical infractions can be reduced by focusing on four dimensions: the desire to help, the opportunities available to professionals, personal values, and education. Each of these dimensions can enhance ethical behavior and resilience, but also contribute to vulnerability. By addressing these dimensions, psychotherapists can reduce vulnerabilities, enhance resilience, and improve their practice. Traditional ethics education, focused on rules and codes, is insufficient. A broader approach is needed, incorporating contextual, cultural, and emotional factors. Resilience involves skills, personal characteristics, support networks, and their integration. Vulnerability includes general factors like stress, and idiosyncratic factors like personal history. Prevention involves self-awareness, emotional honesty, and addressing vulnerabilities. The DOVE framework (Desire, Opportunities, Values, Education) can help psychotherapists enhance resilience and minimize vulnerabilities, ultimately leading to more ethical and effective practice.