Ethics-Based Training for Clinicians: Moving Beyond Ethical Decision Making Models
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ORIGINAL PAPER
Ethics‑Based Training for Clinicians: Moving Beyond Ethical Decision Making Models Bobbi J. Miller1 · Paul Springer2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Clinical training in ethical decision making processes has relied heavily on teaching students to apply ethical codes and legal statutes to written scenarios using ethical decision making models. While an excellent academic exercise, this approach tends to remain abstract and does not prepare students for the complexities of making decisions during the process of therapy. Recently, experts in the field have called for reforms in ethical training, believing current models must move beyond cognitive exercises that detach students from the humanity of their clients and themselves. The described pedagogical approach bridges the gap by using a modified Objective Structured Clinical Exam to provide a safe context for students to practice ethical decision making and receive feedback before entering actual clinical practice. Keywords Ethics · Training · Decision making models · Experiential activities · Objective structured clinical evaluation (OSCE) “There is nothing more useless than a merely well informed [person]” Alfred North Whitehead.
Beginning-level clinicians, regardless of discipline, confront a myriad of ethical dilemmas as they endeavor to provide effective and competent treatment. These ethical dilemmas have become an issue of growing concern and reflect an awareness that resources for decision making in these situations may be limited (Caldwell and Stone 2016; Levitt et al. 2015; Green and Hansen 1989; McLaurin and Ricci 2003; Part of the contents of this manuscript were previously presented at: Miller, B., & Springer, P. (2012). Ethics in action: An integrative approach to teaching ethics. Workshop presented at the annual conference of the American Association for Marriage and Family Therapy, Charlotte, NC. * Bobbi J. Miller [email protected] Paul Springer [email protected] 1
Department of Couple and Family Therapy, Regis University, 500 East 84th Avenue, Suite B‑12, Thornton, CO 80229, USA
Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, 138 Mabel Lee Hall, Lincoln, NE 68588, USA
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McLaurin et al. 2004; Woody 1990). Beginning level clinicians need to be better prepared to enter the wider social and cultural workforce, while working within their relevant professional codes and state laws. In fact, positive ethical decision making requires not only a commitment to ethical ideals and standards, but access to necessary tools and skills that can be utilized when faced with challenging and compelling ethical dilemmas. As educators with over 30 years of combined experience training therapists, we have noted that new therapists have little practice in addressing these ethical issues, outside of academic activities within ethics focused courses, prior to being confronted with dilemmas that involve actual clients. Within the United States, the predominant existi
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