Re-visiting professional ethics in psychotherapy: reflections on the use of talking therapies as a supportive adjunct for myalgic encephalomyelitis/chronic fatigue syndrome and ‘medically unexplained symptoms’

Following years of debate over the effectiveness of cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), public health bodies in the UK and beyond have determined that no psychotherapy is clinically proven for this patient group. In the field of ME/CFS and t...

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Veröffentlicht in:Journal of medical ethics S. jme-2023-109627
Hauptverfasser: Hunt, Joanne, Blease, Charlotte
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group Ltd and Institute of Medical Ethics 31.12.2024
BMJ Publishing Group LTD
Schlagworte:
Attitudes
Boolean
Chronic fatigue syndrome
Chronic illnesses
Clinical standards
Codes of conduct
Codes of practice
Cognitive behavioral therapy
Cognitive-behavioral factors
Counseling
COVID-19
Debates
Disabled Persons
Encephalomyelitis
Ethics
Etik
Extended essay
Fatigue
Feedback
Idiopathic
Medical ethics
Morality
Patients
Policy
Professional ethics
Psychology
Psychotherapists
Psychotherapy
Public health
Qualitative research
Quality of Health Care
Reflexivity
Symptoms
Talking
Transparency
Treatment methods
United Kingdom > UK
United States > US
Policy
Psychotherapy
Ethics
Disabled Persons
Quality of Health Care
ISSN:0306-6800, 1473-4257, 1473-4257
Online-Zugang:Volltext
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Zusammenfassung:Following years of debate over the effectiveness of cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), public health bodies in the UK and beyond have determined that no psychotherapy is clinically proven for this patient group. In the field of ME/CFS and the wider arena of ‘medically unexplained symptoms’ (MUS), patient survey data and qualitative research capturing patient experiences and psychotherapist attitudes suggest that therapeutic practice may sometimes fall short of required ethical standards. This raises questions about how psychotherapists can safely support, as opposed to treat, people with these debilitating conditions. We consider four ethical principles that feature throughout psychotherapists’ codes of practice, those of respect, competence, responsibility and integrity, and discuss examples of good and poor practice in this arena as evinced by recent empirical literature. Following this, we offer a variety of suggestions to help strengthen ethical psychotherapy practice with patients with ME/CFS and other MUS. In terms of practitioner education, we recommend greater emphasis on humility, reflexivity and disability-affirming practices, exploration of personal as well professional ethics, and integration of patient expertise-by-experience, accompanied with the latest evidence, into foundational and ongoing training. In terms of ongoing practice, we suggest consideration of formalised patient-focused feedback systems and greater transparency vis-à-vis patient access to clinical notes. Finally, we underline the importance of elevating patients from mere subjects to co-producers of psychotherapy research.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0306-6800
1473-4257
1473-4257
DOI:10.1136/jme-2023-109627