An exploration of clinical psychologists’ ethical sensitivity

Purpose: To understand how clinical psychologists identify ethical issues. The specific aims were to describe the process of ethical sensitivity and examine how clinical psychologists identify a need to engage in ethical decision-making.

Design: A qualitative design was adopted using Grounded Theory method.

Findings: Twelve clinical psychologists participated in semi-structured interviews. A model of how participants identified ethical issues was developed. The three core categories were discomfort, conscious realisation of an ethical problem and the impact of context on the assessment of the situation. The service context, specifically the balance of service demands to resources resulted in either thinking space or restricted thinking. Thinking space enabled participants to attend to their discomfort, understand its cause and identify a clash with their values. This process of ethical sensitivity being facilitated led to a restored sense of coherence with participants’ values. When the context restricted thinking this resulted in an ongoing emotional burden. Participants described this as unsustainable long-term and it had led several to changing jobs, reducing their hours or leaving the national healthcare service altogether to work for private providers or in independent private practice.

Value: The paper details an empirically developed theory of clinical psychologists’ ethical sensitivity. It describes the process experienced by practicing clinical psychologists when noticing potential ethical issues in their work practice. Limitations are discussed and practical recommendations made for mental health services, clinical psychologists and supervisors.