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Ethical Issues in Psychotherapy Punishment Informed consent Transference Abreaction Value systems Psychoanalysis an hedonism Punishment • Reject psychotherapy as punishment • Some neurotic px may perceive it as such Punishment • Penological reform by the court – Decide first on the facts of criminal action – Secondly: moral responsibility of the person – * Moral freedom can be destroyed by mental confusion • Based on expert testimony from psychiatrist – Should be directed to determining the defendant’s freedom limited by the psychological factors – Why the accused chronic or temporary psychological condition did or did not render him so unfree – Whether he cant be held responsible for the act – If he is partially responsible, in what degree or in what respect • It is unjust to punish someone for acts for which he or she was not MORALLY responsible • Role of the psychiatrist in the process of punishment – Limited to 2: 1. diagnose inmates who develop mental illness and thus treatment 2. As consultants to penologists in setting up routines that make good for mental health and discipline Informed consent • Issue of comptency • Mentall disturbed pxs: – Unable to understand the risk or purpose of treament – May not be truly free to make a decision • Fear • Masochistic tendecies (desire to suffer or to be humiliated) • Narcississm Informed consent • If impossible for the patients: patient’s guardian with observance of legal process • Treatment without consent: – Must have the objective to bring the patient as as soon as possible to the level of mental integration • Use of drugs or psychosurgery transference • Primarily in therapy • Termination of therapy: patient is sufficiently autonomous and under self control • Issue of responsibility by the therapist – Must be trustworthy – Maintain secrecy – True concern for the px – Prompt in appoinments *avoid manipulating the patient for personal gratification