Therapist-client sexual involvement has been shown to have damaging effects on clients, therapists and the mental health professions. As sexual attraction necessarily precedes sexual involvement, the incidence, experience and management of sexual attraction to clients was investigated in a sample of 485 South African clinical psychologists (return rate 23%). Evaluation of training and attitudes to sexual involvement with current and former clients and to other forms of touch in therapy were also investigated. Survey data from 111 psychologists reveal that 63.1% (79.1% of men and 52.9% of women) have been sexually attracted to clients, at least on occasion, while 97.1% have never become sexually involved with a client. Most (61.4%) do not feel anxious, guilty or uncomfortable about the attraction, although more women (50%) than men (26.5%) do. More than half (58.2%) felt that their sexual attraction had benefited the therapy process, while 76.1% believed that it had never been harmful. Men reported significantly more frequent benefit than women. In managing their sexual attraction, 60.8% sought support from supervisors, peers and their own therapists, while 31.9% worked through the feelings on their own. Ethical practice and welfare of clients were more important reasons for refraining from acting on sexual attraction than fear of legal or professional censure. Ethics codes consulted reflect the lack of nationally endorsed guidelines. Almost half (45.7%) had received no education about therapists' sexual attraction to clients, while only 10.6% had received adequate education. Education about the ethics of therapist-client sexual involvement was rated as significantly more adequate than training about therapists' sexual attraction to clients. Most (74.2%) said that their training was useful in helping them to make informed decisions about sexual involvement with clients. The majority (92.5%) felt that education on these issues should be a required part of training for clinical psychologists. Sexual involvement with former clients was considered less unethical than with current clients (65.2% vs 98.9%). 55.9% believe that there are circumstances in which sexual involvement with former clients might not be unethical, particularly depending on time since termination. Appropriate time between termination of therapy and sexual involvement ranged from immediately (1.8%) to never (44.1 %). Certain forms of touch are considered ethical, although attitudes varied depending on context and form. A handshake was rated to be always ethical by 66.3%, while 83.2% believe kissing is never ethical. There was lack of consensus about hugging and holding hands. Implications of findings and directions for future research are discussed. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

This study examined the ethical decision-making process as it transpired in the everyday context of the therapeutic space. In-depth interviews explored the subjective experiences of six South African psychologists, practicing as psychoanalytic psychotherapists, and their efforts to resolve real-life ethical dilemmas. The theoretical framework used to interpret the data subsumed professional literature in psychology on principle-based ethical decision-making as well as contemporary psychoanalytic debates on the phenomenon of countertransference enactments. A review of ethics codes, survey research and seminal decision-making frameworks suggests that ethical dilemmas have traditionally been resolved by recourse to an objective and impartial “principle ethics” perspective. Empirical evidence shows, however, that logical thinking and the rational application of codes, principles and standards are often insufficient to secure ethical action. The establishment of reflective space and the core theoretical notion of “ethical decision-making enactments” were proposed in order to address the subjective, irrational and unconscious dimension of professional decision-making. This study used a broadly hermeneutic research method which transformed participants‟ descriptions of engagement with real-life dilemmas into a psychoanalytically informed interpretive account of ethical decision-making. Twelve aspirational ethical principles were found to guide participants‟ daily analytic work. Beneficence was the principle most strongly identified with and nonmaleficence was the most neglected ethical principle. Unprocessed countertransference responses were shown to drive earlier prereflective phases of the ethical decision-making process. Mature ethical judgment was predicated upon the retrospective analysis of enactment phenomena. Dissatisfaction was expressed by all participants with regard to the role of professional resources in aiding the resolution of stressful ethical dilemmas. Risk factors for compromised professional decision-making included the paucity and perceived irrelevance of postgraduate ethics training, supervisory failure to confront the ethical and countertransference dimensions of common dilemmas and professional isolation. Rather than eliciting the hope of emotional support and greater insight, professional resources on the contrary mostly appeared to induce anxiety, mistrust and fearfulness. Based on the data and the literature, a pragmatic psychoanalytically informed ethical decision-making model was finally generated. The model, which considers both principle ethics as well as countertransference phenomena, offers a preliminary contribution to professional dialogue on the development and evaluation of empirically based decision-making frameworks. Practical recommendations are made for both the revision of the current South African ethics code and for improving the postqualifying ethics education of psychoanalytic practitioners and supervisors. The limitations of the data are discussed and directions for future research initiatives are proposed.

Based on the above findings, the researcher has the following suggestions: (1) The use of therapeutic settings and therapeutic relationships in working with clients should be strengthened in education and continuous professional training for Chinese psychotherapists, especially to those who do not have educational background in medical science. Simultaneously, it is important to enhance the reflectivity of Chinese psychotherapists on their work and life experience. (2) To emphasize the legitimacy of psychotherapy in China, we have to regulate the norms of the profession according to the professional Code. Further, the principle of "do no harm" should be given higher priority in psychotherapy, psychotherapist need to cope with the demands from reality using wisdom and reason, pay attention to the affective needs of clients and promote social justice. (3) In the development of psychotherapy in mainland China, special efforts should be made to preserve the positive elements in traditional Chinese culture for the helping professions, keeping a balance between technical rationality and humane concern. We should pay attention to the goals of enhancing individual development, respect for diversity and importance of equality in practice as well as utilize the Chinese tradition and culture in helping clients to develop compassion, having empathetic understanding on the needs of one another. The purpose of doing so is to develop a new culture valuing compassion and reason in relating to one another. / The major findings of this research are as follows. (1) The understanding on the role of the therapeutic settings by the therapists are different. In comparison, those with training in psychoanalysis tend to attach more importance on the role of therapeutic settings than those who do not have such training. (2) The mainland psychotherapists still emphasis the importance of affection in relating with clients, using special rather than standard treatment for particular clients, which may result from the "differential distance in interpersonal relationship" dominant in Chinese culture. (3) Professional ethics for communities of counseling practice is newly introduced into mainland China, and people are beginning to pay attention to its relevant ethics. Its development, however, is still in infancy stage. (4) The mainland Chinese psychotherapists emphasis more on building relationship with people than developing technical skills in psychotherapy. This may be related to the fact that Chinese culture attaches more importance to interpersonal relationships. / This research attempts to answer the following questions: (1) What are the understanding of mainland Chinese psychotherapists about the meaning of professional ethics and therapeutic relationships? (2) How do they establish therapeutic relationships with their clients? (3) Are there any patterns in their establishment of therapeutic relationships, and how they interpret these patterns? (4) In their views, what are the principles and main points in establishing a healthy therapeutic relationship? / This study has implications for the helping professions in mainland China that it reveals the experiences, feelings and cognition of some mainland Chinese psychotherapists in their embodied professional ethical norms and therapeutic relationships. It illustrates the characteristics of these psychotherapists in dealing with professional relationships in a country which still values relationships and human feelings. The study also examines the factors that have influenced these psychotherapists in the development of their characteristics, e.g. the country's history, modern cultural atmosphere, and the ordinary people's routine styles of interpersonal exchange in China. The findings of this study, as a preliminary exploration of the process of establishing ethical norms and principles in mainland China, would be helpful to the development of social work in mainland China. (Abstract shortened by UMI.) / This study is significant as it is the first qualitative inquiry of the therapeutic relationships between clients and psychotherapists in mainland China. It explores the the impact of Chinese cultural tradition and modern social development on the mentality of mainland Chinese psychotherapists. / Using social constructivism as the epistemological frame, ecological systems theory is chosen as the theoretical framework in conducting the study using qualitative research. In-depth interviews and on-site observations are the methods chosen to collect data. The main source of data comes from in-depth interviews with 15 psychotherapists in different institutes located in four cities in mainland China. Through careful analysis of the data, thick description is used to describe the data. And using thematic analysis for the interpretation of the findings. / 陳向一. / Source: Dissertation Abstracts International, Volume: 71-01, Section: A, page: 0332. / Thesis (doctoral)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (p. 277-300). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Chen Xiangyi.

Privilege is an evidential principle which, on the grounds of public policy, excludes evidence relevant and otherwise admissible. This thesis aims to discover whether privilege should be applied to the psychotherapeutic profession in South Africa. At present, the only profession in South Africa afforded privilege is the legal profession. There are two main theoretical justifications for privilege: the utilitarian and the individual/human rights approach. This thesis considers whether the psychotherapeutic profession wan-ants privilege under either theory, and recommends that the law of privilege integrate both theories rather than adopt one or the other. The impact of the Constitution and the right to privacy receive particular attention. Very little literature or case law on the question of psychotherapeutic privilege was found in South Africa. Consequently, extensive comparative research into the common-law systems of England, Canada and United States of America was done. This research yielded some interesting findings. The first is that case-by-case development of the law of privilege is uncel1ain and fragmented. The next is that psychotherapeutic privilege exists in almost absolute form in the United States of America, but is littered with lacunae causing as much uncertainty as the case-by-case approach to privilege law. The most helpful method of dealing with the problem was found in Canada, where a two-stage approach to protecting personal information, including psychotherapeutic records, has been developed. In light of this research, this thesis reassesses the original viability of psychotherapeutic privilege in South Africa. Privilege, it was found, is not the best solution to protecting psychotherapeutic communications. This thesis recommends legislative adoption of an amended two-stage approach based on the Canadian model for sexual offence trials as the best method of protecting psychotherapeutic communications in both civil and criminal proceedings. The thesis ends by suggesting draft legislative provisions.

The tone of this dissertation is in the first person as allowed by the lens of constructivism used in it. Being constantly self-reflective, the author takes the reader through his personal journey to be a therapist, and the ethical dimensions encountered in the process, to indicate that one cannot do therapy \\'ithout considering ethics in the fusion of the professional and personal selves of the therapist.- What is lost in the delineated field of observation is hoped to be gained, in the richness of its personal material. Not aiming at drawing any generalisable arguments, the purpose of the dissertation is to provoke a dialogue about our ethical conduct with clients, indicating that our therapeutic conduct is enriched by constantly involving ourselves in the ethical dilemmas that emerge in the therapeutic process. / Psychology / M.A. (Clinical Psychology)

The tone of this dissertation is in the first person as allowed by the lens of constructivism used in it. Being constantly self-reflective, the author takes the reader through his personal journey to be a therapist, and the ethical dimensions encountered in the process, to indicate that one cannot do therapy \\'ithout considering ethics in the fusion of the professional and personal selves of the therapist.- What is lost in the delineated field of observation is hoped to be gained, in the richness of its personal material. Not aiming at drawing any generalisable arguments, the purpose of the dissertation is to provoke a dialogue about our ethical conduct with clients, indicating that our therapeutic conduct is enriched by constantly involving ourselves in the ethical dilemmas that emerge in the therapeutic process. / Psychology / M.A. (Clinical Psychology)

This qualitative study aimed to trace the psychotherapeutic development of clinical and counselling psychologists across the careerspan within the South African context. Through purposive sampling 34 psychologists were recruited according to the inclusion criteria of the study. Five distinct career levels were explored, namely, student (n=10), intern (n=7), early career (n=7), experienced (n=5), and senior (n=5) psychologists in relation to the Society of Psychotherapy Research’s international model of psychotherapist development. By means of semi-structured interviews, couched in the social constructionist position, participants’ experiences were thematically analysed from over 600 pages of transcription. Additionally, the researcher’s personal journey of developing as a psychotherapist was reflected upon. The current study found that a number of aspects fostered the development of psychotherapists. Participants reflected on personal and familial wounding events that influenced them choosing a career as a psychologist; this awareness was gradual over their development. Across theoretical orientations, participants resisted adhering to one way of working in light of the diverse South African context. However, the need to limit the number of theoretical orientations taught within the first months of training was proposed. Professional sources of influence highlighted by participants were personal therapy and peer supervision or reading groups. Qualified professionals to a lesser extent made use of individual supervision which when pursued needed to be a ‘felt’ collaboration. Participants found as they developed they became more comfortable being a psychotherapist however the complexity of cases still kept them humble. Limitations of the study, potential future research directions as well as recommendations for practicing clinical and counselling psychology were outlined. / Psychology / Ph. D. (Psychology)