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.