‘Power positions are embedded in our minds’: focus group discussions on psychotherapy ethics in India

ABSTRACT Background: Ethical issues are ubiquitous during therapeutic work, despite the presence of professional ethics codes that guide ethical decision making. This exploratory research looks at how mental health trainees and practitioners, across various mental health disciplines, perceive and experience ethical dilemmas in the therapy space. Method: The sample included 12 mental health practitioners from varied mental health disciplines (clinical psychology, psychiatry and psychiatric social work), and practising counsellors, from an urban city in India. Three focus group discussions were conducted, where participants expressed the ethical issues and challenges encountered during their sessions with clients. Results: Content analysis of the narratives of the focus group discussions highlighted prominent ethical dilemmas in these domains: negotiation of boundaries or frames of the interaction; involvement of family in therapeutic decisions; negotiation of issues of gender and power in therapy; value conflicts in working with sexuality issues; therapist competence; and method of resolution of ethical dilemmas. Personal and cultural values emerged as impacting the perceptions, interpretations and experience of ethically challenging situations. The findings have implications for the development of culturally sensitive and value-based training methodologies.