Intrusive advocacy occurs when psychologists place a social
cause or their own personal values above their patients’ welfare
(Pope & Brown, 1996) and fail to separate personal values from
therapeutic ones ( Tjeltveit & Gottlieb, 2010). Consider this
A psychologist expressed anger at a patient who refused
to file charges against an inpatient facility that had, probably
inadvertently, violated her privacy rights by giving out
information in a nonemergency situation without a proper release
or court order.
Other psychologists have tried too strenuously to convince
patients to file complaints against previous therapists with
whom they had a sexual relationship or to file criminal
suits against a parent who had abused them as a child. One
psychologist told a patient that the patient had a social
obligation to other victims to publicly expose and humiliate
the offender. Another psychologist believed so strongly in
protecting children that she included campaign literature in
her waiting room for a political candidate who was vocal on the
need for increased funding for child welfare programs.
Such well-meaning efforts fail to respect patients’ autonomy
in choosing their own goals and values. The psychologists’
role is to establish conditions that allow patients to reach
autonomous decisions; focusing on the psychologists’ goals
instead is likely to lead to a poorer quality of service, including
an increase in the number of patients who resist or drop out of
treatment. In the extreme, such behavior could also cause harm.
Failing to maintain professional boundaries
Effective professional relationships focus on patient well-being.
Consider this situation:
At an initial evaluation, a patient reported that she was
coming to therapy to deal with a recent sexual assault. The
psychologist immediately shared her own assault history, as she
had been instructed to do years earlier when she volunteered in a
sexual assault facility.
The general rule for psychologists is to self-disclose
deliberately and selectively, based on a patient’s need
(Sommers-Flanagan, 2012). The psychologist’s discussion
of her own sexual assault, especially when she did not know
the patient well, was ill-considered and potentially harmful.
Although this sharing might have been appropriate in a
friendship or paraprofessional relationship, excessive self-disclosure early in the professional relationship risks derailing
the focus of attention from the patient onto the psychologist
(for further reading, see Gottlieb, Younggren, & Murch, 2009).
Allowing personal values to trump professional values
Although it is commendable to respond with concern
and loyalty and to assist friends, in professional roles,
psychologists should decline some requests for help. Consider
A psychologist was contacted by an attorney who told him
about a man who was alienated from his daughter through
no fault of his own, and the court had issued an order for
reunification therapy. The psychologist agreed to conduct the
therapy, even though he had no training or experience in this
modality and was unprepared for the difficulty and the intensity of
emotion generated by the case.
Another psychologist was treating a patient with a long
history of disruptive interpersonal relationships, including failed
treatment relationships with previous therapists. To reassure her
patient, who was going through deep depression, the psychologist
told her, “I will always be here for you.” One year later, the
psychologist terminated treatment with the patient who had
continually missed appointments, made inappropriate nighttime calls, refused to comply with reasonable treatment plans
and failed to pay her bills. The patient filed a licensing board
complaint noting that the psychologist had lied about always
being there for her.
When a former patient was having trouble finding a place to
live, a psychologist rented an apartment to her well below market
rates. Two years later, the former patient was far behind in her
rent and unemployed. When the psychologist attempted to collect
the rent, the patient filed a licensing board complaint against the
It’s important for psychologists to set limits on their
assistance and loyalty to patients, especially when such
help exceeds the psychologist’s competence, misleads
patients concerning psychologists’ roles or creates clinically
contraindicated multiple relationships.
How to protect yourself
We view ethics acculturation as a developmental process that
occurs throughout one’s career. In that spirit, we offer these
suggestions for balancing your personal ethical systems with
professional rules, standards, values and principles.
1. Reflect on your behaviors. By reflecting on your
professional conduct, you can explicitly link your behavior
to both the rules governing the profession (such as the APA
Ethics Code, state and federal laws, etc.) and to personal
overarching ethical theory, whether that theory be principle-based ethics, virtue ethics, deontological ethics, feminist
ethics or a system based upon your religious traditions.
You can evaluate behaviors based on both personal and
professional standards of conduct and then deliberate in
a more comprehensive way (Anderson & Handelsman,
2010). Explicit instruction using the EAM (such as through
readings or continuing education) may be one way to better
understand how to integrate personal and professional ethics
(Gottlieb et al., 2008).
2. Exhibit good ethical behaviors. Graduate students in
psychology observe how their professors and supervisors
respond to ethical problems. Of course, this knowledge is
not transmitted by osmosis (Handelsman, 1986); faculty and