When teaching students about APA's Ethical Principles of Psychologists and Code of Conduct, instructors may productively explore with students what is uniquely psychological about the ethics of our profession. The answer is not immediately obvious.
As an example, Ethical Standard 10.05, Sexual Intimacies with Current Therapy Clients/Patients, states simply, "Psychologists do not engage in sexual intimacies with current therapy clients/patients." A student could respond to an instructor's question by arguing that although the reasons for the rule have particular applicability to psychologists, the rule itself is straightforward and does not require any special psychological expertise to apply. A description of the relevant behaviors will usually be sufficient to determine whether a psychologist's behavior is consistent with this standard.
This student's response has merit but would invite the instructor to press more deeply. Ethical Standard 3.05, Multiple Relationships, provides another perspective on the instructor's question:
A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.
The instructor could make a compelling argument that determining when a relationship impairs "a psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist" is uniquely and thoroughly psychological, in two senses. First, psychologists are trained to do the work that is under scrutiny, so psychologists are in the best position to assess when a multiple relationship could reasonably be expected to impair their work. Second, psychologists are trained to consider the psychological implications of interpersonal relationships. Assessing how a multiple relationship could impair a psychologist's work often entails understanding the psychologies of the individuals involved. Insofar as the application of Ethical Standard 3.05 may call for a deep understanding of human psychology, this standard offers a more nuanced reason why our Ethics Code is about psychology than does Standard 10.05.
The framework that Standard 3.05 contains may therefore provide an opportunity to go even deeper into our thinking about what is psychological about our ethics. Standard 3.05 begins by defining a multiple relationship:
A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.
Standard 3.05 explicitly addresses relationships external to the psychologist. Implicitly, Standard 3.05 invites psychologists to think about our internal relationships — that is, the relationships among our own identities. It is crucial to stress that the term "multiple" or "self- identities" here does not suggest pathology. Rather, each of us has multiple identities in our everyday lives. We are parents, siblings, children, grandchildren, significant others, teachers, psychologists, coaches, members of faith communities and myriad others. These identities reside with us in our healthy, non-pathological, daily activities. These identities populate our internal lives and may be thought of as our self-identities.
Our instructor may press the students further to explain what happens to various of these identities when a psychologist offers services in a professional role. This line of questioning often highlights how Standard 3.05 may be used creatively to think about our ethics. Asked what happens to one's identity as a parent when providing psychotherapy to a client, especially a client who is struggling as a parent, the student may quickly respond, "I'm there as a psychologist, not as a parent." True enough, the instructor may respond with a twinkle in her eye, but that's not the question at issue. The question is rather how these two self-identities — parent and psychologist — relate to one another. Not uncommonly, the class turns to Standard 3.05 as a way of thinking about this question. What's interesting, and can be playful for the class to ponder, is where one's self-as-parent goes when the person is in the role of a psychologist. Does it, should it, could it disappear?
Here our profession's rather rigid history with multiple relationships may get in the way of good ethical thinking. The belief that all multiple relationships are unethical may lead a student to conclude that a rigid demarcation among identities is preferable or necessary. Of course, such demarcations are not possible and attempting to behave as though they are is futile, counterproductive and painfully distracting. Although a psychologist who is a parent is not parenting during psychotherapy, such a psychologist nonetheless remains a parent during the session. Standard 3.05 offers a way to think about this intra-psychic condundrum.
The analysis posed by Standard 3.05 examines whether the psychologist can draw flexibly upon different self-identities to help the client move toward his or her goals. The important language from the standard is "in performing his or her functions as a psychologist," which provides a touchstone for the psychologist in assessing the appropriate role of different self-identities. When in a professional role, the psychologist is firmly planted in his or her role as a psychologist and other self-identities fade into the background. But they do not disappear, and are available in the service of the client should the psychologist deem it helpful to draw upon them.
Applying Standard 3.05 to an intra-psychic context can be helpful in thinking about the ethics of self-disclosure. Self-disclosure can be viewed as invoking aspects of a particular self-identity and intentionally making those aspects available to a client. Standard 3.05 gives useful guidance for when not to self-disclose, namely, when the disclosure would impair the psychologist's objectivity, competence or effectiveness in performing his or her functions as a psychologist. Carefully scrutinizing this language illustrates its relevance to intra- as well as extra-psychic contexts. Inappropriate self-disclosures can create significant problems for a psychologist remaining objective and effectively doing the work of a psychologist, just as engaging in inappropriate multiple relationships with clients can have these very same effects.
The Ethics Code is written by and for psychologists. The code offers deep psychological insights, with profound clinical implications. We are at our best as ethics instructors when we help students appreciate the many levels on which the code can be read, and teach them how the code speaks to all the psychologies involved in the work psychologists do.
Dr. Stephen Behnke is director of APA's Ethics Office.
