Potential ethical pitfalls and dilemmas in the promotion and use of American Psychological Association-recommended treatments for posttraumatic stress disorder.

A variety of potential unrecognized ethical concerns arise from the American Psychological Association's (APA, 2017) Clinical Practice Guideline for the Treatment of PTSD in Adults. In privileging short-term treatments that underscore symptom reduction as the predominant index of outcome, such as cognitive processing therapy and prolonged exposure, there is a susceptibility to mislead mental health professionals and clients alike to believe that lasting improvements in socioemotional well-being, and a time-intensive approach, are unrealistic, rather than realistic psychotherapy expectations. There are ethical implications to incompletely addressing clients' preferences and clinicians' judgments on matters such as preferred socioemotional outcomes, and desirable qualities in a therapist and therapy. As regard combat veterans, treating trauma-related guilt and shame as symptoms to be eliminated, rather than moral feelings to be acknowledged, expressed, and self-forgiven, warrants special ethical consideration. The high dropout rates of cognitive processing therapy and prolonged exposure raise questions as to whether their protocol-driven methods alienate substantial numbers of traumatized clients. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Ethics and endings in group psychotherapy: saying good-bye and saying it well.

Endings in group psychotherapy are suffused with complexity and potential conflict, some of which entail ethical quandaries. Ethical issues attending endings in group therapy are explored through a discussion of informed consent, time and role boundaries, privacy and confidentiality, unplanned endings, therapist-initiated termination, and competence. Findings from an exploratory survey of members of the American Group Psychotherapy Association and clinical-ethical vignettes are presented to highlight these issues. Clinicians need to develop and maintain ethical fitness and awareness, including attunement to personal responses, to endings and loss.