| ObjectiveThe present research,based on the investigation of the clients,aims to evaluate the counselors or psychotherapists' ethical behavior from a client perspective,which can more objectively reflects the current situation of abiding by the code of ethical behavior of practitioners who are engaging in psychological counseling and psychotherapy industry in our country,as well as to discussing the client's influence on counselors or psychotherapists' ethical behavior.ObjectsIn terms of administrative areas in China(except for Hong Kong,Macao and Taiwan),six administrative areas are chosen as investigation areas,namely:North China,Northeast China,East China,Middle South China,Southwest China,and Northwest China.Twelve cities from these areas are chosen as the investigation spots according to the ongoing situation of the psychological counseling and psychotherapy industry.1104 questionnaire were delivered to 1104 clients form 11 investigated areas. 807 validated ones of which are collected,including 209 from Shanghai,170 from Guangdong Province,112 from Zhejiang,Shandong 72,Hubei 48,Sichuan 38,Gansu 36,Yunnan 30,Liaoning 29,Heilongjiang 27,Anhui 25,Inter Mongolia 11. Investigation time:During October,2007 to February 2009.The validated rate is 73.09%.The average age of the validated samples is 30±11,including 336 males(which takes up 41.6%of the samples) and 456 females(which takes up 56.5%).MethodsThis research is carried out thought questionnaire method.A self-made ethical questionnaire,"ethical questionnaire in counseling and psychotherapy(for clients)"was designed as an evaluation tool.The questionnaire contains tow parts:1) Demographic data and the status quo of clinic-visiting in psychiatry department, including gender,age,marriage state,monthly income,education level,having a abuse experience or not,times of psychological counseling and psychotherapy, average time for once,visiting frequency,charge,drug treatment or not,the number of the previously treated clients,gender of counselors and psychotherapist,etc.2) Investigation on ethical behaviors with 59 items,mainly including competence, psychological consultations services,treatment setting,privacy and confidentiality, informed consent,double relations,charge,etc,some of which involves the client's personal emotional experience.Some questions should be answered only with"Yes"or"No".In the process of research,Foxpro6.0 is used to build a database,and software Spss11.5 is used to process data.The statistical methods are descriptive analysis and x~2 test.Results1.Result of client's evaluation of counselors or psychotherapists' ethical behavior.1.1 Most of the clients have confidence in the ongoing treatment.About 85.0% of the clients consider their counselors or psychotherapists to be qualified.About 15.0%reveals that sometimes their counselors or psychotherapists show their disappointment and impatience.Sometimes counselors or psychotherapists even confide their pressure to the clients.1.2 91.0%of the clients think that their privacy and the content of their treatment are kept secret.50.0%of the clients are aware of the nature,the name and the charge standard of their counseling or treatment.They are also aware of the professional background of the counselors or psychotherapists,the aim of the test and the approach of the test.Up to 30.0%of the clients are aware of the potential risk of the treatment.Only 17.5%knows the ratio of remission or deterioration of the disease.1.3 7.0%of the clients have established close relationship with their counselors or psychotherapists.1.5%of them have had sex with their counselors or psychotherapists.About 18.3%of the clients are friends with their counselors or psychotherapists in their daily life.1.4 About 80.0%of the clients can start and end their psychological counseling or treatment as scheduled.About 60.0%of the clients know the approach to get in touch with their counselors or psychotherapists in emergency.About 40.0%of the clients reveal that their counselors or psychotherapists answer phone calls during the treatment.1.5 About 15.0%of the clients reveal that they are not charged of the psychological counseling;the counseling are discontinued once they cannot afford the fee or they are still charged of even when they can't show up for the appointment. Less than 5.0%of the clients say that their counselors or psychotherapists raise the fee during the process of treatment.2 Relation between client's personal factors and counselors or psychotherapists' ethical behavior 2.1 GenderWith regard to the relation between gender and the evaluation of the counselors or psychotherapists,there is pronounced difference(p<0.05 or p<0.01),which mainly focuses on the entry of dual relation between sex or non-sex.Male clients tend to establish close relationship with their counselors or psychotherapists.More male clients reveal that they have sexual excitation or sexual fantasy towards their counselors or psychotherapists.With regard to establishing business relation or economic relation with their counselors or psychotherapists,male clients outnumber female clients.2.2 Educational levelWith regard to the relation between educational level and the evaluation of the counselors or psychotherapists,there is pronounced difference(p<0.05),which mainly focuses on certain matters including privity,consent,privacy and confidentiality.As to their counselors or psychotherapists abiding by ethical behavior, clients with higher educational level have higher evaluation than clients with lower educational level.Clients with higher educational level receive more information about privity or consent.They tend to regard that their privacy and the content of their treatment are kept secret.2.3 Experience of having been abused Whether a client has the experience of being abused or not is related to their evaluation of their counselors or psychotherapists' ethical behavior.With regard to this,there is pronounced difference(p<0.05 or p<0.01),which mainly focuses on certain matters related to dual relations,principles of privity,consent or confidentiality and the ability of their counselors or psychotherapists.Clients with experience of being abused can establish close relationship more easily with their counselors or psychotherapists.They are more easily attracted to the charm(sexual or non-sexual) of their counselors or psychotherapists.Compared to clients without experience of being abused,it's more often that clients with the experience of being abused meet the counselors or psychotherapists who reveal negative emotions to them.They know more information about privity or consent and they incline to trust their counselors or psychotherapists.2.4 Number of times of treatmentWith regard to the relation between number of times of treatment and the evaluation of the counselors or psychotherapists,there is pronounced difference (p<0.05 or p<0.01),which mainly focuses on certain matters including privity, consent,privacy and confidentiality,dual relationships and ability.With more and more times of treatment,the ratio of clients being attracted to the charm(sexual or non-sexual) of their counselors or psychotherapists and the ratio of clients knowing information about privity or consent increases at the same time.It's easier for clients with 3 to 5 times of treatment to believe that their privacy and the content of their treatment can be kept confidential.Conclusions1 As for evaluation of the counselors or psychotherapists,clients make a high evaluation of counselors or psychotherapists' competence and confidentiality,but make a low evaluation on informed consent,double relations,and counseling setting.2 Clients' personal factors can influence their counselors or psychotherapists' ethical behaviors.Males are easier to build a sexual relationship with the counselors and psychotherapists.Clients with a higher educational level will get more information.The ever-abused clients are easier to build a sexual relationship with the counselors or psychotherapists.The more times clients visit,the more information they will get. Features of this research1 The present research,based on the investigation of clients,aims to study the present situation of the counselors and psychotherapists' ethical behavior from a client perspective.2 The investigation is carried out through the whole country and in many main spots as a cross-section investigation.Limitations of this research1 The present research is carried out in many main spots of the whole country and questionnaires are delivered by the person in charge of these spots.The fact that the questionnaires are filled voluntary clients makes the validated rate low.2 Ethics is a sensitive topic.Even though the confidential of the investigation is guaranteed in the whole research,some clients are still not willing to reveal their real situation.The further investigation can carry on a deeper research,like individual interview,qualitative study,testing and verifying the results of this research as a supplement of a cross-section investigation.
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