International Journal of Applied Philosophy

Volume 15, Issue 1, Spring 2001

Is the Current Practice of Psychotherapy Morally Permissible?

This essay aims to morally evaluate psychotherapy as it is currently practiced through the lens of sales/exchange ethics. The main focus of the essay is on psychotherapists’ claims to special expertise at diagnosing and treating mental illness. I review the research evidence relevant to these claims and conclude that these claims are not supported by the available evidence. Psychotherapists do not appear to be any better than actuarial tests at diagnosing mental illnesses, and meta-analyses of psychotherapy outcome studies casts serious doubt on the existence of treatment expertise. Given that the expertise that psychotherapists claim to have is lacking, those seeking psychotherapy are not adequately informed about the quality of the product that they are seeking. Using Holley’s principles of sales ethics as a springboard, I argue that this situation is morally unacceptable; thus the current practice of psychotherapy is morally impermissible. I provide and evaluate some suggestions for rectifying this problem. The most important of these is Dawes’s suggestion that psychotherapists be licensed according to their use of experimentally confirmed diagnostic and treatment methods.