Gavazzi, J. D., and Slattery, J. M. (2025).
The Pennsylvania Psychologist, (85)4, 19-21.
Abstract
This article explores the spectrum of patient harm in psychotherapy, ranging from routine clinical errors to the severe phenomenon of moral injury. While the therapeutic relationship is built on a fiduciary responsibility to act in a patient's best interest, unintentional missteps—such as cognitive errors, cultural insensitivity, or boundary crossings—can disrupt a client's "meaning-making" process and erode trust . In extreme cases, unprofessional conduct and unethical "innovative" techniques can lead to moral injury, characterized by deep feelings of betrayal, shame, and the violation of one's moral code. By examining the catastrophic case of Genesis Associates, the authors illustrate how the structure of psychotherapy can be weaponized to cause lasting psychological damage. Ultimately, the article advocates for a proactive commitment to ethical pillars (including cultural humility and transparent consultation) to protect the sanctity of the therapeutic alliance.