Investigating Online Psychotherapy in the Framework of Ethical Codes

Öz

The ways people communicate and interact have been changing over time as a result of the increasingly widespread developments and changes in technology. The use of the Internet, which has become an inevitable part of human life, increasingly raises the question of whether psychotherapy can be performed over the Internet. At the same time, doubts about the effectiveness of online psychotherapy; worries about not being able to establish a therapeutic alliance; the lack of technological infrastructure, privacy, and security; and ethical problems pose serious obstacles to the developments in this field. The aim of this study is to examine therapists’ reactions to unexpected situations that occur in the literature within the framework of ethical codes and that are found to be the most concerning to therapists regarding online psychotherapy. This study’s participants involve 43 therapists working in different provinces of Türkiye. The study examines online psychotherapy with the aim of revealing psychotherapists’ perceptions with regard to hypothetical situations and analyzes the obtained data according to the qualitive analytical method of inductive thematic analysis. The findings can be grouped under five themes: (1) how to not lose control of the area of responsibility, (2) how to cope with out-of-control situations, (3) how to maintain the limits of competence, (4) how to cope with the lack of nonverbal cues, and (5) a red line not to be crossed (i.e., these participants do not prefer online therapy). When considering the findings regarding their views, they are seen to range from online therapy being considered completely unethical at one extreme and unethical not to use online therapies at the other. The study discusses these emerging themes with reference to the Code of Ethics of the Turkish Psychologists Association while also analyzing therapists’ reactions to the situations and determining the needs for and resolving which items should be present in the code of ethics.

Anahtar Kelimeler

• Online psychotherapy
• ethics
• qualitative method
• thematic analysis

Çevrimiçi Psikoterapinin Etik Kodlar Çerçevesinde İncelenmesi

Öz

Giderek yaygınlaşan, gelişen ve değişen teknolojinin bir sonucu olarak kişilerin iletişim ve etkileşim kurma yolları da zaman içinde değişime uğramış, hayatımızın bu derece kaçınılmaz bir parçası haline gelen internet kullanımı, artan bir şekilde “psikoterapi hizmeti de internet üzerinden uygulanabilir mi?’ sorusunu beraberinde getirmiştir. Aynı zamanda çevrimiçi psikoterapinin etkililiğine dair şüpheler, terapötik ittifakın kurulamaması endişesi, teknolojik alt yapı yetersizliği, gizlilik, güvenlik ve etik sorunlar ise bu alandaki gelişmelerin önünde ciddi bir engel oluşturmaktadır. Bu çalışmanın amacı da çevrimiçi yürütülen psikoterapilerde yaşanabilecek, en çok kaygı uyandırdığı alanyazında tespit edilen durumlar karşısında, terapistlerin öngörülerinin etik kodlar çerçevesinde incelenmesidir. Araştırmaya, Türkiye’nin farklı illerinde çalışan 43 psikoterapist katılmıştır. Çevrimiçi psikoterapi sürecinde hipotetik durumlar aracılığıyla terapistlerin tepkilerinin açığa çıkarılması hedeflenmiş, elde edilen veriler ‘tümevarımsal tematik analiz’ (inductive thematic analysis) prosedürü kullanılarak analiz edilmiştir. Araştırmada katılımcıların hipotetik durumda ne yapacaklarına ilişkin yanıtları ‘tepkiler’; bu tepkileri verirken yaptıkları açıklamaları ise terapist olarak ‘görüşleri’ olarak kavramsallaştırılmıştır. Tepkilere ilişkin elde edilen bulguların çevrimiçi psikoterapide (1) Sorumluluk alanının kontrolünü kaybetmek, (2) Sürecinin kontrolden çıkması durumunda başa çıkma, (3) Yetkinliğin sınırlarını korumak (4) Sözel olmayan ipuçlarını kaçırabilme durumuyla başa çıkma ve (5) ‘Kırmızı çizgi’: Çevrimiçi terapiyi tercih etmemek şeklinde 5 temada gruplandırılabileceğine karar verilmiştir. Görüşlere ilişkin elde edilen bulgular göz önünde bulundurulduğunda, bir uçta çevrimiçi terapilerin tamamen etik dışı olduğu, diğer uçta çevrimiçi terapileri kullanmamanın etik dışı olduğu görüşlerinin bir boyut üzerinde yer aldığı görülmüştür. Ortaya çıkan bu temalar Türk Psikologlar Derneği Etik Yönetmeliği referans alınarak tartışılmış, terapistlerin durum karşısındaki tepkileri incelenirken etik yönetmelikteki maddelerin içeriğine dair ihtiyaçlar ve çözüm önerileri belirlenmiştir.

Anahtar Kelimeler

• Çevrimiçi psikoterapi
• etik
• nitel yöntem
• tematik analiz

Kaynakça

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