Therapeutic Missteps and Moral Injury: When Helping Harms

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.

A copy of the article is here.

Why Artificial Intelligence Will Not Replace Human Psychologists: Legal, Ethical, and Clinical Limitations

Gavazzi, J. (2025, December).

Psychotherapy Bulletin, 61(1).

Clinical Impact Statement

The responsible integration of artificial intelligence (AI) into the practice of psychology requires that it functions strictly as a tool for human psychologists who must retain ultimate accountability for all clinical decisions. AI systems cannot replace empathy, judgment, and professional responsibility, which form the foundation of high-quality psychological care.

This article builds on previous arguments (Gavazzi, 2025a; Gavazzi, 2025b) stating that although AI technologies are rapidly advancing, they cannot replace human psychologists performing psychotherapy; this is simply the result of evolutionary advantages in humans across social, emotional, and cognitive domains that are essential for therapeutic interactions. In addition, these systems are unlikely to replace psychologists in the foreseeable future for practical reasons. Legal, ethical, and clinical barriers— particularly those involving state licensing, clinical judgments, forensic considerations, and accountability—make the deployment of autonomous systems in therapeutic settings impractical and potentially dangerous. This article presents key structural and philosophical reasons why human oversight and involvement remain essential in psychological practice.

The article is here.

Happy New Year!! I will be taking a health hiatus. I hope to be back soon.