Ethical Perspectives on ‘Fit’ and Fidelity in Clinical Practice

Two Couples 2001 Diana Ong (b.1940/Chinese-American) Computer graphics

The Bruce Wine Memorial Fund and ICP+P present: The play, Dinner with Friends, by Donald Margulies, is a cautionary tale about the vagaries of compatibility and commitment in long-term relationships—platonic, professional, romantic, and familial. The play will be presented as a parable about complex questions in clinical practice that have neither easy nor proscribed answers:

“What unconscious personal biases and values inform therapist ethical decision making?”

“Am I a ‘good enough’ therapist—for this patient, at this time?

“Are my co-therapist and I an effective therapeutic team?”

“Is being a psychotherapist (still) a vocational choice I want to commit to?”

This interactive program will give participants an opportunity to explore these and related questions, as they might be relevant to their clinical practice.

At the conclusion of this program, participants will be able to:

  1. Recognize ethical issues related to effective working relationships—between therapist and client, colleague-to-colleague, and self to the profession.
  2. Identify personal values and biases that inform ethical decision making in clinical practice.
  3. Apply a collaborative decision making process to the resolution of ethical dilemmas.

This conference is appropriate for clinicians at all levels of experience.


About our Presenters:

The Red Well Theater Group of Washington, D.C. contributes to the professional development of psychotherapists through continuing education presentations that combine a dramatic reading of a stage play with clinically informed commentary and a moderated audience discussion. The mission is to illuminate and explore themes related to ethical clinical practice and therapist wellbeing, in and beyond the consulting room. Members of the Red Well Theater Group share a love of theater and a commitment to dynamic therapy training and practice, approaching each discipline as a healing art.

Robert Schulte, MSW is a clinical social worker and psychotherapist in practice in Old Town Alexandria, VA. He is a graduate of the ICP+P Psychotherapy Training Program. Bob is also a faculty member of the Washington School of Psychiatry National Group Psychotherapy Institute.

What is the Bruce Wine Memorial Conference?

Bruce Wine was a founding member of ICP+P. The Bruce Wine Memorial Fund was created in 2008 with a mission to sponsor conferences that bring creative and innovative theoretical and clinical perspectives to ICP+P and to the larger mental health community. The Fund’s central mission is focused on fulfilling Bruce’s wish to bring cutting edge thought to theory building and clinical practice.


Conference Fees

Free for ICP+P Members and Fellows                                 $90 for Non-members                                    $35 for Unaffiliated Students

For more information, to request reasonable accommodations, email administrator@icpeast.org.

Continuing education credit:  3 CE credits available for full attendance. The Institute of Contemporary Psychotherapy and Psychoanalysis (ICP+P) is approved by the American Psychological Association to sponsor continuing education for psychologists. ICP+P maintains responsibility for this program and its content. ICP+P is approved by the Maryland Board of Social Work Examiners to offer Category I continuing education credit. Because ICP+P has approval from the Maryland Board, CE credit hours awarded by ICP+P may also be claimed by social workers licensed in Virginia and the District of Columbia. These continuing education credits meet the ANCC approval standards for nurses and the approved standards for marriage and family therapists. Attendees from the above professional groups will earn 3 CE credits for attending the conference. Full attendance is required to receive the designated CE credit. ICP+P is accredited by MedChi, the Maryland State Medical Society to provide continuing medical education for physicians. ICP+P designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Red Well Theater Group of Washington, D.C. and the planners have informed us that they do not have a conflict of interest and have disclosed that they have no relevant financial relationship with any commercial interests pertaining to this educational activity. Additionally, the presenters have been instructed to disclose any limitations of data and unlabeled or investigational uses of products during this presentation. This presentation will not contain any references to off­label (non­FDA approved) use of products or devices.

CE Credit is granted to participants with documented attendance at individual workshops and completed evaluation forms for those sessions. Credit will not be granted to registrants who are more than 15 minutes late or depart more than 15 minutes early from a session. Please arrive at least 10 minutes before the scheduled start time of 9:00 am to allow time to check in.

Please contact Jen Bissell, ICP+P’s Associate Director of Conferences, with any questions, jenbissellLICSW@gmail.com.


MEMBER Profiles

Members, guest artists and guest discussants include Founding Director Robert Schulte MSW, Maryetta Andrews-Sachs MA, Kavita Avula PsyD, Eleanor Counselman Ph.D., John Dluhy M.D., Mary Dluhy MSW, Molly Donovan Ph.D., Hallie Lovett Ph.D., Liz Marsh MSW, Yavar Moghimi M.D., Rosemary Segalla Ph.D., Paul Timin MSW, Barry Wepman Ph.D., Rob Williams MSW, Connor Dale MA, Lee Futrovsky Ph.D., Macario Giraldo Ph.D., Ron Goldman Ed.D., Barbara Keezell MSW, Angela Snyder PsyD, and Tom Teasley.

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Robert Schulte MSW, CGP, FAGPARobert Schulte, MSW Bob attributes a recommendation from Mary Dluhy in 1998 that he attend a performance of ‘Art’ as the transformative moment in the creation of the Red Well Theater Group. Four years later Bob directed a dramatic reading of ‘Art’ at the Fall 2002 MAGPS Conference. Thus began a decade of dramatic play readings, study groups and workshops. He is grateful to his RWTG colleagues for their talent, therapeutic sensibilities and courage. Bob is a Past President of MAGPS, a faculty member at the Washington School of Psychiatry National Group Psychotherapy Institute and a clinical instructor at the GW University Department of Psychiatry.  He maintains a psychotherapy practice in Alexandria, VA.

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Kavita Avula, Psy.D. Kavita specializes in international and cross-cultural psychology, serving as a consultant for coordinated trauma responses around the globe.  Her adventure with RWTG began in Northern Ireland, where she delivered a bravura performance as strong willed, young Bo Groden in Off the Map.  A versatile and adventurous actress, Kavita has portrayed an array of clinically complex characters, including a psychopathic teenage Kathy in Dog Sees God, a 30-something, lovelorn Becky in Becky Shaw, a soul-searching Paige in The Great God Pan and later as eating disordered Joelle.

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Maryetta Andrews-Sachs, MA, CGP Maryetta was cast as the ‘dumb blonde’ in her high school senior play and proudly served as the head majorette for the Flushing, MI marching band. “I was also Homecoming Queen for my high school—a true celebration of my then ‘false self’!” Her moving portrayal of plucky Arlene in Off the Map vastly expanded her range beyond her humble origins as a “dumb blonde”. Maryetta also appeared as a grieving Becca in Rabbit Hole, the certifiable Van’s Sister in Dog Sees God, and long-suffering Annette in God of Carnage. Maryetta is the President of the Mid-Atlantic Group Psychotherapy Society (2013-15), faculty and past-Chair of the WSP Group Psychotherapy Training Program.  She maintains a private psychotherapy practice in Washington, D.C.

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AGPA 2017 Special Institute

Special Institute, Monday, March 6, 2017, New York City

By Bob Schulte, MSW

Red Well Theater Group members and guest artists participating in the APGA Special Institute include Kavita Avula, Connor Dale, John Dluhy, Mary Dluhy, Barbara Keezell, Liz Marsh, Yavar Moghimi, Bob Schulte, Rosemary Segalla, Tom Teasley, and Rob Williams.

People Flying Peter Sickles

People Flying
Peter Sickles

Our daylong ethics-focused program, Wounded Healers and Suffering Strangers: Navigating Ethical Dilemmas Together, features two dramatic play readings, each illuminating a variety of ethical delimmas relevant to dynamic group psychotherapy. We will also examine a collaborative process by which ethical dilemmas, understood as situations whereby multiple ethical imperatives are in conflict, might be resolved by therapists and group members working together.

Play Selections

The morning session features The Great God Pan, by Amy Herzog. The Great God Pan is “an unsettling yet deeply compassionate account of what is lost and won when long hidden truths are revealed. Jamie Perrin has a seemingly idyllic life in Brooklyn, NY—a beautiful girlfriend, a budding journalism career, and parents who live connorjust far enough away” (Herzog, 2014). But then his childhood friend Frank Lawrence visits to reveal a history of childhood sexual abuse perpetrated by his own father. He suggests that Jamie may also have been a victim during a week when Jamie’s parents sent him to stay with the family of his childhood friend. All this comes at a delicate juncture as Jamie and his pregnant girlfriend Paige are in conflict over the prospect of becoming parents.

rosemaryThe Great God Pan explores the impact of complex trauma on attachment relationships, the destabilizing effects of family secrets, and the healing power of truth seeking within a group context. Themes relevant to group psychotherapy include the risk of vicarious trauma, the impact of unconscious enactments on group functioning, and the ethical obligation of the therapist to maintain a safe therapeutic environment.

The afternoon session features Dinner with Friends, by Donald Margulies (2002). The play opens in the fashionable Connecticut home of Karen and Gabe who are giving a dinner for their married best friends Beth and Tom, which Beth attends alone. By dessert the truth emerges from the devastated Beth that Tom has left her for another woman. We approach the play as a parable about ethical dilemmas faced by professional colleagues with one another, most notably those issues related to fidelity and trust within the group co-therapist duo. Dynamics within professional “marriages” inform a group’s formation, survival and capacity to thrive.

Theater & Group Therapy

The central place of dramatic action and values-based ethics in group psychotherapy and theater is well cast50established. In his classic text Poetics, the Greek philosopher Aristotle championed a moral purpose for creating theater. J. L. Moreno’s development of psychodrama in the 20th century reflected his own values-based mission to restore theater to its original civilizing purpose of promoting mutual recognition and communal wellbeing.

Contemporary dynamic group therapists nonjudgmentally recognize the inevitability and utility of unconscious enactments in the process of achieving group therapeutic aims. Therapy groups rely on the emergence into the here-and-now of unconscious enactments. These ‘little dramas’ reveal the contextual and relational compexity of the human condition and the “scripted” suffering that the group members have yet to resolve and “rewrite”. Action, reflection and meaning making are common core endeavors to both theater and group therapy.

Ethical Principles

dsc00561We are all wounded healers. No one escapes childhood to become an effective group psychotherapist without blindspots and vulnerabilities. Ethical failures by primary caregivers are very often implicated in the very decision to become a psychotherapist (Rice, 2011). This Institute will be an opportunity for practioners of all levels to discover something new or to revisit what they may already know—about themselves and their group work—with colleagues who are also on the path of practicing at the highest standard of proffessional care.

We will review basic ethical principles of beneficence, non-maleficence, respect for autonomy, fidelity, and justice and core ethical virtues of the moral practitioner including compassion, discernment, trustworthiness, integrity, and conscientiousness. We will outline a process of resolution that emphasizes the dynamic interplay of information gathering, empathy, transparency, and collaborative decision-making in the here-and-now (Brabender, 2006). Our program illuminates these concepts through the dramatic play readings, each accompanied by a clinically informed commentary and an audience discussion.

Continuous ethical thinking by the group therapist is central in maintaining a safe, therapeutic group 100_8050environment. The dependable modeling of ethical behavior by the therapist has enduring therapeutic impact on a group’s members. Ethical dilemmas are co-constructed from many influences, within and beyond the therapy group. Engaging members in the process of resolution is key.

Registration Continues

The Special Institute is open to training and practicing group psychotherapists. To register go to the Annual Meeting section at: AGPA.org.

References

Brabender, V. (2006). The Ethical group psychotherapist. International Journal of Group Psychotherapy, 56 (4), 395-414.

Halliwell, S. (1998). Aristotle’s Poetics. London: Gerald Duckworth & Co.

Herzog, A. (2014). The Great god pan. New York: Dramatists Play Service.

Margulies, D. (2002). Dinner with friends. New York: Dramatists Play Service.

Rice, C. (2011). The Psychotherapist as “wounded healer”: A Modern expression of an ancient tradition. In On Becoming a psychotherapist. Edited by Klein, R., Bernard, H., and Schermer, V. Oxford: Oxford University Press. p. 165-189.

Schulte, R. (2016). Red Well Theater Special Institute Preview. AGPA Group Circle Newsletter. Portions of this article are included or paraphrased in this blog post.