Naked Ethics

Far from crying out “Look the Emperor has no clothes!” it may be time to exclaim “Look, the Emperor is wearing too many codes!” What the public needs most is for us to make our ethics more visible, to be more naked in fact.

The creation of professional ethical guidelines for the Transactional Analysis community has engaged some of the best minds within our community.

The complexity of establishing ethical codes can perhaps be best appreciated with EATA’s heroic attempt to find common ground between the clear but simplistic ‘rules’ approach as expressed in their ‘Deontological Guidelines’[1] and the more comprehensive but sometimes more vague ‘principles’ approach as expressed in their ‘Ethical Code’[2].

For EATA, this resulted in a code which brought together ‘Basic Values’ (based on the universal Declaration of Human Rights) with ‘Ethical Principles’ and then applies these to the 5 ‘Target groups’ of: Self, Practitioner, Trainees, Colleagues, Community  (Fig 2 EATA Ethical Code 2011 p.12). Overall, however, this code consists of a staggering 13 pages comprising 90 separate paragraphs or ethical statements and 2 diagrams. One of these diagrams is a 25 grid matrix which could be argued as adding a further 25 ethical statements to the picture but I have only counted it as ‘one’ ethical statement.

This code, however, is only half of the EATA ethics story as the ‘Ethical Code’ instructs all practitioners to integrate their code alongside EATA’s ‘Deontological Guidelines’. These are to be found in section three of the EATA training and examinations handbook: Ethical Code, Professional Practice Guidelines and Ethics Committee (Section 3, p.2-7). This section contains a further 6 pages that consist of 37 ethical paragraphs or statements – all very relevant to the TA practitioner.

Unfortunately the ethics story does not stop there. Those of us within EATA must then integrate this with the 10 pages and 98 paragraphs/ethical statements of our national governing body’s code (UKATA)[3].  Whilst these are stated to be “congruent” with EATA there is no explicit statement about how they absorb or replace all elements of the EATA code. In fact, any reading of the two codes will make it clear that neither seeks to absorb or replace the other. This just means that they provide different insights into this complex issue of ethics.  For the professional therapist this means we are professionally obliged to be familiar with both EATA and UKATA codes.

Nor does our ethics journey stop there. For most UK therapists, these two codes for example must then be integrated with the 8 pages containing 50 ethical statements or paragraphs of the ‘ethical principles and code of professional conduct’ of our umbrella organisation (UKCP[4]). Some of us also need to belong to an additional national organisation (the BACP) for a variety of different reasons. This organisation has its own code of ethics and conduct[5] which amounts to a further 16 pages which consists of  98 paragraphs or statements. I am reliably informed that TA practitioners from different countries must perform a similar ‘ethical code quadrille’.

In addition to this, in order to stay up to date in the evolution of our TA community many of us are also members of the founding TA regional body, ITAA. This organisation produces the TA community’s academic journal and actually has 26 pages in their codes comprising over 316 paragraphs and points as well as a 20-box flow chart[6].

This means that there may well be TA psychotherapists who are walking around needing to integrate a staggering grand total of 80 pages of ethical codes comprising 690 ethical paragraphs or statements, two diagrams (one of which is a 25 box matrix) and a 20 – box flow chart.

One is tempted to add “and a partridge in a pear tree”…

More seriously, this begs the question of how realistically we can study all of these properly without drowning in a surfeit of ethical codes. At the very least, from the professional therapist’s point of view this is a lot to comprehend, absorb and integrate into each session with a client. Far from crying out “Look the Emperor has no clothes!” it maybe time to exclaim “Look, the Emperor is wearing too many codes!”

What strikes me most about all these codes however, is their utter incomprehensibility to any member of the public. I mean, let’s face it, even those of us trained and qualified in psychotherapy and holding high level degrees can often find the language and meaning of these codes difficult to wade through. What chance is there that a poorly educated client would have a clue about what these codes mean for them? Do we seriously expect members of the public to read 690 paragraphs over 80 pages in order to know if their practitioner is being ethical or not?

Which led me to the all important question of just who these codes of ethics are meant to protect?

It seemed clear to me that all five codes that I mention above (UKATA, EATA, UKCP, ITAA and BACP) were written largely as direction and guidance to the professional members of their associations. This makes very good sense as it is the first priority of each professional body to make sure that its members have a clear understanding of what constitutes proper ethical standards. If members do not know what ethical practice actually means then such high standards and any good reputation is not possible. This ‘practitioner emphasis’ was most pronounced in my national association’s code (UKATA) which dedicates two whole pages to giving what can only be described as ‘teaching examples’ to its members (pages 6 + 7) as if its code of ethics were in fact a training manual for TA psychotherapists. Likewise, the EATA code exhibits the same inevitable ‘practitioner development focus’ by stating that each ‘practitioner’ should take full responsibility for their decision making. In none of these 5 codes could I find any mention of what the clients must consider when dealing with a practitioner.

Accessible and useful to the public, these codes most definitely are not…

When I looked at the code of ethics of the ITAA, I found that their actual ‘code’ was refreshingly short. It currently stretches to just one page of the more traditional ‘rules list’ to its practitioners. However, this code then dedicates TWENTY FIVE PAGES to their complaints procedure. Mostly it reads as an instruction manual to those sitting on the committees who deal with such complaints. Whilst its one page 12 point code is certainly simpler than the other codes, such a ‘rules’ format is still directed at its professional members. Such a short code to members also means that it is somewhat thin on the ground as far as offering guidance to its professional members regarding the moral complexity of the many ethical issues that can arise in practice.

At the same time, its language is not easily accessible to members of the public who may know very little about the profound meaning that we as TA practitioners ascribe to words such as “autonomy” or “personal responsibility”. Such simple language is jargonistic and  hides years of training and learning about the meaning and significance of such phrases. Like most of the other codes, its language is clearly geared to the post graduate literary abilities of qualified psychological professionals.

All of which left me wondering if we perhaps need two distinct codes – one for practitioners and one for clients?

The first code must necessarily be written as an ethical guide and standard to its professionally qualified and well educated members. As I have shown, such codes or guides already exist, albeit in a bewildering variety even within TA.  The second code which is currently absent, would be a code that describes our professional responsibility towards our clients and is written entirely for our clients. This would need to be done in a language that all clients could understand. By definition such a simple code must be limited to a few key points so that all members of the public could identify just what ethical behaviour actually looks like – an ‘ at a glance’ one page document, if you will. Something that could be read and understood in a waiting room. For this second code to be effective it would also need to be displayed and made readily available to the public, by the practitioner. This second code would make it clear to members of the public just what the first code (or codes) means in simple observable terms.  It would be in effect, a clear demonstration of TA’s principles of ‘objectively observable behaviour” (Berne, E. 1961).

Here in the UK, the average reading age of the public is about 9 years old[7]. This is not particularly low globally and explains the simplistic language of most country’s tabloids. Perhaps we need to pitch our language somewhere that is a bit closer to this reading age than existing codes?  The Emperor may well be “wearing too many codes” and such a complex multiplicity of codes only covers up the simple and powerful truth of our high ethical standards. What the public need is for us to make this truth more visible, more naked in fact.

If the psychologically untrained public do not know what our professionally agreed standards of behaviour towards them are, then how can they possibly know if there has been a breach? As it is the public who are the ones that we wish to protect, such an ‘over-clothed’ and hidden approach strikes me as ‘an own goal’. It is also in conflict with TA’s stated purpose of explicit and overt contractual communication. It seems to me entirely possible that the only people who really understand our codes are qualified and training psychotherapists and only then, if they have been thorough and diligent. It would make an interesting piece of ethics research to find out what percentage of ethical complaints against TA therapists are made by trainee and qualified psychotherapists and what percentage by ‘non psychotherapy’ clients. This would be an interesting measure of the accessibility of our current codes.  The simple fact of the matter is…

If the public do not understand our codes, then we can never be held to account…

The saying “Knowledge is power” points out that most organisational abuse throughout history has been achieved through the active maintenance of ignorance. This is the mechanism of most organisational corruption and abuse.  All organisations can have powerful and abusive influences on those connected with them. It behoves us to do everything we can to make sure that TA, as an organisation, is not fostering the maintenance of such ignorance (Jacobs, A. 1987). Complex and difficult to understand codes can only hide our ethics from the public and keep them ignorant of our stated standards. This ignorance is a dangerous thing and could contribute to a climate where clients are being oppressed or even harmed.

“Primum Non Nocere” was one of Eric Berne’s most treasured healing principles, translated from his medical background and the Hippocratic oath into psychotherapy. As this risk of harm is largely psychological in this profession, it is vital that in our TA community, we hold those people who have grown up with abusive scripts in the forefront of our minds when we draw up our codes. For these people, inappropriate relationships often appear ‘normal’. This group is particularly at risk from unethical practitioners, especially as this vulnerability is often the very reason why they come for our help in the first place. In cathexis terms, they may habitually discount any abuse they experience. They either simply do not ‘see’ it e.g. at the level of T1, or they do not think the behaviour to be a significant problem e.g. at the level of T2 (Mellor & Sigmund. 1975).

I believe that this means it is our responsibility as individual professionals, to produce a document which means clients can understand at a glance what professional boundaries and ethical practice actually look like in observable terms. They can then know what to expect if they work with a TA practitioner. As a result of such a clear code, they are more likely to identify and signify when their practitioner’s behaviour becomes unprofessional, regardless of their life script or background.

Sadly, our existing codes look as if they were specifically designed to be incomprehensible to the lay reader in the same way that the handshake of a freemason is designed to be invisible to all outsiders…

As a profession we have a culture of being explicit and open in our communication. We share the models that we use. We teach the drama triangle, we explain ego states and draw transactions. We also have a philosophy of OK/OK communication that is aimed at empowering our clients. This philosophy of client empowerment is the reason why we take time to make sure our contracts are explicit and bilateral. And then we go and write our codes in an incomprehensible format and in a language designed to alienate!

By failing to address this issue, we may leave the more vulnerable members of society unprotected. It could also be argued that TA trainees are left exposed without even a few explicit guidelines to direct their behaviour. The subtleties and complexities of much ethical and philosophical discussion may be lost on a new practitioner who is struggling to work out what to wear, where to keep their notes and who they can and cannot work with and whether they should even shake hands with a client.

The harsh reality is that the effectiveness of any code of ethics is directly proportional to its level of comprehension by its end users…

If a ‘professional standard’ means anything, it means that we can be held accountable to it by members of the public who actually understand what this ‘professional standard’ is in simple observable terms. This is professional accountability in action. One of the main problems in all of this is that we cannot actually “see an ethic”, any more than we can see a belief or a moral. We can only see the consequent behaviour. Which means that we must translate ethics into observable behaviour. Whilst I am all for the in depth considerations and guidelines such as those contained in the EATA code, I believe our job is still only half done at this point.

To get this particular ball rolling, I have designed my own code of observable professional behaviour for use with my clients. It is my own ‘Code of Professional Responsibility’ written specifically to make my existing (UK) codes ‘naked’ to my clients. It attempts to distill the most important behavioural elements of all five codes that I must subscribe to, into a document that anyone client can understand, whatever the background. I have done this by translating them into simple TA ‘observable outcomes’. I also provide a Comparative Ethics Chart that identifies which codes of each of the five different Associations relate to each of my 10 point code.

There is no reason why each individual TA practitioner cannot create and display such a simple and accessible Code of Professional responsibility’ for their clients right away. Writing and designing such personal ‘codes of professional responsibility’ could even become valuable and creative topics for discussion in supervision and training. For this reason, there is absolutely no copyright on my code – please make use of it and change it to whatever reflects your codes and works for you. Like most authors however, I always appreciate a reference at the bottom! It can be downloaded for free in digital form for use and/or alteration at the end of this article in PDF and MS Word formats.

As you will see it is written directly to the end users of TA and that, in point five, it explicitly addresses the issue of what constitutes physical and sexual abuse in observable terms as specific protection for those with violation or abusive scripts. I make no apology for such bluntness. The protection of the vulnerable matters more to me than pandering to the ‘political correctness’ of the delicate. I believe that “calling a spade a spade” is part and parcel of the clarity that makes TA so effective in battling the more shadowy and covert world of abuse. If TA practitioners wish to either use this code of mine or simply use it to create their own code of professional responsibility, then overnight, clients could be brought into the revolutionary clarity and accessibility that is the hallmark of TA.

Conclusion

In summary then, it is my contention that such an observable and quintessentially ‘naked’ Code of Professional Responsibility’ makes our ethics immediately recognisable and understandable to most members of the public in less than 30 seconds and that this could happen overnight. As my ‘Comparative Ethics Chart’ demonstrates, whatever Association you belong to, it is likely that it integrates the vast majority of your ethical intentions. In this sense it could be considered a universal code for both clients and practitioners.

Such a code is accessible to the public without a degree in either philosophy or English, or indeed any degree at all. Nor is it necessary for the public to know anything about TA to understand it. It can easily be sent as a pdf when confirming a first appointment along with directions and any administrative or financial details. For those that work in ‘walk in’ environments or in organisations, it can be displayed in a waiting room or office. Such a ‘client friendly code’ can be drawn up and displayed immediately by every practitioner who cares about our principles of overt and explicit communication.

What is perhaps much more important than how complaints are dealt with, is whether anyone, regardless of their history or education, could easily identify an unprofessional practitioner in their first few appointments. This is surely the goal – before attachment and script issues start to muddy the relationship waters.I believe this would be much more possible after reading such a publicly displayed code. Clients who identify a breach could then simply remove themselves from future appointments and thereby immediately avoid the damaging interactions that otherwise lie in store for them. The complaint is then expressed in the ‘real world’ way of simply removing business and income from the practitioner. This actually means that the clients themselves are likely to be the best enforcers of such a code. Private clients really do hold all the economic power and any breach of these 10 points are likely to be in breach of the codes of any organisations that provide TA services to clients.

It should also be pointed out that many people inevitably experience the process of making or receiving an ethical complaint as either abusive or shaming in and of itself. This is despite the heroic and compassionate efforts of those who volunteer their time and energy to ensure that both clients and practitioners are kept as safe as possible throughout such painful processes. Such complaints also absorb a great deal of time and emotional energy and place a high stress level on all concerned. How much better that much of the enforcement of such a code be resolved by simple market forces, thereby saving everyone time and energy and also avoiding any of the shaming and the abuse that can so easily be experienced?

The abusive practitioner will simply go out of business if they work in the private sphere. The supervisor of a practitioner who constantly reports that their clients stop working with them, is alerted to the possibility of unethical behaviour and can explore this possibility. In organisational settings, such an explicit and accessible publicly displayed code would have a powerful impact on both clients and colleagues alike and should fit in well with most organisation’s stated concerns regarding safety and transparency.

Equally important, such a naked code has the added advantage that it makes it crystal clear to new trainees exactly what our behavioural expectations of them as professionals are, when working with clients. This behavioural expectation already exists, so why not make this explicit in observable terms? This means they can practice professionally and safely regardless of their training developmental stage (Erskine 1982), their personal morality or the state of their own personal therapy journey with their own script.

Another benefit of such a naked code, is that it gives all supervisors a simple check list that they and their supervisees can run through together to ensure that at least some of the most basic visible indicators of safe ethical practice are being observed. This could then help avoid some of the conscious and unconscious ‘hiding’ that can so easily go on in supervision. Such ‘hiding’ is of course a dangerously parallel process to the secret nature of abuse (Mothersole 1999). Such patterns can only be changed by explicit challenges made as early as possible by the supervisor, both for client safety and for the professional development of the practitioner. Such discussions and challenges often lead to insightful exploration both in supervision and in therapy that can transform the sensitivity and effectiveness of the practitioner and above all, to increased safety for the client.

Of course, any such ‘naked’ codes of professional responsibility would need to be continually reviewed and updated in line with the ethical output of our Associations. What is most important however, is that the public can understand what they have a right to expect from members of our professional association. As professionals we have an ethical responsibility towards our clients, towards society and towards other professionals. I believe that this ethical responsibility extends to making our ethical codes naked to the public.  I believe this is good TA, good professionalism and good transparency.

And what of all the ethical complexities of working with clients and the sometimes negative impact that our own script beliefs can have on such work? I believe such issues will continue to be dealt with through the existing professional ethical groups and their guidelines. All five of the organisations that I mention in this article have each appointed dedicated and gifted individuals to make sure we do not ‘go to sleep’ on such matters. Such groups will continue to reflect the latest and best thinking and expectations of our profession regarding safety, standards, morality and ethics.

These issues will also continue to be explored and made safe in the training rooms, therapy rooms and supervision rooms of our TA association members right across the globe. It is my contention that such activity will only be enhanced by the active creation of the kind of ‘naked’ code presented here. As practitioners we should be mindful that it is a sign of juvenile passivity to wait for our Associations to do this work for us. These are our codes and this is a great way to take ownership of the impact of our ethics on our professional behaviour. Our clients deserve this clarity and above all they deserve the empowerment that such a code fosters. I rest my case.

Downloadable Code of Professional Responsibility

There is absolutely no copyright on my code – please make use of it and change it to whatever reflects your codes and works for you. Like most authors however, I always appreciate a reference at the bottom! (“Gerry Pyves and, or, www.gerrypyves.com). It can be downloaded for free in digital form for use and/or alteration below:

Code of Professional Responsibility – PDF

Code of Professional Responsibility – MS Word

References

BIS research paper 139 (Oct 2013)

Berne, Eric ‘Transactional Analysis in Psychotherapy’ 1961

Erskine, R. ‘Supervision for Psychotherapy: models for professional development’ TAJ 12 314-321

Jacobs, Alan ‘Autocratic Power’ TAJ 17 1987 59-71

Mellor, K. & Sigmund, E. ‘Discounting and Redefining” TAJ 5, 3, 1975 295-302

Mothersole, G ‘Parallel Process’, The Clinical Supervisor, (1999) 18:2, 107-121

Notes

[1]http://www.eatanews.org/wp-content/uploads/2014/10/Section-3-ETHICAL-CODE.pdf

[2]http://www.eatanews.org/wp-content/uploads/2012/09/ethics-code-feb-13th-edit.pdf

[3]http://www.uktransactionalanalysis.co.uk/images/pdf/UKATA-Code-of-Ethics-Professional-Practice.pdf

[4]http://www.psychotherapy.org.uk/UKCP_Documents/standards_and_guidance/32_UKCP_Ethical_Principles_and_Code_of_Professional_Conduct_approved_by_BOT_Sept_09.pdf

[5]http://www.bacp.co.uk/events/learning_programmes/ethical_framework/documents/ethical_framework.pdf

[6]https://www.itaaworld.org/sites/default/files/itaa-pdfs/gov-admin-docs/ITAA%20Ethics%20Procedures%20Manual%20v.2002.pdf

[7]The International Survey of Adult Skills 2012: Adult literacy, numeracy and problem solving skills in England BIS Research Paper 139 Oct 2013(Dept for Business Innovation and Skills).

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