The Unbearable Implications of Setting Goals: Ethics in the World of Therapy: A Phenomenological Study

Emiliussen, Jakob

4. term

Psychology, Master

2011

2011-06-01

80

Denne afhandling undersøger de etiske dilemmaer ved at sætte mål i terapi: Hvem bestemmer målene, og hvem afgør, hvornår de er nået? Undersøgelsen bygger på fire semistrukturerede, fænomenologiske interviews med praktiserende terapeuter med forskellig erfaring. Interviewene varede omkring en time, blev transskriberet umiddelbart efter, og materialet blev analyseret med fortolkende fænomenologisk analyse (Interpretative Phenomenological Analysis, IPA) med mindre ændringer i kategoriseringsproceduren. Analysen identificerede 19 temaer, hvoraf 10 var centrale for problemstillingen, herunder revision af mål, patientens vilje, afslutning af terapi og evaluering af forløb. Et hovedfund vedrører begrebet terapeutisk neutralitet. Selvom neutralitet forventes i arbejdet med klienter, viser studiet, at fuld neutralitet i praksis næppe er mulig—selv ved tæt fastholdelse af en bestemt teori kan neutraliteten betvivles. Dette er problematisk, ikke mindst fordi neutralitet efterspørges i de nordiske psykologers etiske principper. Afhandlingen diskuterer, om neutralitet bør være et hovedkendetegn ved terapeutisk arbejde, og undersøger ideen om oplevet neutralitet—hvordan neutralitet fremstår for klient og terapeut. Der rejses også bekymring for, at behandlingsbeslutninger i nogle tilfælde styres mere af etiske principper end af teoretiske modeller. Metodiske spørgsmål behandles indgående, og resultaterne perspektiveres analytisk med positioneringsteori (Ron Harré) for at belyse de magtforhold, der er indlejret i terapeutrollen. Konklusionen er, at både fastsættelse af terapimål og vurdering af, om de er opnået, sker i et samarbejde mellem terapeut og klient. Processerne er dog ikke 'sterile', fordi begge parter kan have forskellige dagsordener. De deltagende terapeuter synes ikke fuldt ud at være bevidste om den magt, der følger med deres professionelle position; om dette er bevidst eller udspringer af uvidenhed, kan undersøgelsen ikke afgøre.

This thesis examines the ethical dilemmas involved in setting goals in therapy: Who should set the goals, and who decides when they have been reached? The study draws on four semi-structured, phenomenological interviews with practicing therapists with varying levels of experience. Each interview lasted about an hour, was transcribed promptly, and the material was analyzed using Interpretative Phenomenological Analysis (IPA) with minor adjustments to the categorization procedure. The analysis identified 19 themes, 10 of which were central to the research questions, including revising goals, the patient’s wishes, ending therapy, and evaluating progress. A key finding concerns therapist neutrality. Although neutrality is expected in work with clients, the study shows that full neutrality is difficult—perhaps impossible—to maintain; even close adherence to a given theory does not guarantee it. This is problematic in part because neutrality is demanded by the Ethical Principles of Nordic Psychologists. The thesis questions whether neutrality should be a defining feature of therapeutic work and explores the idea of perceived neutrality—how neutral the therapist appears to both client and therapist. It also raises concerns that treatment decisions may sometimes be guided more by ethical rules than by theoretical models. Methodological issues are discussed in depth, and the results are analytically generalized using positioning theory (Ron Harré) to highlight the power relations embedded in the therapist’s role. The study concludes that both goal setting and judging whether goals have been achieved are collaborative processes between therapist and client. However, these processes are not sterile, as both parties may bring different agendas. The participating therapists may not be fully aware of the power inherent in their professional position; whether this is intentional or due to lack of awareness remains unclear.

[This abstract was generated with the help of AI]

Phenomenology ; Interviews ; Goals ; Therapy ; Ideographic ; Qualitative ; Neutrality ; Ethics ; Setting Goals ; Therapists

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