Morality and Responsibility in Marriage and Family Therapy

Morality in Marriage and Family Therapy (MFT) is an unavoidable topic that is necessary for therapists to think about and discuss despite its complex and controversial nature. According to the Merriam-Webster dictionary, one definition of morality is "conformity to ideals of right human conduct" (para. 3). The idea of what constitutes "right human conduct" is dictated by a society or a particular group that an individual conforms to. In other words, morality is the distinction between right and wrong as it pertains to a society or group of individuals.

As Marriage and Family Therapists (MFTs), it is important to be knowledgeable and aware of morality in relation to values, culture, ethics, context, autonomy, and responsibility. Our personal and professional morals and ethics will begin to merge, grow, and expand as our theoretical and experiential knowledge of MFT continues. As this happens, we start to gauge our own boundaries and establish our standing as responsible professionals with personal values, biases, and beliefs.

The Controversy of Morality in MFT

As humans, we grow up with our own personal values. As a society, we share some of these values, inherently present in our everyday lives. However, sometimes our values differ, leading some to think that we should remain neutral and not bring our personal values into therapy sessions. I believe this is impossible to do. Chapter One in Ethical, Legal, and Professional Issues in the Practice of Marriage and Family Therapy (2013) talks about how a therapist’s practice decisions include personal values and outside systems to create a balance. More specifically, Remley and Herlihy (2010) believe that practice decisions are built from within and balanced from without. The within encompasses the personal values a person holds, and the without refers to the legal and ethical systems put in place to guide therapists in their practice, like the American Association of Marriage and Family Therapy’s (AAMFT) Code of Ethics. The legal and ethical systems guiding a therapist’s decisions are useful and continue to shape our ways of thinking in both therapy sessions and our personal lives. Even with this guidance, our base values still have an effect on our actions with consequences that could be deemed right or wrong. Therapists will encounter several clients whose values differ from their own. Therefore, it becomes the therapist's responsibility to understand their personal values and how they may present themselves in the therapy room. Remaining neutral becomes impossible, and that is why morality could be considered controversial in MFT (Wilcoxon, Remley, & Gladding, 2013).

Addressing Morality in MFT

Fortunately, external factors like ethics and laws exist to challenge and expand our personal values and morals. In my opinion, ethics challenge us more than laws do because they are more open to interpretation and require therapists to grow as people. To begin, being culturally competent in MFT is crucial in addressing morality. For example, an article by Lettenberger-Klein, Fish, and Hecker (2013) discusses the American Indian (AI) and Alaskan Native (AN) populations, noting that the extended family has high value in these populations. This is in contrast to an individualistic mindset, which the majority of Western culture possesses. Therapists have a responsibility to be culturally aware of populations with different values so that their actions or beliefs, stemming from personal values, do not negatively affect the client.

Another aspect of addressing morality in MFT is balancing the autonomy of each client, as well as their relationships with one another. As MFTs, we work from a systemic and relational point of view. Still, autonomy is important. An article by Kurri and Wahlstrom (2005) looks at how therapists solve moral dilemmas in real-time contexts by analyzing client responsibility to value both autonomy and relationality. They provide an example of a conversation between a husband and a wife, highlighting how each partner blames the other for their joint problems. Therapists cannot interject their personal values and opinions into the session as they might take sides. Morally and ethically, the therapist needs to decide how to value the autonomy of each client. Moreover, they must also assist the clients in their relationships with one another, keeping context in mind.

Furthermore, morality also comes into play when power imbalances are presented in couples or families. For example, if a spouse is physically abusing their partner, the application of analyzing responsibility of clients and respecting autonomy and relationality is not easily applied to both partners. In this case, the therapist has a moral, ethical, and legal responsibility to protect the client who is being harmed (Kurri & Wahlstrom, 2005).

Lastly, morality emerges when gauging what is appropriate to discuss in front of children. Some parents may believe they can say whatever they want in front of their children. However, it is the therapist's responsibility to protect children from possible harm if they believe the conversation is inappropriate for the child to hear, while also not shaming or blaming the parents. To address this, the therapist should create a new narrative regarding the appropriateness of the conversation with the parents (O’Reilly & Parker, 2014).

AAMFT Code of Ethics and Moral Attitude.

The AAMFT Code of Ethics serves as a set of guidelines that should help govern the type of moral attitude and behavior an MFT should display. In other words, a therapist should act morally by referring to and adhering to the AAMFT Code of Ethics. As mentioned before, while laws are rigid and not flexible, ethics and morals are more open to interpretation. An example of this is the idea of gift-giving. Standard 3.9 addresses this concern by saying MFTs should “attend to cultural norms” when deciding whether or not to give or receive gifts (AAMFT, 2015). Referring back to the article by Lettenberger-Klein, Fish, and Hecker (2013), giving gifts in the AI and AN populations is “a sign of honor and respect” that doesn’t necessarily have a monetary value placed on it. Therefore, it would be appropriate to accept the gift.

In regards to my personal moral attitude, I am open-minded and curious. This is comparable to the moral attitude I believe all MFTs should have. All MFTs understand that they are going to encounter clients with different cultures, ideas, beliefs, opinions, morals, and ethics. This necessitates MFTs to expand their knowledge about these differences to become more competent therapists.

However, I can also be naïve. I understand that this could be interpreted by others as being disrespectful and rude, while I may only perceive it as inexperience. To avoid this, I need to continue learning and always be mindful of my words and inquiries. Understanding my own biases and reflecting on sessions as much as possible is important to my journey as an MFT.

The idea that the AAMFT Code of Ethics is open to interpretation applies to numerous scenarios. Therefore, my moral attitude should be constantly evolving towards the improvement of myself, my practice, and the practice of MFT, while referring to the guidelines offered to all MFTs.

"The Person of the Therapist"

I agree that the persona of a therapist, as well as their personal and professional character, is vital as it applies to therapy and our personal lives. As we become professionals in the field, our personal and professional characters fuse together into one. I believe this is necessary to be a competent and genuine therapist. The article by Scher and Kozlowska (2012) discusses the transition from theoretical thinking to the practical application of ethics in therapy. An important point made by the authors is that decisions in therapy are made in the moment. Therefore, they require practice and experience so as to make ethical decisions. Furthermore, it is crucial to know and understand your personal boundaries, biases, and limits because, in a therapy session, you do not have the opportunity to pause and reflect before responding; it needs to flow naturally and genuinely. Therapists are just like everyone else. We apply our personal ethics to our daily practices, both implicitly and explicitly, due to our knowledge and experience. Most importantly, as the authors point out, once you enter the therapy room, with the exception of supervision and team therapy, you are alone with that client. Hence, the implicit moral self becomes crucial in the session (Scher & Kozlowska, 2012).

"Promoting Moral Responsibility as an MFT"

Finally, how should I and other therapists promote moral responsibility with clients, colleagues, and in the professional and public communities? First, I believe it is important to continue learning and expanding our knowledge of cultures, while questioning existing codes and guidelines to further promote the well-being of our clients, ourselves, and the field of MFT. Second, I believe we should be the examples and role models we want to see. By being the example for others, we begin to set standards for others to follow. If we begin to fall out of line with our ethics and morals, we need to be accountable for one another and lift each other up. Not only do we represent our personal character, but we also represent a respectable field.

Conclusion.

I believe morality is key to the foundation of MFT. There are laws and ethics that serve as guiding principles for MFTs, but our personal values from within are the basis for how we act personally and professionally. (Remley & Herlihy, 2010; Wilcoxon, Remley, & Gladding, 2013). To address morality in practice, we need to be culturally competent, respect autonomy and relationality, understand the implications of power imbalances in respect to responsibility, and understand how to create a balance with parents when deciding what is appropriate to say in front of children. (Lettenberger-Klein, Fish, & Hecker, 2013; Kurri & Wahlstrom, 2005; O’Reilly & Parker, 2014). Fortunately, the AAMFT Code of Ethics exists to help MFTs further create a professional moral attitude that melds with their personal moral attitude. (AAMFT, 2015). Furthermore, this joining of personal and professional moral self is important to becoming a genuine therapist.

The person of the therapist is as important as the move from theoretical thinking to practical doing. Therapists must understand their own boundaries, biases, and limits in therapy sessions. Constant reflection and expanding our knowledge and experiences will propel us both personally and professionally (Scher & Kozlowska, 2012). Lastly, we need to set the example to promote moral responsibility with clients, colleagues, and in our professional and public communities. This includes continuing to learn and keeping each other accountable as peers, colleagues, and professionals. Morality is essential and unavoidable in MFT. It is our responsibility to understand this important aspect of therapy.

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