臨床心理師對心理治療知後同意倫理態度與行為之調查研究

Informed Consent in Psychotherapy: The Ethical Attitudes and Behavior of Clinical Psychologists

研究目的：本研究旨在探討台灣地區臨床心理師知後同意的倫理態度與行為現況，並提供相關專業倫理省思及未來訂定專業倫理守則與規劃倫理教育之參考。研究方法：以隨機叢集抽樣針對184位臨床心理師進行問卷調查，內容包括知後同意倫理態度、行為及基本資料，以SPSS12.0統計套裝軟體進行描述性統計及差異考驗。研究結果：在臨床實務上，認為符合倫理且經常告知之訊息包括，保密、時間安排、治療目標、終止的權利、應配合事項等；不確定是否合乎倫理且少告知的訊息是治療者專業背景、花費總額、治療技巧發展現況、督導及其他專業者的涉入；合乎倫理但少告知則為接觸治療記錄的權利。不同性別、年齡、工作年資、教育程度、倫理訓練及工作場域之臨床心理師在部分反應上有顯著差異。研究結論：台灣臨床心理師知後同意的倫理態度與倫理行為具一致性；台灣臨床心理師部分知後同意的倫理態度與倫理行為現況與守則要求有落差；部分倫理行為表現有個別差異。

A cluster random sample of 184 licensed Taiwanese clinical psychologists (mean years of experience is 8.02, among them, 80 were male and 104 were female) responded to questionnaires eliciting demographics and ethical attitudes and behavior toward informed consent in psychotherapy. Statistical analysis demonstrated that confidentiality, appointment scheduling, treatment goals, the right to terminate treatment, and professional compliance were recognized ethical codes often executed by respondents. Therapist background and qualification, total treatment cost, treatment development, and collaboration with supervisors and other professionals were areas of ambiguity that respondents were less likely to reveal. The right to access treatment records was recognized as an ethical issue, but seldom complied with it. Some items were significantly influenced by gender, age, years of experience, level of education, ethics education, and work place. In conclusion, in terms of informed consent, the ethical attitudes of clinical psychologists are consistent with their behavior. However, in some areas of informed consent, there were discrepancies between ethical attitudes and behavior and the codes of ethics. There were also discrepancies in ethical behaviors. The results of this study are helpful for formulating codes of ethics and planning for ethics education.