Ethical considerations for addressing distorted beliefs in psychotherapy

Abstract

With rising rates of misinformation, psychotherapists are likely to encounter clients with distorted beliefs that are scientifically unsound. In situations where these beliefs are harmful (e.g., vaccination refusal, misunderstanding of sexual consent), psychotherapists may face an ethical dilemma regarding how to proceed with psychotherapy. This is especially true if such beliefs are impairing treatment progress or resulting in safety concerns for the client or society. Questions about whether and how the psychotherapist should address these distorted beliefs are therefore likely to arise. In such cases, psychotherapists are tasked with respecting the client's autonomy, while simultaneously being of maximum benefit to the client and to society at large. Not all distorted beliefs warrant therapeutic intervention, but this judgment requires careful consideration. The current article addresses the relevant ethical considerations for navigating and addressing distorted beliefs in psychotherapy. A vignette is offered, and relevant sections of the American Psychological Association's Ethics Code are discussed, both as they pertain to this scenario and as they apply more generally to the practice of psychotherapy. The article concludes with questions for psychotherapists to consider and recommendations for how to proceed when confronted with harmful distorted beliefs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Figure 1.

Decision Tree for Addressing Distorted Beliefs. We define a distorted belief as “necessary” to discuss if disregarding the belief would impede the client’s recovery or pose legitimate risk to the client or others.