Aile ve Grup Psikoterapilerinde Etik İlkeler ve Uygulama Süreçleri: Güncel Psikoloji Literatürüne Dayalı Bir Derleme

Abstract

Psikoterapistlerin temel mesleki sorumluluklarından biri etik ilkelere uygun kararlar almaktır. Birden fazla danışanı içeren aile ve grup psikoterapileri, doğaları gereği, bireysel terapilere kıyasla daha karmaşık etik sorunlar ve ikilemler barındırmaktadır. Psikoterapistler, bu tür problemlerle karşılaştıklarında başvurabilecekleri kapsamlı kaynaklara ihtiyaç duymaktadırlar. Bu sebeple, bu çalışmasının amacı, aile ve grup psikoterapisinde etik ilke ve yönergelere dair kapsamlı bir Türkçe kaynak oluşturmak ve uygulayıcıların olası etik ikilemler konusundaki bilgi ve farkındalıklarını artırmaktır. Bu amaç doğrultusunda, herhangi bir zaman kısıtlaması uygulanmadan Türkçe ve İngilizce yayınlar incelenmiş; taramalar Google Scholar, Semantic Scholar, PsychNet, SAGE Journals ve ResearchGate veri tabanları üzerinden gerçekleştirilmiştir. Taramalar, “ethics”, “fee”, “termination”, “confidentiality”, “online”, “competence”, “multicultural”, “sexual intimacy” ve “record” anahtar kelimelerinin “group therapy” ve “family therapy” ile kombinasyonları kullanılarak yapılmıştır. Bulgular, bu psikoterapi türlerinde etik karar almanın çok boyutlu olduğunu göstermiştir. Bu bağlamda öne çıkan temel ilkelerden bazıları, psikoterapistlerin mesleki yetkinliklerini sürdürmesi, insan haklarına saygı göstermesi, gizliliği koruması ve çoklu ilişkiler ile sınırlar konusunda titiz davranmasıdır. Uygulama süreçlerinde ise grup oluşturma, çok kültürlü duyarlılık, bilgilendirilmiş onam ve sistematik kayıt tutma gibi konular, danışan özerkliği ve güvenliğini sağlamak açısından kritik öneme sahiptir. Mali konular, yönlendirme ve sonlandırma süreçleri şeffaflık, adalet ve danışan yararının gözetilmesini gerektirmektedir. Çevrimiçi psikoterapide ise teknoloji kaynaklı risklerin yönetimi, klinik uygulamanın güvenliği ve etkinliği açısından elzemdir. Son olarak, psikoterapistin yetkinliği, süpervizyon desteği ve meslek örgütlerinden sağlanan rehberlik etik kararlar vermede belirleyici olmaktadır. Sonuç olarak, aile ve grup psikoterapilerinde etik ilkelerin özenle uygulanması, danışanların psikolojik iyilik hâlini güvence altına almak ve terapötik sürecin etkinliğini artırmak açısından kritik bir öneme sahiptir.

Keywords

• aile psikoterapisi
• grup psikoterapisi
• etik ilkeler
• etik ikilemler

Ethical Principles and Clinical Practices in Family and Group Psychotherapies: A Literature Review in Contemporary Psychology

Abstract

One of the fundamental professional responsibilities of psychotherapists is to make decisions in accordance with ethical principles. Family and group psychotherapies, by their very nature, pose more complex ethical challenges and dilemmas than individual therapy. Psychotherapists, therefore, require comprehensive resources to address such issues effectively. The present study aims to provide a comprehensive Turkish-language source on ethical principles and guidelines for family and group psychotherapy, thereby enhancing practitioners’ knowledge and awareness of potential ethical dilemmas. To this end, both Turkish and English publications were reviewed without time restrictions, using databases such as Google Scholar, Semantic Scholar, PsychNet, SAGE Journals, and ResearchGate. Searches were conducted with the keywords “ethics,” “fee,” “termination,” “confidentiality,” “online,” “competence,” “multicultural,” “sexual intimacy,” and “record,” in combination with “group therapy” and “family therapy.” Findings indicate that ethical decision-making in these psychotherapies is multidimensional. Key principles include maintaining professional competence, respecting human rights, ensuring confidentiality, and exercising caution regarding multiple relationships and boundaries. At the practice level, issues such as group formation, multicultural sensitivity, informed consent, and systematic record-keeping are critical to safeguarding client autonomy and safety. Financial arrangements, referrals, and termination processes must prioritize transparency, fairness, and client welfare. In online psychotherapy, managing technology-related risks is essential to ensure both safety and clinical effectiveness. Finally, therapist competence, supervision, and guidance from professional associations are decisive in making sound ethical decisions. In conclusion, careful implementation of ethical principles in family and group psychotherapy is vital to securing clients’ psychological well-being and enhancing therapeutic effectiveness.

Keywords

• family psychotherapy
• group psychotherapy
• ethical principles
• ethical dilemmas

References

1. Akyıl, Y., Üstünel, A., Alkan, S. ve Aydın, H. (2015). Türkiye’de çift ve ailelerle çalışan uzmanlar: Demografik özellikler, eğitim ve klinik uygulamalar. Psikoloji Çalışmaları, 35(1), 57-84.
2. American Association for Marriage and Family Therapy (2015). Code of ethics. https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx
3. American Counseling Association (2014). Code of ethics. https://www.counseling.org/Resources/aca-code-of-ethics.pdf
4. American Group Psychotherapy Association. (2002). AGPA and NRCGP guidelines for ethics. https://www.agpa.org/home/practice-resources/ethics-in-group-therapy
5. American Group Psychotherapy Association. (2017). Practice guidelines for group psychotherapy. https://www.agpa.org/home/practice-resources/practice-guidelines-for-group-psychotherapy
6. American Psychological Association (2017). Ethical principles of psychologists and code of conduct. http://www.apa.org/ethics/code/index.aspx
7. American Psychological Association (2024). Proposed revision of guidelines for the practice of telepsychology. https://www.apa.org/practice/guidelines/telepsychology-revisions.pdf
8. Arcuri, A. (2015). Money matters: A case study of a therapist’s and a family’s joint enactment of monetary issues in family therapy. Australian and New Zealand Journal of Family Therapy, 36(4), 518–523. https://doi.org/10.1002/anzf.1127

9. Beahrs, J. ve Gutheil T. (2001) Informed consent in psychotherapy. American Journal of Psychiatry, 158(1), 4–10. https://doi.org/10.1176/appi.ajp.158.1.4
10. Bernard, J. M. ve Goodyear, R. K. (2019). Fundamentals of clinical supervision (6. Basım). Pearson.
11. Blumer, M. L. C., Hertlein, K. M. ve VandenBosch, M. L. (2015). Towards the development of educational core competencies for couple and family therapy technology practices. Contemporary Family Therapy, 37(2), 113–121. https://doi.org/10.1007/s10591-015-9330-1
12. Boszormenyi-Nagy, I. ve Ulrich, D. N. (1981). Contextual family therapy. İçinde A. S. Gurman ve D. P. Kniskern (Edl.), Handbook of family therapy (ss.159-186). Brunner/Mazel.
13. Bowen, M. (1978). Family therapy in clinical practice. Jason Aronson.
14. Brabender, V. M. (2006). The ethical group psychotherapist. International Journal of Group Psychotherapy, 56(4), 395–414. https://doi.org/10.1521/ijgp.2006.56.4.395
15. Brabender, V. M. ve Fallon, A. (2009). Ethical hot spots of combined individual and group therapy: Applying four ethical systems. International Journal of Group Psychotherapy, 59(1), 127-147. https://doi.org/10.1521/ijgp.2009.59.1.127
16. Canter, M. B., Bennett, B. E., Jones, S. E. ve Nagy, T. F. (1994). Ethics for psychologists: A commentary on the APA ethics code. American Psychological Association.
17. Champe, J. ve Kleist, D. M. (2003). Live supervision: A review of the research. The Family Journal, 11(3), 268-275. https://doi.org/10.1177/1066480703252755
18. Chen, E. C., Thombs, B. D. ve Costa, C. I. (2003). Building connection through diversity in group counseling: A dialogical perspective. İçinde D. B. Pope-Davis, H. L. K. Coleman, W. M. Liu ve R. L. Toporek (Edl.), Handbook of multicultural competencies: In counseling & psychology (ss. 456–477). Sage Publications.
19. Corey, G., Corey, M. S. ve Corey, C. (2018). Groups: Process and practice (10. Basım). Cengage Learning.
20. Clark, P. ve Kimberly, C. (2014). Impact of fees among low-income clients in a training clinic. Contemporary Family Therapy, 36(3), 363–368. https://doi.org/10.1007/s10591-014-9303-9
21. Corey, G., Williams, G. T. ve Moline, M. E. (1995). Ethical and legal issues in group counseling. Ethics & Behavior, 5(2), 161–183. http://dx.doi.org/10.1207/s15327019eb0502_4
22. Debiak, D. (2007). Attending to diversity in group psychotherapy: An ethical imperative. International Journal of Group Psychotherapy, 57(1), 1–12. https://doi.org/10.1521/ijgp.2007.57.1.1
23. Fallon, A. (2006). Informed consent in the practice of group psychotherapy. International Journal of Group Psychotherapy, 56(4), 431-453. http://doi.org/10.1521/ijgp.2006.56.4.431
24. Ford, G. G. (2000). Ethical reasoning in the mental health professions. CRC Press.
25. Forsyth, D. R. (2019). Group dynamics (7. Basım). Cengage Learning.
26. Goldberg, P. D., Peterson, B. D., Rosen, K. H. ve Sara, M. L. (2008). Cybersex: The impact of a contemporary problem on the practices of marriage and family therapists (MFTs). Journal of Marital and Family Therapy, 34(4), 469–480. http://doi.org/10.1111/j.1752- 0606.2008.00089.x
27. Gurman, A. (1985). On saving marriages. Family Therapy Networker, 9(2), 17-18.
28. Hays, P. A. (2016). Addressing cultural complexities in practice (3. Basım). APA.
29. Health Privacy Project. (2003). Medical privacy stories. patientprivacyrights.org/wp-content/uploads/2013/08/True_Stories1.pdf
30. Hecker, L. L. ve Murphy, M. J. (2015). Contemporary and emerging ethical issues in family therapy. Australian and New Zealand Journal of Family Therapy, 36(4), 467-479. http://doi.org/10.1002/anzf.1121
31. Hoffman, L. (1981). Foundations of family therapy (1.Basım). Basic Books.
32. Horton, E. G., Garratt, G. ve Miller, J. P. (2022). Multicultural competence and ethical decision-making in counseling: A contextual approach. Journal of Counseling & Development, 100(2), 145-156. https://doi.org/10.1002/jcad.12415
33. Hutchby, I., O’Reilly, M. ve Parker, N. (2012). Ethics in praxis: Negotiating the presence and functions of a video camera in family therapy. Discourse Studies, 14(6), 675–690. http://doi.org/10.1177/1461445612457487
34. International Association for Group Psychotherapy and Group Processes (2016). Ethical guidelines and professional standards for group psychotherapy. https://www.iagp.com/about/ethicalguidelines.htm
35. Jensen, J. A., McNamara, J. R. ve Gustafson, K. E. (1991). Parents’ and clinicians’ attitudes toward the risks and benefits of child psychotherapy: A study of informed–consent content. Professional Psychology: Research and Practice, 22(2), 161–170. https://doi.org/10.1037/0735-7028.22.2.161
36. Kivlighan, D. M. ve Chapman, N. A. (2018). Extending the multicultural orientation (MCO) framework to group psychotherapy: A clinical illustration. Psychotherapy, 55(1), 39-44. http://dx.doi.org/10.1037/pst0000142
37. Knapp, S. J. ve VandeCreek, L. D. (2010). Psikologlar için pratik etik: Pozitif yaklaşım (M. Yılmaz, T. F. Karahan, S. Balcı Çelik ve M. E. Sardoğan, Çev.). Mentis Yayıncılık. (2006)
38. Knauss, L. K. (2006). Ethical issues in record-keeping in group psychotherapy. International Journal of Group Psychotherapy, 56(4), 415-430. https://doi.org/10.1521/ijgp.2006.56.4.415
39. Korkmaz, B. (2019). Yapısına göre psikoterapi türleri ve etik meseleler. Uludağ Üniversitesi Fen-Edebiyat Fakültesi Sosyal Bilimler Dergisi, 20(36), 513-543. https://doi.org/10.21550/sosbilder.418687
40. Krogel, J., Beecher, M. E., Presnell, J., Burlingame, G. ve Simonsen, C. (2009). The group selection questionnaire: A qualitative analysis of potential group members. International Journal of Group Psychotherapy, 59(4), 529–542. https://doi.org/10.1521/ijgp.2009.59.4.529
41. Lakin, M. (1992). Morality in group and family therapies: Multiperson therapies and the 1992 ethics code. Professional Psychology: Research and Practice, 25(4), 344-348. https://doi.org/10.1037/0735-7028.25.4.344
42. Lasky, G. B. ve Riva, M. T. (2006). Confidentiality and privileged communication in group psychotherapy. International Journal of Group Psychotherapy, 56(4), 455–476. https://doi.org/10.1521/ijgp.2006.56.4.455
43. Lee, R. E., Nichols, D. P., Nichols, W. C. ve Odom, T. (2004). Trends in family therapy supervision: The past 25 years and into the future. Journal of Marital and Family Therapy, 30(1), 61-69. https://doi.org/10.1111/j.1752-0606.2004.tb01222.x
44. Leigh, G., Loewen, I. ve Lester, M. (1986). Caveat emptor: Values and ethics in family life education and enrichment. Family Relations, 35(4), 573-580. http://doi.org/10.2307/584519
45. Mangione, L., Forti, R. ve Iacuzzi, C. M. (2007). Ethics and endings in group psychotherapy: Saying good–bye and saying it well. International Journal of Group Psychotherapy, 57(1), 25–40. https://doi.org/10.1521/ijgp.2007.57.1.25
46. Margolin, G. (1982). Ethical and legal considerations in marital and family therapy. American Psychologist, 37(7), 788–801. https://doi.org/10.1037/0003-066X.37.7.788
47. Marton, K. ve Kanas, N. (2015). Telehealth modalities for group therapy: Comparisons to in-person group therapy. International Journal of Group Psychotherapy, 66(1), 145–150. http://dx.doi.org/10.1080/00207284.2015.1096109
48. Minuchin, S. (1974). Families and family therapy. Harvard University Press.
49. Opoczyńska-Morasiewicz, M. ve Janusz, M. (2015). Ethics and psychotherapy. Psychoterapia, 4(175), 21-34.
50. Owen, J. J., Tao, K., Leach, M. M. ve Rodolfa, E. (2011). Clients’ perceptions of their psychotherapists’ multicultural orientation. Psychotherapy, 48(3), 274–282. https://doi.org/10.1037/a0022065
51. Parker, J., Clevenger, J. E. ve Sherman, J. (1997). The psychotherapist–patient privilege in group therapy. Journal of Group Psychotherapy, Psychodrama & Sociometry, 49(4), 157–161.
52. Pepper, R. S. (2002). Emotional incest in group psychotherapy. International Journal of Group Psychotherapy, 52(2), 285–294. https://doi.org/10.1521/ijgp.52.2.285.45504
53. Satir, V. (1967). Conjoint family therapy (Gözden geçirilmiş 2. Basım). Science and Behavior Books.
54. Scalise, J. (2000). The ethical practice of marriage and family therapy. İçinde A. M. Horne (Ed.), Family counseling and therapy (3. Basım, ss. 565-596). F.E. Peacock Publishers
55. Shapiro, E. L. ve Ginzberg, R. (2006). Buried treasure: Money, ethics, and countertransference in group therapy. International Journal of Group Psychotherapy, 56(4), 477–494. https://doi.org/10.1521/ijgp.2006.56.4.477
56. Shaw, E. (2015). Ethical practice in couple and family therapy: Negotiating rocky terrain. Australian and New Zealand Journal of Family Therapy, 36(4), 504–517. https://doi.org/10.1002/anzf.1129
57. Shonfeld-Ringel, S. (2021). Theoretical and clinical foundations of multicultural psychotherapy: Examining the role of culture in the therapeutic process. Routledge.
58. Silverstein, R., Crane, D. R. ve Anderson, S. R. (2023). Relational ethics in contextual family therapy: A contemporary review of clinical applications. Contemporary Family Therapy, 45(1), 88-101. https://doi.org/10.1007/s10591-022-09654-7
59. Smokowski, P., Rose, S., Todar, K. ve Reardon, K. (1999). Post-group casualty status, group events and leader behavior: An early look into the dynamics of damaging group experiences. Research on Social Work Practice, 9(5), 555-574.
60. Somer, E. ve Saadon, M. (1999). Therapist-client sex: Clients’ retrospective reports. Professional Psychology: Research and Practice, 30(5), 504-509. https://doi.org/10.1037/0735-7028.30.5.504
61. Sue, D. W. ve Sue, D. (2012). Counseling the culturally diverse: Theory and practice (6. Basım). Wiley.
62. Taube-Schiff, M., Suvak, M. K., Antony, M. M., Bieling, P. J. ve McCabe, R. E. (2007). Group cohesion in cognitive-behavioral group therapy for social phobia. Behaviour Research and Therapy, 45(4), 687–698. https://doi.org/10.1016/j.brat.2006.06.004
63. Thoreson, R. W., Shaughnessy, P. ve Frazier, P. A. (1995). Sexual contact during and after professional relationships: Practices and attitudes of female counselors. Journal of Counseling and Development, 74(1), 84-89. https://doi.org/10.1002/j.1556-6676.1995.tb01827.x
64. Treacher, A. (1989). Termination in family therapy-developing a structural approach. Journal of Family Therapy, 11(2), 135–147. http://doi.org/10.1046/j.1989.00341.x
65. Turliuc, M. N. ve Candel, O. (2019). Ethical issues in couple and family research and therapy. İçinde E. Unguru, A. Frunza ve A. Sandu (Edl.), Ethics in research practice and innovation (ss. 226-242). IGI Global.
66. Türk Psikologlar Derneği (2004). Türk Psikologlar Derneği etik yönetmeliği. https://www.psikolog.org.tr/tr/files/folder/etik-yonetmeligi-x389.pdf
67. Türk Psikologlar Derneği (2020). Çevrimiçi psikolojik müdahale ve uygulamalar için telepsikoloji kılavuzu. https://www.tpd.com.tr/tr/files/folder//telepsikoloji-kilavuzu-x150.pdf
68. Vlastelica, M., Pavlovic, S. ve Urlic, I. (2003). Patients’ ranking of therapeutic factors in group analysis. Collegium Antropologicum, 27(2), 779-788.
69. Watkins, C. E., Hook, J. N., Owen, J., DeBlaere C., Davis, D. E. ve Van Tongeren, D. R. (2019). Multicultural orientation in psychotherapy supervision: Cultural humility, cultural comfort, and cultural opportunities. American Journal of Psychotherapy, 72(2), 38-46. https://doi.org/10.1176/appi.psychotherapy.20180040
70. Weinberg, H. (2020). Online group therapy. İçinde H. Weinberg ve A. Rolnick (Edl.), Theory and practice of online therapy: Internet-delivered interventions for individuals, groups, families, and organizations (ss. 159-209). Routledge.
71. Welfel, E. R. (2006). Ethics in counseling and psychotherapy: Standards, research, and emerging issues (6. Basım). Cengage Learning.
72. Wilcoxon, S. A. ve Gladding, S. T. (1985). Engagement and termination in marital and familial therapy: Special ethical issues. The American Journal of Family Therapy, 13(4), 65–71. http://dx.doi.org/10.1080/01926188508251278
73. Woody, J. D. (1990). Resolving ethical concerns in clinical practice: Toward a pragmatic model. Journal of Marital and Family Therapy, 16(2), 133–150. http://doi.org/10.1111/j.1752-0606.1990.tb00834.x
74. Yalom, I. ve Leszcz, M. (2018). Grup psikoterapisinin teori ve pratiği (A. Tangör ve Ö. Karaçam, Çev.). Pegasus Yayınları. (1970)
75. Zur, O. (2017). Dual relationships and psychotherapy: A comprehensive, relational, and ethical approach (2. Basım.). Oxford University Press.
76. Zygmond, M. J. ve Boorhem, H. (1989). Ethical decision making in family therapy. Family Process, 28(3), 269-280. https://doi.org/10.1111/j.1545-5300.1989.00269.x