不同职业背景心理咨询和治疗从业者的伦理行为

Ethical behaviors among counselors and psychotherapists with different professional background

目的:了解不同职业背景心理咨询和治疗从业者的伦理行为,加强心理咨询和治疗职业伦理教育。方法:以前期编制的心理咨询或治疗伦理问题调查问卷(咨询师版),对全国西北、华北、华东、中南、东北、西南每个行政区的3～4个城市共690名心理咨询和治疗从业者进行调查,并分析精神科医师、临床心理治疗师、学校心理咨询师三种职业背景从业者的伦理行为状况。结果:三种职业背景的从业人员中,以精神科医师的从业年限最长(>10年的占16.7%),对于每一个来访者平均的治疗次数最多(>10占20.1%),平均每次咨询时长最短(≤30分钟的占3.4%)。伦理行为调查中,在胜任力方面,三组人员各有70%都"感到力不从心、难以胜任";67.7%的精神科医师和62.5%的学校心理咨询师害怕自己不能够满足患者的需要;在知情同意和保密方面,17.4%的精神科医师"在走廊、电梯等公共场所与同事讨论来访者治疗方案";84.5%的临床心理治疗师"在治疗前向来访者讲明收费标准和规定";双重关系条目中,超过30%的精神科医师、临床心理治疗师和学校心理咨询师"特别喜欢某些来访者";14.1%的精神科医师对某些来访者产生性幻想;在咨询设置方面,有31.4%的精神科医师、25.0%的临床心理治疗师和20.1%的学校心理咨询师在咨询期间接听电话。不同性别、从业年限的心理咨询和治疗从业者"害怕不能满足患者需要"等部分条目差异有统计学意义。结论:本研究显示,不同职业背景心理咨询和治疗从业者都存在一定比例的违背伦理要求的行为,精神科医师出现违背伦理行为的比例较高。提示需要根据不同职业不同特点有针对性的进行伦理教育。

Objective： To explore the ethical behavior among counselors and psychotherapists with different professional background, provide the psychological counseling and therapy professional ethical education. Methods： Totally 690 participants were investigated with the self-compiled questionnaire for ethical problems in psychotherapy and counseling （for the psychological counselor）. Every 3 -4 cities were chosen in 6 administrative areas including North China, Northeast China, East China, Middle South China, Southwest China, and Northwest China. The current states of ethical behaviors on psychiatrists, clinical psychologists and school counselors were analgzed. Results： In the three groups, psychiatrists＇ working years （ 〉 l0 years accounted for 16.7% ） and the average treatment times for each client（ 〉 10 times accounted for 20. 1%）were the longest. In addition, the average counseling time was shortest（ ~〈30 min accounted for 3.4% ）. In confidence, 70% of each group ＂felt powerless, difficult to be compe- tent＂; 67.7% of the psychiatrists and 62. 5% of the school counselors ＂feared that not meeting with client＇s needs＂ , In privacy and confidentiality, 17.4% of the psychiatrists ＂talked about treatment with colleagues in the hallways, elevators and other public places＂; 84.5 % of the clinical psychologists ＂talked about fee before charge standard＂. In double relations, more than 30% of the psychiatrists, clinical psychotherapists and school counselors ＂specially liked some visitors＂; 14. 1% of the psychiatrists ＂produced sexual fantasies for clients＂. In treatment setting, 31.4% of the psychiatrists, 25.0% of clinical psychotherapists and 20. 1% of the school counselors ＂answered the phone in counseling＂. Different gender, working life and having supervisor of different background of counselors and psycho- therapists were partly significantly different, such as ＂feared that not meeting with client＇s needs＂. Conclusion： This study indicates a certain percentage between the different professional background of counselors and psychothera- pists violate the ethic behavior, but a higher proportion for psychiatrists. According to professional background of the different characteristics targeted for ethics education is necessary.