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I Can’t Do What?! A Recap of Ethics, Ethical Dilemmas, Decision-Making And Countertransference

In early June, SHA students were lucky enough to attend the Ethics, Ethical Dilemmas, Decision Making And Countertransference conference online. Throughout the weekend, we learned from some incredible subject-matter experts, including Dr. David J. Ley, Jen Meyer, Kelvin Pace, Renee LaVail, Melinda Porter, and SHA’s very own founder, Heather McPherson. While many may worry that learning about ethics might be boring, this fabulous group was able to make it fun, entertaining, and filled with so much incredible knowledge.

Here are some of the things we learned during the two-day event:

Introduction to Ethical Decision-Making Processes and Sex Therapy-Specific Ethics

Dr. David J. Ley

Our weekend started out with the ever-amazing Dr. David J. Ley, who introduced us to the idea of ethics and how it’s important to all students at SHA. Regardless of what track you might be on, it’s important to understand what you can and can not do with clients.

Disclosures and Ethical Considerations in Therapy and Presentations

Personal disclosure in professional settings, like therapy and presentations, can be a bit of a balancing act. It's important to be transparent and let your audience know about any potential conflicts of interest. For example, if you're a Certified Continuing Education Unit (CEU) provider, you need to make sure to disclose that to meet professional standards. And in therapy, it's crucial to be honest about any areas where you might not be as skilled in order to avoid causing harm to your clients.

But when it comes to sharing personal information, it's key to strike the right balance. Starting a session with a personal disclosure can sometimes take the focus away from the client, so it's important to be mindful of that. The main goals of ethical disclosures are to help professionals become more self-aware, improve their skills, and ultimately protect both themselves and their clients.

In sexual health professions, there are added complexities to consider. Professionals in this field often work with sensitive and stigmatized issues, like sexual minorities and relationships. And because there are fewer established guidelines and higher levels of scrutiny, ethics play an even bigger role in ensuring the well-being of both professionals and clients.

Ethical Decision-Making and Professional Standards

The ethical decision-making process, as shown by the DREDD framework, encourages us to really dig deep into defining problems, considering ethical principles and standards before laws, and reflecting on our own biases and competency. It's all about coming up with thoughtful responses, putting them into action, keeping an eye on the results, and keeping a record to stay accountable. Meanwhile, Kohlberg's Theory of Moral Development teaches us about the different stages of moral reasoning, from just following rules to embracing universal principles.

When it comes to ethics in coaching and therapy, it's crucial to steer clear of misusing our influence, be open to different approaches, and set clear boundaries. Professional guidelines, like those put forth by AASECT, emphasize the importance of competence, integrity, informed consent, and avoiding exploitation. In coaching, being upfront about any conflicts of interest and respecting confidentiality are absolutely key.

As ethics continue to evolve, there's a growing focus on diversity, equity, and inclusion, alongside the impact of social media and shifting societal attitudes toward sexuality. AASECT's guidelines on touch in therapy remind us to always get informed consent and make sure our governing bodies recognize touch as a valid part of our practice. It's all about having transparent ethical standards that guide our work.

Wait! Did We Fuck?: Navigating Clinical Ethics as a Nonmonogamous Clinician Working with Nonmonogamous and Kinky Sexual Communities

Kelvin Pace

Dual Relationships and Self-Disclosure in Therapy

Dual relationships occur when a psychologist has both a professional role and another connection with the same person, like being friends or in a relationship with them or someone close to them. These types of relationships can potentially be harmful, so psychologists are required to navigate them carefully, always prioritizing the well-being of the person involved and following ethical standards (APA Code of Ethics, 2016). 

In therapy, self-disclosure - where therapists share personal information with clients - can have its advantages and disadvantages. It can help validate the therapist's expertise, ensure informed consent, support clients in reaching their goals, and make them feel less alone. However, it can become tricky if clients think the therapist is looking for personal advice or if they both live in a small community and might see each other outside of therapy.

Ethics of Erotic Transference and Veto Power in Relationships

Erotic transference involves patients having those "crush-like" feelings towards their therapists, even though they know it's not realistic. On the other hand, eroticized transference means having intense and somewhat irrational fantasies about the therapist. It's actually pretty common for therapists to find themselves attracted to their clients. But it's important to remember that ethical guidelines are in place to make sure that things don't get out of hand. For example, therapists shouldn't get involved romantically with their clients' family members or exes, to prevent any potential harm.

When it comes to relationships where partners are open to having other lovers, the idea of veto power can raise some questions about ethics. Basically, one partner has the ability to end the other's new relationships or say no to certain activities. Whether or not this is okay really depends on the specific relationship and how things are set up. The key to making it work is clear communication and making sure everyone is on the same page.

There go I - Lessons from the Ethical Missteps of Other Therapists

Dr. David J. Ley

Ethics of Sexual Surrogacy and Therapist Boundaries

Sexual surrogacy in therapy is a topic that involves several important ethical considerations such as liability, consent, and potential risks. It's important for therapists to carefully navigate these issues. 

When considering the use of surrogates, therapists should be cautious, especially when clients are already in a relationship. It's crucial to ensure that any involvement of surrogates is done with the full consent of all parties involved, especially in cases of consensual non-monogamous relationships.

Therapists should not engage in any sexual activities with surrogates or use their partners in this role. Working with uncertified sex workers can also pose risks, so it's important to thoroughly vet all potential surrogates and ensure proper education and support are provided.

Maintaining ethical practices means avoiding dual relationships and setting clear professional boundaries to protect the well-being of both clients and therapists. By following these guidelines and obtaining informed consent, therapists can navigate the complexities of sexual therapy in a responsible and ethical manner.

Challenges of Maintaining Professional Boundaries in Therapy

It's not uncommon for therapists to struggle with feelings of sexual attraction towards their clients. Factors like personal issues, relationship problems, and difficulty controlling impulses can sometimes lead to crossing professional boundaries, which is strictly prohibited by ethical guidelines to prevent harm. Cases where therapists develop inappropriate connections with clients or engage in unprofessional behavior underscore the importance of maintaining clear boundaries. 

Complicating matters are situations involving conflicts of interest, legal disputes, and substance abuse issues. It is crucial for therapists to thoroughly document and be aware of anything that may trigger them in order to avoid making career-ending mistakes. Navigating these challenges requires sticking to ethical standards, seeking guidance when needed, and understanding the limitations of their professional roles.

Frenemies, Friends & Lovers: How to Navigate Personal Relationships Within the Professional Space

Jen Meyer

Protecting Organizations and Navigating Professional Relationships

Businesses often adopt guidelines to protect themselves from potential risks, including issues like decreased employee productivity, power imbalances, exploitation, and unwanted advances. It's important to remember that even relationships that start off consensually can turn sour and impact the overall atmosphere at work. The result could be a loss of professional connections, networking prospects, trust within the organization, community standing, friendships, and a feeling of safety at work. 

Additionally, individuals may find themselves dealing with baseless or deceitful complaints and pressure from higher-ups. These policies are put in place to promote a workplace that is both respectful and efficient, while also preventing any conflicts or inappropriate behavior.

Balancing Professional and Personal Relationships in Sexual Health Professions

Sex therapists and sexual health professionals often find themselves working in a bit of a lonely bubble, with their colleagues being somewhat of a gray area. That's why it's so important to build a network of trusted friends in the field for collaboration, bouncing ideas off each other, and even just for support. 

It's totally normal for professional relationships to turn into personal ones, but it's important to approach this transition with care and consideration. By evaluating your friendships and getting advice from trusted pals, you can make sure you maintain boundaries and uphold your professionalism. This approach not only helps create a sense of community, but also ensures you steer clear of any ethical pitfalls.

"Do No Harm": Performing Psychosexual Assessments & Working With Youth

Renee Lavail

Types of Assessments and Their Uses

Assessments in the field of psychology and sexual health cover a wide range of topics and are often used interchangeably. These assessments can include general intake evaluations for diagnosis and treatment planning, thorough level of care assessments, evaluations of sexual behavior, and forensic assessments, also known as "sexual deviancy evaluations." Requests for these assessments can come from various sources such as state workers, residential treatment facilities, providers, attorneys, and judges. 

The reasons for these assessments vary from addressing allegations of sexual behaviors to determining the risk of harm and identifying patterns of problematic behavior. They can also help to evaluate paraphilias, compulsive behaviors, and non-traditional sexual activities. However, it's important to remember that not all requests for these assessments are necessary.

Components and Considerations in Sexual Behavior Assessments

When conducting assessments, it's important to take into consideration a variety of factors. This includes interviews to delve into different aspects of a person's life, like their intelligence, emotional well-being, and sexual behaviors. It's also crucial to look at different perspectives and review any relevant documents, such as police reports or victim statements. Assessments should aim to identify both protective factors and areas of vulnerability.

In particular, assessments for youth offenders need to be handled with care. By understanding the factors that drive their behavior and focusing on prevention, we can help keep our communities safe. It's worth noting that youth offenders often have different needs and motivations compared to adults, so it's important to approach assessments with an open mind.

Mistakes in assessments can have serious consequences, impacting someone's life in a lasting way. That's why it's crucial for professionals to be well-informed and base their decisions on solid evidence. By prioritizing education and taking a thoughtful approach, we can create a healthier and more understanding society.

Responding to And Dealing With License Complaints, Ethics Complaints, Malpractice Suits, Ethics and Social Media, and the Modern World on Fire

Dr. David J. Ley

Ethical Considerations for Therapists on Social Media

Therapists today are facing some pretty tricky ethical dilemmas when it comes to using social media. The way we use media has changed a lot over the years, and industry standards on professional privacy are constantly evolving. It's a bit of a juggling act trying to balance our professional responsibilities, our right to free speech, and our personal freedom. 

The Association of State and Provincial Psychology Boards (ASPPB) warns that a therapist's behavior on social media could land them in hot water if it starts affecting their work. The American Counseling Association (ACA) suggests having separate social media accounts for work and personal stuff, making sure personal accounts are private, and knowing how to control who sees what on each platform. It's a big no-no to share any confidential info online or try to diagnose someone over the internet. And therapists should always make sure their credentials are accurately represented online. 

Oh, and it's a big deal to snoop on a client's social media without their permission. Counseling groups should have clear social media policies in place, so everyone knows the dos and don'ts, and these policies should be discussed with clients upfront and available online.

Navigating Benefits and Risks of Social Media Engagement

Social media can be a great tool for therapists to market themselves, reach a wider audience, engage in social issues, and connect with other professionals. However, it's important to be aware of the potential risks involved. For instance, there are concerns about personal safety, online attacks, privacy issues, and even possible actions from governing boards.

Therapists should avoid connecting with clients on social media and make sure to have discussions with them about boundaries and consent. It's also important to be cautious about what you post publicly, as nothing online is truly private. Setting up Google alerts for your name and practice can help you stay on top of your online presence.

Regulatory bodies have noted an increase in issues related to social media use among therapists, so having clear guidelines on confidentiality, security, boundaries, and record-keeping is essential. It's also a good idea to incorporate your social media use into your overall public relations strategy, making sure it aligns with your writing, website content, and any media appearances.

If you do happen to face a complaint, being thorough and carefully communicating your side of the story is key. It's best to avoid reacting impulsively online. Seeking advice from legal and insurance professionals can help you navigate any potential disciplinary actions and protect your professional reputation.

Ethics Role-Play: Shades of Grey?

Melinda Porter

Our next session was led by Melinda Porter, who had the SHA team break us up into eight groups, where we focused on how to ethically approach the scenario assigned to our group. Each group had the chance to work together to act out and discuss each scenario in depth before returning to the large group. When we arrived back to the main room, each group had the opportunity to go through the scenario with Melinda, and showcase their response. 

Throughout this time, Melinda gave us a lot of incredible insight into the scenarios, and how many of them can have multiple outcomes while still following the ethics outlined by a governing board. All of the weekends students were able to hear about each scenario in detail, and gain a better understanding of what can and can’t be done. 

Navigating Today's Moral Panics and Maintaining Sex Positivity

Dr. David J. Ley

Current Socio-Legal Challenges and Shifts in Sexual Values

Hey there! So, there's been some interesting stuff happening lately in terms of legal changes surrounding things like pornography, drag shows, trans rights, abortion, and marriage equality. It's definitely been creating some tension in our socio-political climate. Controversies related to QANON, pedophilia accusations, and grooming claims have also been adding fuel to the fire when it comes to public discussions.

Despite a general trend towards more liberal sexual values over time, a recent Gallup poll actually showed a 7% decline in support for LGBTQ relationships. There have been significant drops in support for other sexual behaviors and issues as well, although there was a slight increase in the acceptability of infidelity.

These shifts in attitudes have some pretty big implications for those of us in the field of sexual health. It's affecting everything from how we present ourselves on social media, to how we interact with clients, and even the legal coverage we receive. As professionals, we're definitely having to navigate these changes and figure out how we want to respond - whether that means adapting to the new landscape, considering a change of career, or maybe even thinking about moving to a different country. It's a lot to think about, but we're all in this together!

Navigating Moral Panics and Compassionate Practice

Moral panics, according to Stanley Cohen, happen when certain conditions or groups are seen as threats to societal values. This leads to social and governmental reactions, often exaggerated by the media, which tends to portray these threats in a very basic way, causing public anxiety. 

Remember the sex education debates from the 1960s to the 1990s? Those were classic examples. When facing these challenges, it's important for professionals to be thoughtful, monitor themselves, and practice empathy. The Sanctuary Model stresses the importance of non-violence, emotional intelligence, learning from others, democracy, open communication, and social responsibility. 

By navigating with compassion, being adaptable, and building a support network, professionals can stay true to their goals despite any social or political turmoil. Taking care of yourself and having a strong community around you are key for staying resilient and effective in a high-pressure environment.

Building an Ethical and Sex-Positive Organization

Heather McPherson

Standing for Your Ethics and Mission in a Sex-Positive Framework

Having enemies can actually be a sign that you are standing up for what you believe in. It's important for both individuals and organizations to have a clear understanding of their values and ethics by establishing personal, professional, and organizational mission statements. This foundation serves as a helpful guide when making decisions and facing challenges.

Take the Sexual Health Alliance (SHA) for example. Their mission is all about reducing shame, promoting open communication, keeping things light-hearted, and pushing boundaries in an inclusive way. These principles are at the core of their commitment to sex positivity, allowing them to align their personal and professional beliefs and stay ahead of the curve in their field.

In the world of sex-positive work, it's crucial for organizations like SHA to consistently reflect their values in their actions, especially when it comes to how they are perceived by the public and industry. By staying true to their mission, they can navigate through the complexities of their work with integrity and purpose.

Navigating Ethical and Practical Challenges in Sex-Positive Work

Working within a sex-positive framework comes with its own set of ethical challenges. Sex therapists and coaches often have to deal with societal expectations and must be mindful of maintaining professional boundaries, such as being mindful of setting and dressing appropriately. 

It's important to practice ethical business conduct by maintaining clear communication, honoring agreements, and upholding integrity, especially during unexpected events like the COVID-19 pandemic. Supervising therapists also requires handling confidential information with care and practicing ethical disclosure. 

When faced with criticism or accusations of unethical behavior, it's crucial to know when to address them or simply let them go, always staying true to the organization's mission and the positive impact of their work. Building an ethical, sex-positive organization requires ongoing consultation, meticulous documentation, and a strong commitment to core values and ethical standards.

Overall, the speakers throughout the weekend emphasized the importance of ethics in all professional fields, particularly in sex therapy. They discussed the need for transparency and ethical disclosures in therapy and presentations to ensure professional standards and protect clients. Speakers highlighted the complexities in sexual health professions, such as dual relationships and erotic transference, stressing the importance of maintaining professional boundaries. The discussion also covered the ethical decision-making process, the impact of social media, and navigating moral panics. The overall message was to uphold ethical standards, follow professional guidelines, and prioritize the well-being of clients and professionals. If you’re interested in learning more about working in the sexual health industry, SHA offers so many amazing programs to choose from. You can also follow any of the brilliant speakers who spent their time with us!  

Written by Kihya McComb

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