Clients’ and therapists’ perspectives on the role of therapists’ values in psychotherapy

Abstract

Background: There has been a growing concern about the ethical aspects of psychotherapy and the role that personal values can play in this context. Objective: To explore the role of therapists’ personal values in psychotherapy, considering the perspectives of expert therapists and former clients in Chile. Method: Individual semi-structured interviews with 15 expert therapists and 13 former clients were carried out. A content analysis was conducted according to Grounded Theory. Results: Despite the consensus among therapists and clients regarding certain core values, such as autonomy, confidentiality, and tolerance, there exists a divergence of opinion concerning the role therapists’ values play in the therapeutic process. We have identified four perspectives regarding the management of therapists’ values in psychotherapy. Furthermore, our findings underscore a recurring ethical dilemma faced by therapists – the delicate balancing between respecting patients’ autonomy and avoiding potential paternalism as clinicians. Within this context, therapists’ conceptualization of autonomy encompasses several progressive dimensions, including responsible autonomy, relational autonomy, informed autonomy, and guided autonomy. We discuss these findings in relation to the ethical pluralism and we mention some practical recommendations for therapists and supervisors. Conclusion: The training of therapists is inseparable from the development of an ethical sensitivity based on ethical pluralism