心理咨询师/治疗师与来访者对职业伦理的态度比较

目的:考察我国当前心理咨询或治疗师与来访者在心理咨询与治疗领域职业伦理上的态度和意识,以帮助专业人员更好地理解和解决职业伦理困境,并为制定我国在该领域的职业伦理规范提供参考。方法:采用自编心理咨询与治疗职业伦理意识和态度问卷对48名专业人员(咨询师/治疗师)和48名来访者进行调查,比较两组人群在职业伦理意识和态度上的差异,以及一些重要人口学变量的可能影响。结果:两组人群在自编问卷的12个条目评判上有显著差异,其中涉及咨询关系原则4条(如47.9%的来访者认为专业人员可以和来访者发展私人关系,专业人员持同样看法的为4.2%,P<0.01);保密性原则1条;职业责任原则2条;评估、测量和解释原则2条;督导、培训和教学原则2条,另有一条为询问被调查者是否听闻过有违伦理的行为,发现来访者知晓的违反伦理行为(35.4%)显著少于专业人员(97.9%)(P<0.001);专业人员群体在17个条目上评判一致,仅在涉及咨询关系原则的1条目有争议,即48.3%的专业人员认为在来访者和咨询师价值观冲突时应转介来访者,51.7%的专业人员认为不应转介;来访者群体则在11个条目上评判一致,有4个争议条目,其中涉及咨询关系原则的条目3条(即在咨询师可否和来访者发生私人关系,咨询可否给来访者带来伤害,咨询师可否接受来访者的礼物问题上持肯定或否定意见的来访者都在40%以上);职业责任原则的条目1条,即56.3%的来访者认为咨询师可以按照自己的喜好选择病人,46.7%的来访者则持反对意见。结论:专业人员总体上表现出较强的伦理意识和较为一致的伦理态度,而来访者的伦理态度更不一致,两组人群在保密原则和咨询关系方面的态度差异尤其明显。

Comparison of Beliefs on Professional Ethics for Counseling and Psychotherapy between Counselors/Therapists and Clients

Objective:Examine and Compare the professional ethical attitudes and beliefs for counseling and psychotherapy between counselors/psychotherapists and clients who receive professional services in the field.Method:A questionnaire concerning ethical behaviors and attitudes was developed based on American Counseling Association Code of Ethics(2005),and administrated to 48 counselors/psychotherapists as well as 48 clients.The similarity and difference between ethical attitudes and beliefs of two groups were compared.Besides,the possible influences of certain important demographical variables were explored.Results:The two groups' responses differed in 12 out of 29 items,including 4 items derived from section of counseling relationship in ACA code of ethics(e.g.,47.9% clients thought clients could form personal relationship with counselors/psychotherapists,while only 4.2% professionals thought it was ethical,P<0.001),1 item from section of confidentiality,2 from section of professional responsibility,2 items from section of evaluation,assessment and interpretation,2 items from section of supervision,training and teaching as well as an item asking whether the respondent had ever knew about incidents of ethical violation and it was found 35.4% clients knew about incidents of ethical violation while 97.9% professionals reported they knew such incidents,P<0.001.Compared with client group,professional group demonstrated more consistent attitudes.For professionals,they agreed on 17 items and disagreed only on 1 item,i.e.48.3% professionals thought it was ethical to transfer clients to other service if counselors/psychotherapists had different values with clients while 51.7% thought it was not ethical to do so.For clients,they agreed on 11 items and disagreed on 4 items,including 3 items derived from section of counseling relationship,i.e.when asked whether it was ethical for counselors/psychotherapists to develop personal relationship with clients,whether counseling/psychotherapy could do harm to clients and whether it was ethical for counselors/psychotherapists to accept presents from clients,40% clients thought it was ethical and 40% clients thought it was not ehtical;1 item derived from section of professional relationship,i.e.56.3% clients thought it was ethical for counselors/psychotherapists to choose clients according to their own preferences while 43.7% clients thought it was unethical to do so.Conclusion:The group of counselors/psychotherapists demonstrated a fairly strict ethical attitude that was consistent with ACA Code of Ethics(2005) and a quite homogenous attitudinal pattern.In comparison,the client group showed a quite heterogeneous attitudinal pattern.The most significant differences between two groups lay in the area of confidentiality as well as professional relationship.