Informed Consent in Psychotherapy: Implications of Evidence-Based Practice
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Evidence-based practice in psychotherapy carries widely unacknowledged consequences for ethical clinical practice. Informed consent to psychological treatments is an ethical imperative in clinical practice, and there is an ethical obligation for psychiatrists, psychotherapists, and clinical psychologists to provide adequate disclosure to patients about treatments. This is codified within the professional guidelines of the American Psychological Association (APA) and the American Medical Association. Given the APA’s commitment to evidence-based practice, the objective of this paper is to argue that the provision of information about how treatments work should be based on evidence-based research on psychotherapeutic treatments. Case-based scenarios are used to illustrate a range of ethical issues pertaining to evidence-based practice and informed consent in psychotherapy. This paper argues that informed consent processes in psychotherapy must be commensurate with the latest integrated findings on empirically—supported treatments; process research into psychological treatments; research into therapist expertise; as well as evidence about individual patients’ characteristics, culture, and preferences. Our conclusions for practice are challenging: standard ethical interpretations of informed consent to psychotherapy must go further. It is not sufficient for therapists only to describe the specific techniques associated with particular treatment modalities, it is also necessary to disclose information about nonspecific factors. There appears to be consensus among therapists and psychotherapy researchers that these factors are relevant to successful treatment outcome. Our paper aims to launch fresh, serious, pragmatic debate in professional psychotherapy about necessary revisions of ethical codes with respect to information disclosure.
KeywordsClinical ethics Informed consent Common factors Evidence-based practice Empirically-supported treatments
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research Involving Human and Animal Participants
This article does not contain any studies with human participants or animals performed by any of the authors.
- American Psychological Association (2010). Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association.Google Scholar
- American Psychological Association (2015). Policy statement on evidence-based practice in psychology. Washington, DC: American Psychological Association. Retrieved April 1, 2016 from http://www.apa.org/practice/guidelines/evidence-based-statement.aspx.
- Beauchamp, T. L., & Childress, J. F. (2009). Principles of biomedical ethics. Oxford: Oxford University Press.Google Scholar
- Beutler, L. E. (2002). The dodo bird is extinct. Clinical Psychology: Science and Practice, 9, 30–34.Google Scholar
- Blease, C., Lilienfeld, S. O., & Kelley, J. M. (2016). Evidence-based practice and psychological treatments: The imperatives of informed consent. Frontiers in Psychology, 68, 7.Google Scholar
- Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52(1), 685–716.Google Scholar
- Fonagy, P., Rost, F., Carlyle, J.-A., McPherson, S., Thomas, R., Pasco Fearon, R. M., Goldberg, D., & Taylor, D. (2015). Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: The Tavistock Adult Depression Study (TADS). World Psychiatry, 14(3), 312–321.CrossRefPubMedPubMedCentralGoogle Scholar
- Gaab, J., Blease, C., Locher, C., & Gerger, H. (2016). Go open: A plea for transparency in psychotherapy. Psychology of Consciousness: Theory, Research, and Practice, 3(2), 175.Google Scholar
- Garfield, S. L. (1996). Some problems associated with “validated” forms of psychotherapy. Clinical Psychology: Science and Practice, 3(3), 218–229.Google Scholar
- Lambert, M. J., Whipple, J. L., Hawkins, E. J., Vermeersch, D. A., Nielsen, S. L., & Smart, D. W. (2003). Is it time for clinicians to routinely track patient outcome? A meta-analysis. Clinical Psychology: Science and Practice, 10(3), 288–301.Google Scholar
- Snyder, T. A., & Barnett, J. E. (2006). Informed consent and the process of psychotherapy. Psychotherapy Bulletin, 41, 37–42.Google Scholar
- Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: Models, methods, and findings (2nd edn.). New York: Routledge.Google Scholar
- Whipple, J. M., Lambert M. J., Vermeersch D. A., Smart D. W., Nielsen, S. L., & Hawkins, E. J. (2003). Improving the effects of psychotherapy: The use of early identification of treatment and problem-solving strategies in routine practice. Journal of Counseling Psychology 51(1):59.CrossRefGoogle Scholar