rights. Still, for the most part, the profession’s standards,
including the APA Ethics Code, represent considered and
deliberative approaches to help psychologists fulfill their
obligations to patients, students, supervisees, research
participants or others.
In the ordinary course of professional practice, psychologists
may slip from an integration strategy, even if only temporarily.
Sometimes, especially when stressed, they may choose an
assimilation strategy and focus excessively on rules and miss
opportunities for empathy and compassion. Sometimes they
will choose a separation strategy and fail to consider how their
feelings of compassion and generosity need to be tempered by
the context and boundaries of the professional relationship.
Ideally, they can monitor and correct these tendencies. However,
at their extremes, or if left unchecked, assimilation or separation
The dark side of assimilation strategies
Although psychologists who use assimilation strategies may
believe they are acting in a highly ethical manner, they may not
appreciate the impact their behaviors have on patients or others.
Assimilation strategies can lead psychologists to interpret rules
too rigidly or without compassion, set lower standards for
professional behavior or create harm by giving disproportionate
attention to certain rules. Below we provide examples of each of
Interpreting rules too rigidly
The APA Ethics Code standards were developed, among
other reasons, to protect the welfare of patients, supervisees,
employees, research participants, students and others. However,
the complexity of professional practice requires discretion
in interpreting and implementing many of these standards.
Consequently, the code has a number of modifiers such as
Consider the different ways that psychologists may respond
“reasonable,” “appropriate,” “to the extent possible” and so
forth in recognition of the need for professional judgment in
unique circumstances. For example, Standard 3.05 (Multiple
Relationships) states that “Multiple relationships that would
not reasonably be expected to cause impairment or the risk of
exploitation or harm are not unethical.” However, psychologists
who use assimilation strategies sometimes act as if the modifiers
did not exist; they may also act as if simply following the rules
ensures the best ethical practice (Handelsman, Knapp, &
to this potential multiple relationship:
A psychologist was treating a medical student suffering
from anxiety and loneliness. The student learned that a local
church sponsored an organization for young singles that was
open to people who were not church members. The psychologist
discouraged the student from joining this group because the
psychologist was a member of that church and there was a
possibility that the patient could become more involved in the
church and that their paths might cross.
A prudent psychologist would weigh the extent and
likelihood of harm that might occur from such an encounter
against the extent and likelihood of benefit to the patient.
For some patients, such as those with problems maintaining
boundaries, it may be appropriate to discourage such
involvement. But this patient had an adjustment disorder
with no personality disorder features, was unlikely to be in
therapy much longer and had a personality that could tolerate
the possibility of future social contact with the psychologist.
From the standpoint of an integration strategy for ethics,
it appears that the psychologist missed an opportunity to
express compassion within the context of a professional
Acting from an assimilation strategy, other psychologists
might interpret the rule against clinically contraindicated
multiple relationships so strictly that they would condemn
any action that might increase the possibility that the patient’s
and psychologist’s paths could cross if the patient ever decided
to become more active in the church. They might decide
that any increased risk of a boundary crossing is too risky.
Thus, psychologists using assimilation strategies may lose the
opportunity to help patients when they fail to weigh thoroughly
both risks and benefits in their decision making.
Interpreting rules without attention to overarching values
At times, psychologists apply rules that appear unnecessarily
to distance themselves from their patients. For example, a
psychologist concerned about boundaries refused to hug any
patient under any circumstances. He even rebuffed hugs from
little children out of a concern that it might be misconstrued.
Another psychologist refused all gifts from patients, even a
holiday card with a pleasant and benign holiday greeting.
Another psychologist focused so much on getting the informed-
All of us have blind spots
…. As part of our lifelong
education in ethics, we
can strive for humility,
use think-aloud processes
and welcome feedback.