By Associate Professor Marie Joyce FAPS, Chair, APS Ethical Guidelines Committee and Mick Symons MAPS, Manager, Member Services

With the increasing interest in spirituality in the community, the intersection of psychological services, religion and spirituality is likely to be a growth area in psychology (Plante, 2007). As an illustration, in recent years within the APS there has been a growth in Interest Groups with links to religion and spirituality. Working with clients around religion and spirituality issues does present potential ethical challenges. Psychologists who hold religious and spiritual beliefs need to remain alert to potential boundary violations when working with their clients. The APS Code of Ethics (2007) provides some useful standards to help navigate this path, and the Guidelines for managing professional boundaries and multiple relationships (2008) gives more specific content to consider.

Four main areas of potential ethical concern for practitioners have been described by Plante (2007) and are outlined below. The relevant standards from the Code of Ethics are provided to offer additional guidance. Psychologists experiencing a sense of concern when dealing with spiritual or religious issues are strongly advised to consult a senior colleague and the APS ethical resources.

Integrity issues: Blurred boundaries and dual relationships

There are instances of registered psychologists providing psychological services who are also members of the clergy and religious orders, raising the potential for dual relationships. In such cases it is advisable that psychologists do not provide psychological services to people to whom they are also providing spiritual/religious guidance. Clients will be less likely to confuse the two roles, or have misplaced expectations of the psychologist.

Where clients are aware of a psychologist's religious affiliation, it is crucial that the boundary between the two roles is clearly communicated. Clients need to know the limits to confidentiality for that situation. For example, if a client spoke to a psychologist believing that the seal of confession applied, he or she may be shocked to find that a psychologist hearing about child abuse could be obliged to report the client under law.

  • Standard C.3.1. Psychologists refrain from engaging in multiple relationships that may impair their competence, effectiveness, objectivity or ability to render a psychological service.

Respect issues: Spiritual and religious bias

Deeply held religious beliefs, or agnostic or atheist views, may form part of a psychologist's world view. However when working with clients, it is important the beliefs do not interfere with the psychologist's primary role, which is to place the wellbeing of the client as paramount.

For example, an atheist psychologist who strongly believes that religion is a way of avoiding responsibility for one's life may advise a client to abandon their use of prayer when overcoming grief, amounting to the psychologist imposing their own world view and not respecting that of the client.

  • General Principle B: Propriety. "... The welfare of clients and the public, and the standing of the profession take precedence over a psychologist's self-interest."
  • Standard A.2. Respect

Competence issues: Membership of a faith tradition does not make one an expert

Situations do arise where clients may attend the same local place of worship as their psychologist. With that knowledge some clients who may be struggling with existential issues might seek the psychologist's own interpretation of relevant religious matters, such as the concept of life after death, ascribing expert status to the psychologist because they are from the same religious institution.

In such situations, psychologists need to be cautious about separating specific questions relating to religion or religious teachings from the primary task of providing a psychological service and working towards the client's psychological goals, whatever they may be. If specific religious knowledge is important to the client, then perhaps that knowledge should be sought from a competent source distinct from the consulting room.

  • Standard B.1.2. Psychologists only provide psychological services within the boundaries of their professional competence...including...basing their service on the established knowledge of the discipline and profession of psychology

Concern issues: Destructive religious beliefs and behaviours

There is a wide array of different religions represented by clients of psychologists. Tragically, some religious beliefs are associated with people taking extreme actions such as acts of terrorism. Other views can also have a potential detrimental effect on clients.

For example, where a psychologist is working with a teenage girl and her parents wish to exclude her from the family because she identifies as a lesbian - a position which is against their religious beliefs - there is a need to balance respect for the family's beliefs against the potential harm to the client. As stated above, ultimately psychologists do need to place the wellbeing of their client as paramount, which would inform the course of action.

References

Australian Psychological Society. (2007). Code of ethics. Melbourne: Author.

Australian Psychological Society. (2008). Guidelines for managing professional boundaries and multiple relationships. Melbourne: Author.

Plante, T. G. (2007). Integrating spirituality and psychotherapy: Ethical issues and principles to consider. Journal of Clinical Psychology, 63, 891-902.

InPsych August 2009