Psychoanalysis Ethical Standards and Practice 2 — Questions and Answers
Question 1: A psychoanalyst discovers their patient is a close friend's spouse. The most ethical course of action is to:
- Continue treatment but document the dual relationship
- Refer the patient to another qualified analyst (Correct answer)
- Consult with a colleague but keep the patient
- Disclose the relationship to the patient's spouse
Correct answer: Refer the patient to another qualified analyst
Dual relationships that compromise analytic neutrality require referral to protect the patient's welfare and maintain professional boundaries.
Question 2: Which ethical principle is most directly violated when an analyst uses information shared in session to benefit themselves financially?
- Beneficence
- Fidelity (Correct answer)
- Non-maleficence
- Justice
Correct answer: Fidelity
Fidelity, which involves faithfulness to the therapeutic relationship and trust, is violated when the analyst exploits privileged information for personal gain.
Question 3: When a patient asks to record their psychoanalytic sessions, the analyst's primary consideration should be:
- The impact on free association and the analytic process (Correct answer)
- The cost of storage for the recordings
- The patient's legal rights to documentation
- Whether the request is covered by insurance
Correct answer: The impact on free association and the analytic process
Recording may inhibit free association and alter the spontaneous nature of the analytic process, which is the primary clinical and ethical concern.
Question 4: An analyst begins experiencing strong romantic feelings toward a patient. The first ethical step should be:
- Immediately terminate treatment and refer the patient
- Seek personal supervision or consultation (Correct answer)
- Increase session frequency to work through countertransference
- Disclose the feelings to the patient to maintain transparency
Correct answer: Seek personal supervision or consultation
Seeking supervision or personal analysis to address countertransference is the appropriate first step before making any treatment decisions.
Question 5: Under what circumstance may an analyst breach confidentiality without the patient's consent?
- When a family member expresses concern about the patient
- When the patient discusses illegal past behavior
- When there is imminent danger to an identifiable third party (Correct answer)
- When the analyst is conducting peer consultation
Correct answer: When there is imminent danger to an identifiable third party
The Tarasoff duty-to-warn obligation requires breaching confidentiality only when there is an imminent, credible threat to an identifiable person.
Question 6: A patient brings the analyst an expensive gift at the end of treatment. The most clinically and ethically appropriate response is to:
- Accept it graciously to avoid harming the therapeutic relationship
- Refuse it and explore the meaning of the gesture analytically (Correct answer)
- Accept it only if the monetary value is below a set threshold
- Donate it to charity on the patient's behalf
Correct answer: Refuse it and explore the meaning of the gesture analytically
Exploring the meaning of the gift maintains the analytic frame and treats the gesture as clinically significant material rather than a social exchange.
Question 7: Which of the following best describes the analyst's obligation regarding informed consent?
- Informed consent is only required for research participants, not clinical patients
- Consent must be obtained once at intake and is valid for the entire treatment
- Patients should be informed of the nature, risks, and alternatives to treatment (Correct answer)
- Informed consent is implied when a patient voluntarily seeks treatment
Correct answer: Patients should be informed of the nature, risks, and alternatives to treatment
Ethical practice requires that patients be provided sufficient information about the treatment process, potential risks, and alternatives so they can make autonomous decisions.
Psychoanalysis Ethical Standards and Practice 2
A psychoanalyst discovers their patient is a close friend's spouse.
The most ethical course of action is to: