Manuel Trachsel - The Oxford Handbook of Psychotherapy Ethics

Bruce E. Wampold, Ph.D. Madison, WI, USA

Professor Emeritus, University of WisconsinMadison and Senior Researcher, Research Institute, Modum Bad Psychiatric Center, Vikersund, Norway

In an evidence-based world, the emphasis in health services is on finding the most effective treatment for a particular disorder. In the latest iteration of the application of evidence to improve health, the notion of personalized medicine has been introduced, turning the focus on what is the most effective treatment for this particular patient with this particular disorder. In many ways this has been a technological endeavor, with attempts to increase longevity by days, it seems, and mortality by minute percentages. In this technological effort to make incremental advances by focusing on treatments, or even for treatments for individual patients, the patient and their context are secondary, if not ignored. Lip service is paid to patient preferences and the psycho and social aspects of the biopsychosocial, but the person as an agentic participant is too frequently ignored.

If health service is to retain the essence of healing practices, with a respect for the patient, health care ethics must be central to all aspects of health systems. Ethical considerations are not simply add-ons to satisfy societys demands for such servicesrather they should be endemic to the study of services, to the training of clinicians, to the delivery of services, to the evaluation of qualityall aspects of health services must be saturated with a consideration of ethics. This is an imperative for an effective health care systemone that not only demonstrates caring and respect for the patient, but one that is sustainable, is utilized by those who need services, and effective. Too many mistakes in health care have been committed by ignoring ethics.

Much has been written about ethics generally and, despite the focus on treatments, in health care specifically. Indeed, there is a name for the field in health carebioethics. There are bioethics academic programs (usually in medical schools), graduate degrees, and professors of bioethics. There is a plethora of experts to comment on thorny problems in bioethics that are raised in public.

Although bioethics is ubiquitous, the ethics of psychotherapy is neglected. This is quite surprising, and frankly disturbing, because the practice of psychotherapy raises ethical issues by its very nature. Psychotherapy is an intimate relationship between two persons but a very specialized oneand this raises a host of ethical issues. Moreover, each type of therapy creates a different type of relating. In each, the therapist takes a different stance.

The psychotherapy field desperately needs a comprehensive volume dedicated to psychotherapy ethics. The editors of The Oxford Handbook of Psychotherapy Ethics xManuel Trachsel, Jens Gaab, erife Tekin, Nikola Biller-Andorno, and John Z. Sadler, collectively have thought and written about this subject to a greater extent that the remainder of the field, most likely. The volume they have created and edited covers the ground comprehensively, with sections and topics as follows:

This volume is a must read for everyone in the psychotherapy field: clinicians, educators, trainees, researchers, policy makers, and managers of mental health care. Unless this material is read and understood, we are flying blind when it comes to becoming ethical professionals.