Ethics of using psychotherapy techniques as a nonprofessional

[loveoforganic]

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I'll give the context this question is arising from from the get go. I'm hoping to teach high school for one or two years prior to attending med school. Lack of desire to perform well I see as being an obvious issue that would come up in at least a couple students. I recently finished reading Motivational Interviewing 2nd Ed., and it seems like the technique would be applicable in working to resolve that ambivalence.

That said, I recognize that the brief "therapy" I'd be administering would likely be pretty crappy at best, but I still feel like it could have better outcomes than other strategies. Essentially, I'm just seeing it as a guided way of communicating with a student that doesn't really have a lot of risk present that wouldn't be present in any other form of communication.

So that said, what are your opinions on a) the ethics in this particular case, b) the ethics in general of nontherapists using techniques from psychotherapies (if this isn't an ethically questionable case, when would it be?), and c) whether you believe MI could potentially be efficacious for this type of work.

Thanks in advance!

 

[deleted176373]

I think Jon pretty well nailed it. Ethically, your use of your knowledge of human behavior to motivate or reduce ambivalence in your students as part of the learning process is completely within bounds. If you were somehow trying to provide psychotherapy, that would be unethical.

Here is how I see it, if you are using techniques and principles that you have learned from outside your profession within the scope of professional duties that you are expected to perform, that's being innovative. You must of course meet the standards expected of you professionally and remember that you are not providing psychotherapy, but rather you are using information you know to enhance your ability to deliver education to your students. The professional practice of psychology is different than the professional practice of teaching, but that doesn't mean I can't use my understanding of instructional techniques when providing psychotherapy any more than it means that you can't use your understanding of psychology in the delivery of education.

Jon asks, "Where is the line?" The line is, of course, fuzzy but exists when you stop practicing your profession and begin practicing a profession you are not qualified to practice. If you are a teacher and you think you're conducting therapy, you're probably not acting ethically. Psychologists do a fair amount of education, but we stick to the psychological (in general), we're not going to try to teach molecular science to our clients as we are (for many of us) not qualified to teach that. It would be unethical to do what we are not trained to do.

Mark

 

[loveoforganic]

Thank you both for your very helpful replies. I think you both pretty much voiced where I think I stood on the issue, but I wanted to make sure I wasn't diluting the effect the "psychotherapy" could have.

Thanks again.

 

[docma]

I think of motivational interviewing as a "technique" and so the question really is what is the "task" you are are teaching/consulting on: It seems to me that a central task for teachers is almost always "motivating" new learning--so if you can be clear that the behavior you are "motivating" someone to increase/decrease is within the scope of your practice as a teacher, I think you can definitely employ MI techniques to promote learning.

 

[futureapppsy2]

I did an undergrad internship in a setting where we used MI with our clients, and we were actually encouraged to practice the skills on friends, relatives, etc., without telling them what we were doing. Always made me feel a bit weird, though it did help me improve my skills.

 

[Therapist4Chnge]

I did an undergrad internship in a setting where we used MI with our clients, and we were actually encouraged to practice the skills on friends, relatives, etc., without telling them what we were doing. Always made me feel a bit weird, though it did help me improve my skills.

I think that is inappropriate, as the non-professional doesn't know what s/he doesn't know, which can do harm.

 

[futureapppsy2]

I think that is inappropriate, as the non-professional doesn't know what s/he doesn't know, which can do harm.

Well, we were just doing basic reflective listening (simple reflections). I've had multiple professors recommend that for reflective listening skill building, so it must be fairly common training practice. 😕

FWIW, we weren't encouraged to do it in a therapeutic context, just a social one, though I agree that the lines can get blurry at times.

 

[loveoforganic]

Follow up to this - another situation.

If I can't manage to land a teaching job, I may be working as a case manager for those affected by the oil spill. In this case - using MI to encourage clients to follow through on obtaining resources and whatnot - what do you all think? While it's within the same scope of "working within your job," I've worked with similar populations in a similar job capacity before and the potential presence of more serious mental illness than is present in kids that would be in high schools as well as the obvious stressors they're going through currently experiencing both complicate the situation in my eyes.

What are your thoughts? Thanks again.

 

[deleted176373]

Follow up to this - another situation.

If I can't manage to land a teaching job, I may be working as a case manager for those affected by the oil spill. In this case - using MI to encourage clients to follow through on obtaining resources and whatnot - what do you all think? While it's within the same scope of "working within your job," I've worked with similar populations in a similar job capacity before and the potential presence of more serious mental illness than is present in kids that would be in high schools as well as the obvious stressors they're going through currently experiencing both complicate the situation in my eyes.

What are your thoughts? Thanks again.

There are two sides to this.

Once again, it sounds as if you want to use your interpersonal skills to motivate and encourage, that's vastly different than trying to deliver therapy. As long as you are not attempting to coerce the actions of your clients and you remain genuine while doing your job to help secure resources for your clients you are probably acting ethically. While motivational interviewing techniques could have other implications, motivational interviewing techniques are also things that many good communicators do naturally.

On the other hand:

This definitely walks closer to the line than the role of teacher. You have to ask yourself why it would be necessary to use these techniques? If it is to build rapport with clients and to reassure them that you are listening to them and are invested in the outcome, that seems like fair game. However if you start trying to use other techniques to encourage them to do things that they might not normally do, then you have to really look at why you are doing that, because perhaps that is not your role. Clearly defining your role is important.

It seems like you may want to apply these tools to situations where they may be less appropriate or at the very least being used in a less ethical manner. I am a firm believer that you should always share your knowledge with others when you can be a catalyst for positive change, however this one leaves me scratching my head a little bit.

Few questions to consider:

1. Why is it so important to use these specific techniques?
2. Who is this benefiting from this and why?
3. How would one feel if one knew that someone was using these techniques on them in this situation?

Mark

 

[loveoforganic]

Thanks for your thoughts.

It seems like you may want to apply these tools to situations where they may be less appropriate or at the very least being used in a less ethical manner.

Could you clarify what you mean here? Less appropriate and less ethical than what? The traditional use in substance abuse?

As far as 1,2,3

1) Because I don't have a repertoire to draw from, I've found it difficult to motivate people in the past, and I feel I'd get better results applying some strategies from MI.

2) Presumably, clients in that they'd be motivated in following through on obtaining resources, and myself, in that I'd be honing reflective listening ability and whatnot for later work as a clinician.

3) I feel like most people would react adversely due to misunderstandings about what it is.

The main issue I personally see is maintaining the boundary of applying it strictly for the motivating to obtain resources only when those things are along the line of obtaining food, shelter assistance, etc. If someone brought up a desire to stop using a substance, for example. I'd need to swap back to just providing information. Using any therapy techniques in that situation would seem pretty ethically muddy to me.

Does that sound appropriate? Thank you again.

 

[Manicsleep]

My mom uses it all the time. On me, my siblings, grandkids, my dad etc.

It is VERY unethical!