AGAINST RECORDING SESSIONS FOR SUPERVISION

The American Psychological Association's (APA) 2014 injunction that supervisors must listen to recorded sessions of their supervisees' work is based on a rich and thorough body of research, and yet it entails a narrative of psychotherapy as a discipline of Science. If psychotherapy is understood as an endeavor also of the Humanities, recording sessions may be anathematic to supervision and training. Developing ideas from Greenberg's (2015) theory of "controlling fiction," the writer presents a narrative of psychotherapy in which it is not wise to review recorded sessions in supervision.

Women Publishing in American Psychological Association Journals: A Gender Analysis of Six Decades

Despite recent advances, gender inequality persists in many scientific fields, and Psychology is not alien to this phenomenon. This study presents the evolution of gender composition in American Psychological Association publications in the past six decades, from 1963 to 2016. Longitudinal analysis revealed an important change: women rose from a tiny 12% to 14% in the 1960s to almost gender parity in the last decade (2010s). The pattern of collaboration (coauthorship) shows that women tend to be slightly overrepresented as first author and underrepresented as the last or senior author. In the last two decades, women outnumber men as "new" American Psychological Association authors (authors who publish for the first time in an American Psychological Association journal). These features and the fact that men's publications tend to encompass a much wider range of years suggest that age may play a role in the gender composition of American Psychological Association contributors.

Positive Psychology: A Personal History

As president of the American Psychological Association in 1998, I organized researchers and practitioners to work on building well-being, not just on the traditional task of reducing ill-being. Substantial research then found that well-being causes many external benefits, including better physical and mental health. Among the applications of Positive Psychology are national psychological accounts of well-being, Positive Psychotherapy, the classification of strengths and virtues, Comprehensive Soldier Fitness, and Positive Education. Positive Psychology has spread beyond psychology into neuroscience, health, psychiatry, theology, and even to the humanities. Positive Psychology has many critics, and I comment on the strongest criticisms. I conclude with the hope that the building of well-being will become a cornerstone of morality, politics, and religion.

The Hoffman report, the Central Intelligence Agency, and the defense of the nation: A personal view

I was asked by the Central Intelligence Agency in the spring of 2002 about how the research on learned helplessness could help captured Americans resist and evade torture and interrogation. There was no discussion of how learned helplessness could be used with detainees nor any mention of the interrogation of detainees. James Mitchell and Bruce Jessen later created a program of “enhanced interrogation” of detainees and it was incorrectly reported that they based it on the theory of learned helplessness. I played no role at all in these developments, and I am grieved that scientific research created to relieve helplessness and depression might have been used for brutal interrogations. The unfounded attacks on me and others, however, may have been intended to discourage young psychologists from working with the Department of Defense, and I urge American Psychological Association not to waver in its long-standing commitment to serve the nation.

The American Psychological Association's Hoffman report allegations of my association with the "CIA torture" program

Until now, I have not responded to the undocumented and untrue portrayal of me in the Hoffman report, or the newspaper and email accounts of my alleged role in "torture." I have waited several years because I believed that the American Psychological Association leadership would completely disavow the Hoffman report and find a way to restore my reputation as well as that of the other former American Psychological Association presidents and the small number of its senior staff who were also falsely accused. Although this has not yet happened, I remain optimistic that it will. Here I present the facts as they relate to me.

American psychologists, the Central Intelligence Agency, and enhanced interrogation

In two commissioned articles, Health Psychology Open clarifies once and for all the role of two prominent American psychologists in the Central Intelligence Agency program of enhanced interrogation post 9/11. The Senate Select Committee on Intelligence Committee Study of the Central Intelligence Agency's Detention and Interrogation Program and the Hoffman Report produced more questions than answers. In these historically significant articles, Martin Seligman and Joseph Matarazzo assert the truth about their actions and the lessons learned.

Errors in the 2017 APA Clinical Practice Guideline for the Treatment of PTSD: What the Data Actually Says

The American Psychological Association (APA) Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD) concluded that there was strong evidence for cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and exposure therapy yet weak evidence for eye movement desensitization and reprocessing (EMDR). This is despite the findings from an associated systematic review which concluded that EMDR leads to loss of PTSD diagnosis and symptom reduction. Depression symptoms were also found to improve more with EMDR than control conditions. In that review, EMDR was marked down on strength of evidence (SOE) for symptom reduction for PTSD. However, there were several problems with the conclusions of that review. Firstly, in assessing the evidence in one of the studies, the reviewers chose an incorrect measure that skewed the data. We recalculated a meta-analysis with a more appropriate measure and found the SOE improved. The resulting effect size for EMDR on PTSD symptom reduction compared to a control condition was large for studies that meet the APA inclusion criteria (SMD = 1.28) and the heterogeneity was low (I²= 43%). Secondly, even if the original measure was chosen, we highlight inconsistencies with the way SOE was assessed for EMDR, CT, and CPT. Thirdly, we highlight two papers that were omitted from the analysis. One of these was omitted without any apparent reason. It found EMDR superior to a placebo control. The other study was published in 2015 and should have been part of APA guidelines since they were published in 2017. The inclusion of either study would have resulted in an improvement in SOE. Including both studies results in standard mean difference and confidence intervals that were better for EMDR than for CPT or CT. Therefore, the SOE should have been rated as moderate and EMDR assessed as at least equivalent to these CBT approaches in the APA guidelines. This would bring the APA guidelines in line with other recent practice guidelines from other countries. Less critical but also important, were several inaccuracies in assessing the risk of bias and the failure to consider studies supporting strong gains of EMDR at follow-up.

Ethical issues in exercise psychology

Exercise psychology encompasses the disciplines of psychiatry, clinical and counseling psychology, health promotion, and the movement sciences. This emerging field involves diverse mental health issues, theories, and general information related to physical activity and exercise. Numerous research investigations across the past 20 years have shown both physical and psychological benefits from physical activity and exercise. Exercise psychology offers many opportunities for growth while positively influencing the mental and physical health of individuals, communities, and society. However, the exercise psychology literature has not addressed ethical issues or dilemmas faced by mental health professionals providing exercise psychology services. This initial discussion of ethical issues in exercise psychology is an important step in continuing to move the field forward. Specifically, this article will address the emergence of exercise psychology and current health behaviors and offer an overview of ethics and ethical issues, education/training and professional competency, cultural and ethnic diversity, multiple-role relationships and conflicts of interest, dependency issues, confidentiality and recording keeping, and advertisement and self-promotion.

An overview of the major changes in the 2002 APA Ethics Code

This article summarizes the major changes that were made to the 2002 Ethical Principles and Code of Conduct of the American Psychological Association. The 2002 Ethics Code retains the general format of the 1992 Ethics Code and does not radically alter the obligations of psychologists. One goal of the Ethics Committee Task Force was to reduce the potential of the Ethics Code to be used to unnecessarily punish psychologists. In addition, the revised Ethics Code expresses greater sensitivity to the needs of cultural and linguistic minorities and students. Shortcomings of the 2002 Ethics Code are discussed.

Ethical issues in therapy: therapist self-disclosure of sexual feelings

Although therapist sexual attraction to clients is common, and therapist self-disclosure is an often-used intervention, therapist self-disclosure of sexual feelings to clients is an understudied phenomenon. In this article, I critically review the small base of literature on therapist self-disclosure of sexual feelings, including information on prevalence rates, empirical research, and case studies. By incorporating these findings with information from relevant sections of the American Psychological Association (2002) Ethics Code, my intent is to evaluate different aspects of therapist self-disclosure of sexual feelings and arrive at conclusions regarding therapists' use of these disclosures. It appears that direct, explicit disclosure of sexual feelings can run the risk of harming clients and may therefore be unethical. Therefore, the use of this technique is discouraged. I discuss the issue of using less explicit interventions.

Sexual contact between psychologists and their former therapy patients: psychoanalytic perspectives and professional implications

Data was analyzed from the semi-structured interviews of 6 heterosexual male psychoanalytic psychotherapists who by self-report had not engaged in a post-termination sexual involvement. The focus of each interview was to elicit the participants' views about sexual contact between psychotherapists and their former therapy patients, as well as their related attitudes towards Standard 4.07 of the APA Ethics Code (1992). The results suggested great disparity of opinion regarding what might constitute acceptable, ethical behavior in this domain. Nonetheless, all the clinicians agreed that the potential for harm resulting from post-termination sexual involvements was great, They all shared the beliefs that transference did not resolve with termination, that professional responsibilities continued after treatment ended, and that power differentials between therapist and patient lingered, perhaps in perpetuity. However, it was determined to be premature to replace the current Standard 4.07 with an absolute prohibition against sexual involvements between therapists and their former patients.

Divergent ethical perspectives on the duty-to-warn principle with HIV patients

This article presents the case of an HIV-positive client who reported having sexual relations with an unknowing partner. The issue raised is whether the therapist was required to warn the unknowing partner, similar to the Tarasoff mandate that is imposed on therapists. The case is analyzed from an ethical framework similar to that presented by Beauchamp and Childress (1994). Two opinions are presented, each leading to different conclusions about whether the therapist should inform the unknowing partner. It is concluded that although such analysis is valuable in aiding the therapist in his or her decision-making process, no clear professional standard for the management of the problem is evident.

On boredom and experimentation in humans

This article discusses the ethical and methodological issues associated with boredom experienced by human participants during psychological experiments. Ways are suggested in which informed consent, briefing, and debriefing can be used to prevent or remedy boredom induced during experiments. We address methodological and ethical concerns, and we discuss the advantages of the proposed approach for experimenters' practice and training of undergraduate students. Future directions for much needed research on these topics are also emphasized.

Deception in research: distinctions and solutions from the perspective of utilitarianism

The use of deception in psychological research continues to be a controversial topic. Using Rawls's explication of utilitarianism, I attempt to demonstrate how professional organizations, such as the American Psychological Association, can provide more specific standards that determine the permissibility of deception in research. Specifically, I argue that researchers should examine the costs and benefits of creating and applying specific rules governing deception. To that end, I offer 3 recommendations. First, that researchers who use deception provide detailed accounts of the procedures they used to minimize the harm created by deception in their research reports. Second, that the American Psychological Association offer a definition of deception that describes techniques commonly used in research. Finally, I recommend that the informed consent procedure be revised to indicate that the researcher may use deception as part of the study.

Intellectual freedom and editorial responsibilities within the context of controversial research

The primary purpose of this article is to explore the limits that an agent, such as the government or the American Psychological Association, may place on one's right to pursue a program of research or to share the findings of a research project. The primary argument that evolves here is that researchers' rights to pursue an interesting hypothesis, and their freedom of expression, are conditional. The author examines the potential pragmatic and epistemological barriers to a program of research and the responsibilities that researchers bear to address epistemological and nonepistemological matters while reviewing the implications of their work.

Confidentiality in end-of-life and after-death situations

Confidentiality is one of the foundations on which psychotherapy is built. Limitations on confidentiality in the therapeutic process have been explained and explored by many authors and organizations. However, controversy and confusion continue to exist with regard to the limitations on confidentiality in situations where clients are considering their options at the end of life and after a client has died. This article review these 2 areas and provides some suggestions for future research.

Therapeutic reactivity to confidentiality with HIV positive clients: bias or epidemiology?

Therapeutic reactivity among psychology trainees (N=68) was ascertained by their response to 10 clinical vignettes depicting clients with HIV who are sexually active with uninformed partners. This construct accounts for the relative change in decisions to maintain the confidentiality of clients who acknowledge safe versus unsafe sexual behavior. As anticipated, an analysis of variance revealed a significant main effect for safety and a significant 3-way interaction (Sexual Orientation X Safety X Gender). Subsequent analyses revealed that trainees exhibit the highest level of therapeutic reactivity toward heterosexual male clients, and the lowest reactive stance toward heterosexual female clients. Although the decisional pattern evidenced toward heterosexuals seems congruent with epidemiological estimates of risk, the decisions toward lesbians and gay males appear more likely a function of bias. The ethical implications of these findings are discussed.

Responding to therapists' sexual abuse of adult incest survivors: ethical and legal considerations

Adult survivors of incest are high-risk candidates for subsequent sexual abuse by their therapists. As with incest, therapists' sexual abuse of their patients has become known as "the problem with no name." In addition, many of the ways in which the profession of psychology and the judicial system respond to patients' allegations of sexual abuse by their therapists often parallel the responses family members and authority figures made to the original allegations of incest. This article discusses some of the complex interactions among therapeutic dynamics, ethical and legal issues associated with this professional dilemma, and outlines ways in which the profession might begin to address this dilemma.

The ethical confrontation of the unethical forensic colleague

In the course of clinical and forensic work, psychologists sometimes discover serious weaknesses in knowledge, performance, or ethics in other psychologists' work. The ethical code of the American Psychological Association mandates confronting such a psychologist prior to making a professional complaint. This mandatory confrontation typically is omitted because of a sense of awkwardness or a fear of insulting the other psychologist. Education and training in psychology does not cover this sensitive and important area. In this article, sample templates of letters are provided to meet that ethical requirement and to begin to resolve problem behaviors by colleagues.

Ethical considerations for peer review in forensic neuropsychology

The role of an expert is to assist the trier of fact in weighing evidence and reaching conclusions. Critical evaluation of opposing experts is an integral part of this process. In more recent times, cross-examination has given way to critical evaluation of opposing experts outside of the courtroom, a tactic we refer to as peer review in this paper. Though neuropsychologists frequently review the work of their colleagues, we are concerned here primarily with commentary that is at best misleading, and occasionally malicious, unethical, and unprofessional. Despite a growing trend to use experts as peer reviewers in the medicolegal arena, expectations concerning ethical and professional conduct of neuropsychologists have been absent. Enforcement of appropriate conduct is further complicated by the ambiguity of existing ethical standards and state statutes, and their limited applicability to all neuropsychologists who provide forensic services. This article provides an overview of ethical and professional issues pertaining to forensic peer review and concludes with recommendations for appropriate professional conduct.

Ethical and legal issues in e-mail therapy

Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed. To address potential hazards to clients and the profession, a new ethical standard for e-mail therapists is offered.

Sex with ex-clients: theoretical rationales for prohibition

Two decades of literature and discussion on the topic of therapist-client sexual relationships have revealed much about the nature and consequences of these relationships and have produced an explicit prohibition against such relationships in American Psychological Association (APA) Ethical Principle 6a. This article reviews the literature as it relates to the ethically gray area of sex with former clients. The relative lack of an empirical basis for extending the prohibition of Principle 6a to posttermination relationships is noted. This article describes concepts from three theoretical perspectives about psychotherapy that support an extension of the prohibition to sexual relationships with ex-clients.

Ethical and legal risks associated with archival research

Mental health facilities and practitioners commonly permit resarchers to have direct access to patients' records for the purposes of archival research without the informed consent of patient-participants. Typically these researchers have access to all information in such records as long as they agree to maintain confidentiality and remove any identifying data from subsequent research reports. Changes in the American Psychological Association's Ethical Principles (American Psychological Association, 1992) raise ethical and legal issues that require consideration by practitioners, researchers, and facility Institutional Review Boards. This article addresses these issues and provides recommendations for changes in ethical standards as well as alternative avenues for conducting research using archival mental health records.

Toward a hermeneutic model of ethical decision making in clinical practice

Documented ethical violations and empirical research have demonstrated that, despite professional standards and formal training in ethical principles, some psychotherapists engage in unethical behaviors that compromise the welfare of clients. It appears that competing values and interests that emerge in the therapeutic endeavor can interfere with therapists' considerations of ethical standards and their willingness to act ethically. Expanding current models of ethical decision making, this article offers a hermeneutic model that recognizes that in addition to moral reasoning, the context of the therapeutic relationship and the therapist's subjective responses are fundamental considerations in the interpretation and application of ethical interventions. Implications for understanding and training of ethics in psychotherapy in this broader context are explored.

Sexual intimacies with clients after termination: should a prohibition be explicit?

The Revisions Task Force of the Ethics Committee of the American Psychological Association (APA) has proposed that prohibition of sexual intimacies with clients after termination of therapeutic relationships be made an explicit part of the new code. This decision was based on much careful deliberation and input from various individuals and groups. This article supports the proposed change and provides a rationale based on emerging theoretical positions and research findings regarding risks to clients, risks to professionals, and risks to the various mental health professions. The revision would read, "Psychologists do not engage in sexual intimacies with current or former psychotherapy clients."

Reports of assent and permission in research with children: illustrations and suggestions

This study ascertained reports of assent (affirmative agreement) and permission (agreement by an adult fully capable of being informed) in 114 children's research articles in 1990 in Child Development (CD), Journal of Consulting and Clinical Psychology (JCCP), Journal of Pediatric Psychology, and Journal of Clinical Child Psychology. Of the research projects, 43% failed to specify permission, and 68.5% failed to specify assent. JCCP reported assent significantly more than CD. Assent was reported significantly more in research with older children than with younger children. This lack of sensitivity to assent and permission suggests that many authors, reviewers, and editors consider reporting assent and permission unessential. We recommend specifying assent and permission in all manuscripts, highlighting children's research issues in graduate training, and using specific safeguards when conducting research with children.

Ethical principles of the American Psychological Association: an argument for philosophical and practical ranking

Unlike the American Psychological Association (APA), the Canadian Psychological Association has adopted a code of ethics in which principles are organized in order of importance. The validity of this hierarchical organization has received some empirical and theoretical support. We conducted a theoretical analysis that revealed conceptual justification for a ranking of the 6 principles in the APA code. Such a ranking could assist psychologists in making more informed and consistent moral choices when confronted with ethical dilemmas that involve conflicts among principles.

Case vignette: to share or not to share

For years, the notion that researchers should share data freely with fellow scientists has been discussed widely. Some argue that this is especially true when the data are generated in federally funded projects. A recent provision in the reauthorization bill for the National Institutes of Health (NIH) would ensconce this principle in law. NIH grantees would be required, on demand, to furnish their data to other researchers. According to the proposed legislation, research data would have to be preserved and made avilable for 3 years after the completion of a project, and for 5 years following publication of the results in a scientific journal. One objective, according to a congressional aide, would be to make it easier for scientists with dissenting views to obtain and reanalyze data collected with public funds. It would also facilitate publication of alternative analyses. Personal records and patent applications would be exempted, but other data from clinical, behavioral, or epidemiological research focused on the evaluation or efficacy of a drug, medical device, or treatment of any sort would be covered immediately. Is such mandatory sharing of data ethical and appropriate scholarship? Does it raise potential for abuse? Should colleagues be required to provide such access to data, whether or not federal support was used in its collection?

Dual relationships in psychotherapy

A dual relationship in psychotherapy occurs when the therapist engages in another, significantly different relationship with the patient. The two relationships may be concurrent or sequential. For both sexual and nonsexual dual relationships, men are typically the perpetrators and women are typically the victims. This article presents examples of dual relationships, notes the attention that licensing boards and other agencies devote to this topic, reviews the meager research concerning nonsexual dual relationships, and discusses common strategies that promote both sexual and nonsexual dual relationships.

Ethical implications in screening for ethics violations

The process of admittance to membership in a psychological organization is an opportune time to take into consideration any questionable behavior in the professional background of a prospective member. Membership application forms of the American Psychological Association (APA) and 58 affiliated organizations are reviewed to determine the kinds of questions that are asked about ethical misconduct. The nature of the inquiry differs considerably from one association to another, with a preponderance of organizations avoiding any direct questions about professional ethics. Discussion is focused on how these different screening strategies impact on the applicant and the organization. There is a demonstrated need for appropriately formulated queries. A case is made for resolving current inconsistencies among associations by adhering to a unified procedure in the ethical screening of psychologist applicants.

Sanctions for ethics violations: does licensure of socioeconomic status matter?

Although sexual relationships between therapists and their clients are unethical, such beahviors still occur. This study investigated whether psychologists with applied versus nonapplied training differed in the severity of sanctions advocated for psychologists charged with sexual ethical violations toward high- or low-socioeconomic status victims. Licensed and Nonlicensed psychologists (N=48) viewed a 15-min videotape simulating the adjudication process about an alleged sexual involvement between client and psychologist, then prescribed either: Dismissal of Charges, Educative Advisory, Educative Warning, Reprimand, Censure, Stipulated Resignation, Permitted Resignation, or Expulsion. The alleged victim was described as a college professor of home economics or a hairdresser. Licensed psychologists chose more severe sanctions ("Stipulated or Permitted Resignation") than did Nonlicensed psychologists ("Censure"). Socioeconomic status made no significant difference in sanctions. Apparently, applied therapy training results in more severe judgements toward those who violate American Psychological Association ethical guidelines than other types of psychology training.

Do authorship policies impact students' judgments of perceived wrongdoing?

Although authorship policies exist, researchers understand little about their impact on perceptions of authorship scenarios. Graduate students (N=277) at a large university read 1 of 3 vignettes about a graduate student-faculty collaboration. One half of the surveys included the American Psychological Association's statement on authorship. Participants rated (a) the ethics of the professor as first author and (b) the likelihood of a dissatisfied student reporting the authorship result, as well as the effectiveness and negative consequences of reporting. Work arrangements on the project had a consistent main effect. Also, an authorship policy impacted women's ratings of first authorship when the student contributed the idea for a project. For men, a policy impacted only ratings of the likelihood of reporting when a professor was first author on a student's dissertation. Apart from sex, no other demographic variables on participants were predictive. Discussion focuses on the policy's potential for making only some specific issues salient.

Deception methods in psychology: have they changed in 23 years?

To learn whether criticism and regulation of research practices have been followed by a reduction of deception or use of more acceptable approaches to deception, the contents of all 1969, 1978, 1986, and 1992 issues of the Journal of Personality and Social Psychology were examined. Deception research was coded according to type of (non)informing (e.g., false informing, consent to deception, no informing), possible harmfulness of deception employed (e.g., powerfulness of induction, morality of the behavior induced, privacy of behavior), method of deception (e.g., bogus device or role, false purpose of study, false feedback), and debriefing employed. Use of confederates has been partly replaced by uses of computers. "Consent" with false informing declined after 1969, then rose in 1992. Changes in the topics studied (e.g., attribution, socialization, personality) largely accounted for the decline in deception in 1978 and 1986. More attention needs to be given to ways of respecting subjects' autonomy, to appropriate debriefing and desensitizing, and to selecting the most valid and least objectionable deception methods.

Five points and a lament about Range and Cotton's "Reports of assent and permission in research with children: illustrations and suggestions

This comment responds to an article by Range and Cotton (1995) on reporting of parental permission and child assent procedures in published articles for 4 psychology journals. Issue is taken with the assumptions, methodology, interpretations, and implications of listing researchers in the Range and Cotton article. There is no evidence researchers failed in their ethical obligations or that children were put at risk. Reporting permission/assent in publications is not an ethical requirement. Listing researchers as "failing" to do something not part of an ethical code is lamentable. Too many unfortunate implications and problems can be derived from Range and Cotton's analysis and conclusions.

Nonsexual relationships between psychotherapists and their former clients: obligations of psychologists

This article examines the issue of nonsexual relationships between psychologists and their former therapy clients. What little research is available concerning nonsexual relationships with former clients suggests that psychologists have clear reservations about some of these relationships, especially personal ones and intentional social interactions. Relationships immediately following termination are seen as particularly suspect. Drawing on the literature dealing with multiple relationships in general, and sexual relationships with former clients in particular, a number of arguments are made outlining why psychologists should avoid significant nonsexual relationships with former clients for at least some period of time following termination.

The emergence of interest in the ethics of psychological research with humans

We describe the growth of interest in the ethics of research with human participants based on articles abstracted in Psychological Abstracts and PsycLIT. Interest was low and variable until 1974, after which there was a marked increase in the number of articles published. We explain this emergence of ethical interest in terms of the social climate of concern for human rights in the 1960s and 1970s, the 1973 revision of the American Psychological Association's ethical principles, and the development of federal regulation of research with human participants.

Mental health professionals and assisted death: perceived ethical obligations and proposed guidelines for practice

I have three purposes in this article: (a) to briefly review the legal obligations a mental health professional has when working with a client who is talking about taking some action that could lead to his or her death, (b) to clarify the positions of the 4 major national mental health organizations regarding the acceptable roles of their members with clients who are discussing the possibility of receiving assisted death, and (c) to propose a set of guidelines for practice for mental health professionals working with clients who are considering assisted death that comport with the various laws and codes of ethics.

Nonerotic dual relationships between therapists and clients: the effects of sex, theoretical orientation, and interpersonal boundaries

We surveyed 223 APA members to investigate the roles of therapists' sex, theoretical orientation, interpersonal boundaries, and clients' sex in predicting therapists' assessments of the ethicality of nonerotic dual relationships with their clients. Results indicated that therapists' sex, interpersonal boundaries, and theoretical orientation influenced ethical judgments of these relationships. Theoretical and practical implications of our findings are discussed.