ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.     

Obstacles to gaining ethical approval for a multi-centre study of family support

The NHS has emphasised the need for rigorous evaluations of preventative home-visiting support (Bull and others, 2004) in building a public health evidence base. Interdisciplinary studies involving the NHS in any capacity are subject to ethical review by NHS Research Ethics Committees. However, the current process of ethical review does not respond flexibly to research conducted by non-NHS organisations. Through documentary analysis, this paper describes the experience of a non-clinical research evaluation of a family support service offered during pregnancy and the difficulties encountered in gaining ethical approval. Implications for social science research with minimal NHS involvement are discussed and recommendations for improvements suggested.     

Health Care and Female Survivors of Childhood Sexual Abuse: Health Professionals' Perspectives

The present study explored health professionals' experiences with adult survivors of child sexual abuse in New Zealand. Face-to-face, semistructured interviews of up to an hour took place with 13 health professionals. The participants were asked about training, screening practices, their response to disclosures, and advice to other health professionals. A model—transition to ethical practice—emerged from the data, where delivering more sensitive health care to child sexual abuse survivors sits on a continuum from lack of awareness of child sexual abuse to delivery of care where all patients are comfortable. We recommend making sensitive care for all as the standard care of practice and providing training for health professionals on how to deal with disclosures.     

Autonomy and Compliance: How Qualitative Sociologists Respond to Institutional Ethical Oversight

Prevailing sociological understandings of institutional ethical review tend to homogenize faculty responses to them, and are predominantly speculative. In this research, we conduct interviews with sociologists from 21 Ph.D.-granting departments across Canada, finding three predominant “ethics orientations” among them, with associated cognitive maps and strategic actions. In our analyses, we use these orientations to complicate homogeneous appraisals of social researchers’ responses to new bureaucratic requirements, enriching our understanding of how such requirements affect the ways sociologists think about their occupation, approach their research, and mentor successive generations. These ethics orientations suggest the field of sociology is comprised of distinct political cohorts with diverging understandings of ethical review, and by extension, power and intellectual work. For some, ethical review signals a more consultative and therefore better approach to knowledge production, while for others it marks the end of an era of unfettered (and superior) intellectual pursuit in sociology.     

A Case for Limiting the Reach of Institutional Review Boards

Institutional review boards (IRBs) governing social and behavioral research seem to systematically exceed the guidelines established by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. We examine a clandestine study of prostitution and another of employment discrimination and conclude that IRBs, more concerned about being sued than they are about protecting research subjects, get in the way of science and cause ethical problems as a consequence. We discuss the ethical principles involved and call for a suspension of all IRB review in the social and behavioral sciences.     

Ethical ‘mess’ in co-produced research: reflections from a U.K.-based case study

Co-producing research is complex and messy. This paper draws on Tina Cook’s argument for the systematic inclusion of ‘mess’ in research accounts as a conceptual framework through which to articulate areas of ethical mess from within a co-produced research project. Through narrating the ‘messy’ ethical complications the paper illustrates a number of specific ethical risks when co-producing research; particularly when working with young people. The paper provides valuable insight into ethical tensions that can emerge when using a co-produced methodology and will be informative for future researchers negotiating their own co-produced research projects. The paper argues for the systematic inclusion of mess in the accounting of participatory research.     

COMMON FACTORS ACROSS THEORIES OF MARRIAGE AND FAMILY THERAPY: A MODIFIED DELPHI STUDY

The Delphi methodology was used to explore common factors across theories of marriage and family therapy (MFT). Leading clinicians and researchers from the American Family Therapy Academy and select faculty members from MFT training programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education were asked to achieve consensus regarding common factors. Respondents were asked to report on commonalities across the various MFT theories, as well as what they personally considered to be the core ingredients of change. A final profile of items was created from the responses. Qualitative interviews were conducted with selected panelists to clarify discrepancies as well as to add meaning to the data. Implications for the training and practice of MFTs as well as direction for future research are discussed.     

Protecting persons in family therapy research: an overview of ethical and regulatory standards

Family therapists are expected to engage in ethical and responsible research, while maintaining rigorous ethical standards and adhering to federal regulations that require protection for research participants. We present a short historical overview of the significant events and ethical controversies leading to the formulation of current regulations in human subject research and review. Federal regulations and guidelines, including issues of informed consent, special populations, and conflict of interest are reviewed. A short list of recommendations to assist family therapists in staying abreast of contemporary research protocol is provided.     

Research ethics committees: values and power in higher education

The rise of research governance structures in universities has created huge disquiet amongst academic researchers. The unquestioning adoption of a medical model of ethical review based upon positivist methodological assumptions has created for many a mismatch between their own ongoing ethical research practice and the process of obtaining clearance from Research Ethics Committees (REC). This paper examines the issues that have contributed to dissatisfaction with the ethical review model that is prevalent within the modern university. Using examples from the authors’ own experiences, the dynamics of values, interests and power in research governance is examined from multiple perspectives including that of REC member and applicant; lecturer/student supervisor; researcher; and university administrator. The paper reveals a rift between the values and objectives of the key players in research governance within the modern university and concludes by asking whether differences can be resolved so that a collaborative approach to ethical review may be incorporated into a renewed academic research culture. It is suggested that the alternative is increasing alienation from anything to do with ‘ethics’, with potentially serious consequences for the ethical standards of social research.     

The bad and the ugly: ethical concerns in participatory photographic methods with children living and working on the streets of Lima,Peru

Visual methods are particularly well suited for getting at the ways in which children living and working on the street understand their socio-spatial environment, and can bridge gaps between researcher and researched. In this study, adolescents who live and work on the streets of Lima are asked to take photographs, documenting their lives and their socio-spatial environments. While participatory methods such as photovoice can bring children and adolescents into the research process and can provide significant benefits to research and its participants, the introduction of photographic methods with marginalised populations carries with it important ethical concerns. This article explores the various critiques of documentary photography, and ethical concerns that arise when using visual methods, including issues of exploitation and intrusion in research with adolescents living on the streets. It also examines the ways in which researchers must continuously reassess their methodological practices in order to protect the best interests of the participants involved.     

Family Communication at the End of Life

This article presents a brief review examining what research has been conducted exploring family communication at the end of life (EOL) and suggestions for future research at the end-of-life context. Future research areas include: 1) the role of culture, 2) family member role and relational climate, 3) ethical considerations in regard to methodological choices, 4) the role of emotional and cognitive development on EOL communication, 5) EOL backstage communication, 6) death circumstances, and 7) the use of interdisciplinary research teams.     

Human research ethics committees and ethical review: The changing research culture for social workers

Social workers have a long-standing concern with developing codes of ethics, which govern and protect those involved in practice and research scenarios. As more social workers engage in research, successfully negotiating the ethical review process becomes imperative. In Australia, the task of ensuring ethical compliance of research protocols resides with human research ethics committees (HREC) mandated under the National Health and Medical Research Council. However, given the scope for discretion exercised by HREC, this process can be intimidating to novice and experienced researchers. The review process needs to be understood in the context of Australian ethics policy, the roles and responsibilities, and cultures of HREC. This paper outlines practical strategies in preparing ethics protocols to increase the likelihood of successful review. To do this, social workers need to recognise the way policy, legal developments and risk management strategies influence the ethical review process.     

Navigating Dual Relationships in Rural Communities

The literature examining dual relationships in rural communities is limited, and existing ethical guidelines lack guidelines about how to navigate these complex relationships. This study uses grounded theory to explore rural therapists' perceptions of dual relationship issues, the perceived impact of minority and/or religious affiliation on the likelihood of dual relationships, and the ways rural therapists handle inevitable dual relationship situations. All of the therapists who participated in the study practiced in small communities and encountered dual relationship situations with regularity. The overarching theme that emerged from the data was that of using professional judgment in engaging in the relationship, despite the fact that impairment of professional judgment is the main objection to dual relationships. This overall theme contained three areas where participants felt they most needed to use their judgment: the level of benefit or detriment to the client, the context, and the nature of the dual relationship. Surprisingly, supervision and/or consultation were not mentioned by the participants as strategies for handling dual relationships. The results of this study are compared with established ethical decision‐making models, and implications for the ethical guidelines and appropriate ethical training are suggested.     

Active parental consent in school-based research. An examination of ethical and methodological issues

To date, most school-based research has used passive parental consent. However, the Family Privacy Protection Act of 1995 aims to change these requirements. The proposed legislation requires written parental consent if minors are to be asked "sensitive" questions as part of any program or activity funded in whole or in part by the federal government. This act is representative of a growing trend toward restricting research involving minors. Whether or not this act is passed by Congress, two lines of concern are highlighted by this legislation. The first deals with ethical issues surrounding consent procedures. For instance, are parental rights compromised when active consent is not mandated? A second line of inquiry pertains to the effect of active consent procedures on response rates and sample bias. In this article, the authors discuss ethical issues surrounding passive and active consent procedures and then report response rates from two projects in which active consent procedures were implemented.     

Engaging with children as co-researchers: challenges,counter-challenges and solutions

Participatory approaches have become de rigueur in social research involving children. A growing trend is research by children where researchers engage (or employ) children as co-researchers or primary researchers. In this paper, we critique the ethical, methodological and practical issues associated with this participatory approach. The discussion is framed around six challenges: (1) Children lack research competence; (2) A comprehensive training programme is required; (3) Insider/outsider perspectives are difficult to balance; (4) Remuneration is complex; (5) Power differentials need to be overcome; and (6) Children need to be protected. For each challenge we propose a counter-challenge. Additionally, we offer pragmatic solutions to the issues raised, so that the paper holds practical utility to social researchers who utilise this type of participatory approach. Overall we argue that despite the approach’s inherent challenges, children as researchers are a powerful conduit for other children’s voices.     

Re-evaluating standards of human subjects protection for sensitive health data in social media networks

This study addresses ethical questions about conducting health science research using network data from social media platforms. We provide examples of ethically problematic areas related to participant consent, expectation of privacy, and social media networks. Further, to illustrate how researchers can maintain ethical integrity while leveraging social media networks, we describe a study that demonstrates the ability to use social media to identify individuals affected by cancer. We discuss best practices and ethical guidelines for studying social media network data, including data collection, analysis, and reporting.     

Therapist Ratings of Frequency and Severity of Marital Problems: Implications for Research*

In order to ascertain fruitful directions for marital therapy research, practicing marital therapists were asked to provide information regarding the clinical relevance of potential research topics. A structured questionnaire was mailed to 250 members of the American Association of Marriage and Family Therapists. Therapists treating at least five couples were asked to rate the frequency, severity, and treatment difficulty for 29 problems commonly experienced by distressed couples. Therapists' responses indicated the clinical relevance of a number of potential directions for research. Communication and alcoholism were most strongly endorsed as priority areas for future marital therapy research.     

Is Family Therapy Including Children?

This paper presents a review of recent child therapy and family therapy texts and training courses in Australia. The aim was to determine the extent to which knowledge and information about child development and emotional and psychological problems in children and adolescents is included in the education and training of family therapists. The paper argues this is crucial to prevent the difficulties of young person's being ignored or exacerbated and discusses relevant ethical issues.