Global Integrity--13

Integrity in Professional Psychology

Moral wholeness for a whole world

 Integrity is moral wholeness—living consistently in moral wholeness. Its opposite is corruption, the distortion, perversion, and deterioration of moral goodness, resulting in the exploitation of people. Global integrity is moral wholeness at all levels in our world—from the individual to the institutional to the international. Global integrity is requisite for “building the future we want—being the people we need.” It is not easy, it is not always black and white, and it can be risky. These entries explore the many facets of integrity with a view towards the global efforts to promote sustainable development and wellbeing.

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What does integrity look like in professional psychology? Here are three examples below. Integrity is a core value which influences the formation and practice of specific ethical principles. Perhap the "I" shape in the Greek psi letter above (psi is the universal symbol for psychology) can stand for the central place of "integrity" in professional psychology.

1. California Board of Psychology

"The mission of the Board of Psychology (Board) is to advance quality psychological services for Californians by ensuring ethical and legal practice and supporting the evolution of the profession. Our values are transparency, integrity, consumer protection, inclusiveness, excellence, and accountability." (California Board of Psychology, Spring Journal, 2016, p. 1)

2. American Psychological Association

“This section consists of General Principles. General Principles, as opposed to Ethical Standards, are aspirational in nature. Their intent is to guide and inspire psychologists toward the very highest ethical ideals of the profession….Integrity. Psychologists seek to promote accuracy, honesty and truthfulness in the science, teaching and practice of psychology. In these activities psychologists do not steal, cheat or engage in fraud, subterfuge or intentional misrepresentation of fact. Psychologists strive to keep their promises and to avoid unwise or unclear commitments. In situations in which deception may be ethically justifiable to maximize benefits and minimize harm, psychologists have a serious obligation to consider the need for, the possible consequences of, and their responsibility to correct any resulting mistrust or other harmful effects that arise from the use of such techniques.” (American Psychological Association, General Principles, Ethical Principles of Psychologists and Code of Conduct, 2002/2010)

3. Universal Declaration of Ethical Principles for Psychologists (2002)

“…The Universal Declaration of Ethical Principles for Psychologists speaks to the common moral framework that guides and inspires psychologists worldwide toward the highest ethical ideals in their professional and scientific work…Psychologists are committed to placing the welfare of society and its members above the self-interest of the discipline and its members. They recognize that adherence to ethical principles in the context of their work contributes to a stable society that enhances the quality of life for all human beings….The Universal Declaration describes those ethical principles that are based on shared human values. It reaffirms the commitment of the psychology community to help build a better world where peace, freedom, responsibility, justice, humanity, and morality  prevail….The Universal Declaration articulates principles and related values that are general and aspirational rather than specific and prescriptive. Application of the principles and values to the development of specific standards of conduct will vary across cultures, and must occur locally or regionally in order to ensure their relevance to local or regional cultures, customs, beliefs, and laws….” (Preamble).

“Principle III Integrity. Integrity is vital to the advancement of scientific knowledge and to the maintenance of public confidence in the discipline of psychology. Integrity is based on honesty, and on truthful, open and accurate communications. It includes recognizing, monitoring, and managing potential biases, multiple relationships, and other conflicts of interest that could result in harm and exploitation of persons or peoples. Complete openness and disclosure of information must be balanced with other ethical considerations, including the need to protect the safety or confidentiality of persons and peoples, and the need to respect cultural expectations. Cultural differences exist regarding appropriate professional boundaries, multiple relationships, and conflicts of interest. However, regardless of such differences, monitoring and management are needed to ensure that self-interest does not interfere with acting in the best interests of persons and peoples…”

Applications

--Identify one aspect of integrity that all three excerpts above have in common.

--Why are “monitoring and management…needed to ensure that self-interest does not interfere with acting in the best interests of persons and peoples…” (Universal Declaration)

MC-MH: Global Integration—8

Climbing or Confining:

Three Commitments for GI

We are sharing some thoughts on future directions for integration. Integration is a field of study which brings together the disciplines of mental health and theology in order to better understand and help humans and thus glorify God. The ongoing/additional links between member care (MC) and mental health (MH) are highly relevant for the global development of integration—global integration (GI). And GI is potentially very relevant for the global development of mission/aid and human health.

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Climb traveller, or stiffen slowly on the plain.

Irish proverb

The current and future course of integration, like that for member care, lies in its global connections and contributions—going global. Climb globally traveler, or stiffen slowly on the familiar plain. Here are three items---suggested commitments--to support you in your “global climb”.

1. Commitment to staying current. These three links track developments in global mental health (GMH). They can help you access resources that are relevant for member care and integration.

• mhGAP, World Health Organization (online updates and newsletter twice/year)
• Movement for Global Mental Health (online updates and monthly newsletter)
• Psychology International (newsletter 3-6 times/year)

2. Commitment to reviewing resources. The latest MCA website focuses on orienting people to GMH. It is called GMH-Map. Here are five resources (in the areas of research, practice, declarations) from the What’s New! section. These resources are also relevant for member care and integration.

• The Global Economic Burden of Non-communicable Diseases (September 2011--with a significant emphasis on MH) World Economic Forum and Harvard School of Public Health
• Lancet journal, special series on GMH (October 2011)
• Psychological First Aid: Guide for Field Workers (2011), World Health Organisation, War Trauma Foundation, World Vision International
• Twelve Critical Issues for Mental Health Professionals Working with Ethno-Culturally Diverse Populations (October 2011), Anthony Marsella, Psychology International, 22(3), pp. 7-10.
• Cape Town Declaration (16 October 2011), Pan African Network of People with Psychosocial Disabilities

3. Commitment to pursuing active involvement. These quotes below are from the October 2011 issue of Psychology International 22(3). They are likewise relevant for member care and integration. For example, where the word psychology or psychologist(s) occur, exchange it with a similar term for member care or integration.
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"International cross-pollination among scientists and practitioners is important if we are to develop better models, methodologies, and perspectives. [The American Psychological Association, APA] may be the largest association of psychologists in the world but because of the psychological, geographical, and political boundaries in the United States and more generally in the west, we may become isolated in our thinking without exposure to perspectives from elsewhere. We as psychologists and members of APA must try to avoid tunnel vision and bias by bringing psychologists with other nationalities, cultures and practices to our table….
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If we cannot invite and support bringing our fellow psychologists from other places to meet with the large numbers of psychologists who attend our Annual Convention, then we fail to educate, inform, and grow the many specialty areas in our discipline in the broadest and deepest ways. And we fail as U.S. psychologists because we do not have the international perspectives that allow us to be relevant in the largest sense. We must come out of our ivory towers by bringing our international psychologists to the Convention and to other meetings. Otherwise, we remain provincial and woefully out of step with the rest of the world." (Julie Meranze Levitt, pp. 2-3)
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"Attendance at psychology world-congresses has been rising, the number of regional conferences that draw across multiple countries is growing, and associations are becoming more active in pursuing international interaction….
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Now that doors are open, how do we move psychology from a tradition of individual exchange and international outreach to being an international discipline? Some suggestions from regional developments are to create structures for cross-country consensus and to ask, as a discipline, what it would take to realize a world in which psychologists can easily gather information about the work, ideas, and plans of colleagues around the world; can easily know how to find colleagues with mutual interests around the world; can be sufficiently mobile to be a psychologist around the world?....
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What can individual psychologists do? From where I sit, the most important way to encourage internationalization is to tell each other about our work, our teaching, and our ideas. The most direct way is face-to-face at international conferences and congresses, or, if your travel budget is strained, by seeking out international attendees at domestic conferences or international colleagues in your own institution. Equally important is seeking out and reading about international work." (Merry Bullock, p. 4)

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So climb...and jump too--ha!

Reflection and Discussion

**Which of the items in the “Saying Current” and “Reviewing Resources” sections above are you aware of already?

**List a few ways that GI can relevantly connect and contribute to GMH (section 3 above)?

**How would you apply the “climb traveler” proverb to your own life as well as to member care and/or integration?

MC-MH: Global Integration--4

Global Integration and Psychology International

(GI-PI)

Image from website of APA office of International Affairs

http://www.apa.org/international

We are sharing a few thoughts on future directions for integration. Integration is a field of study which brings together the disciplines of theology and mental health in order to better understand and help humans. The ongoing/additional links between member care (MC) and mental health (MH) are highly relevant for the global development of integration—global integration (GI). And GI is potentially very relevant for the global development of mission/aid.

Some noteworthy historical examples of the influence of integration on mission/aid are the special issues on psychology and missions beginning in 1983 in both the Journal of Psychology and Theology and the Journal of Psychology and Christianity. (note that some of the articles from these special issues are available at the Member Caravan web site via the online version of Helping Missionaries Grow). Still another example is the integration backgrounds of many practitioners in member care extending back to the initial days of integration endeavors (1960s/1970s). As we stay in touch with global mental health resources and developments, including psychology international, we will be better equipped to provide member care in mission/aid and beyond.

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I just attended the annual convention of the American Psychological Association (APA) in Washington DC. Established in 1892, the 150,000 members of the APA are part of the largest and arguably the most influential psychological association in the world. Its mission is to advance the creation, communication, and application of psychological knowledge to benefit society and improve people’s lives.

I was really inspired by my time at this huge five-day gathering, convened at the Walter E. Washington Convention Center in the historic center of Washington DC. (click here to see a 3 minute promotional piece about this center.) My appreciation of the scope and relevance of psychology soared. My particular interests were oriented towards “psychology international (PI), especially the international applications of psychology for member care and for promoting health/dealing with human problems at the global level. PI can play an increasingly substantial role in the development of GI—global integration—and vice versa. Consider these PI examples from the APA convention.

People and Presentations

The APA convention certainly had a definite American feel and focus to it. Yet the clear signs of the ascendant global mental health world were easy to spot. The most visible evidence was seen in the numbers of international participants, internationally-experienced American colleagues, and the international/global-related presentations. Just a few samplings of the latter included areas such as:

**helping people/children who have been trafficked as sex workers;

**internationalizing psychology training;

**researching assessment and treatment approaches in different countries including post-traumatic stress in conflict areas;

**exploring opportunities for working in different nations.

Here are some other examples of the presentations that I attended (from the hundreds available):

**the use of social media to educate and provide care as well as examples of the darker side of the internet such as cyberstalking (click here for a brief summary of Dr. Elizabeth Carll’s presentation);

**the use of virtual reality treatments (e.g., interacting online with digitalized human helpers; providing burn victims with a virtual experience (Snow World game) to minimize the excruciating pain from having their bandages removed and wounds/skin grafts scrubbed—click here for some information about Snow World and click here for related research article);

**social psychology research on how people can become either heroes or villains (developing pro-social or anti-social behavior or character traits—see Frank Farley’s related comments on the characteristics of heroes by clicking here and click this link for Phil Zimbardo’s on evil/Lucifer Effect); and

**the effects of globalization on human health, governance, and justice (Crazy Like Us: The Globalization of the Western Mind)

**healing after mass violence, reconciliation, evil (see the materials from Dr. Irving Staub)

Another presentation (by Dr. Danny Wedding at California School of Professional Psychology) discussed how clinical psychology and counseling psychology are taught in various countries. It included a brief description/mention of some of the some recent text books which provide a more international overview of psychology/mental health.

• International Handbook of Psychology (2000)
• Handbook of International Psychology (2004)
• Toward a Global Psychology (2007)
• History of Modern Psychology in Context (2010)
• History of Psychology: A Global Perspective (2011)
• Public Health Tools of Practicing Psychologists (2011)

My time at the APA Convention confirmed to me that member care (MC) and global integration (GI) must be further informed by and connected to psychology international (PI). For another tangible example have a look at the latest issue of Psychology International (July/August 2011), published by the APA Office of International Affairs. This issue includes brief pieces about mental health practices in Nepal, Psychology Day at the United Nations (14 April 2011), information on the new site from the International Union of Psychological Science (IUPsyS) called Psychological Resources from Around the World, a short article I did that overviews global mental health, etc.

Member Care Applications

As we have shared with graduate students in the mental health sciences who are interested in member care: get the best education-training that you can; get the best cross-cultural experiences that you can; connect with networks and people in mission/aid/member care; grow as a person; commit to lifelong learning; trust God; get a support group with you and behind you; try to not take on too much debt; and more recently, cross sectors for good practice. Going to the APA convention and considering the current state of PI, reminded me of all the above!

Those who practice Christian spirituality and head into the GI realm can certainly embrace the good in PI without becoming psycho-centirc. A Cristo-centric relationship, commitment, and lifestyle are still at the core of every GI practitioner. 

Reflections and Discussion

1. Which of the above PI resources-links are the most interesting to you?

2. List a few other suggestions for PI resources that are relevant for GI and member care specifically.

3. What can help GI develop into a broad-based movement (and without being overly influenced by one country, discipline, organization, etc.)?

Culture and Diversity in Member Care—Part 5

Resolutions: Multicultural Competence

International Member Care Retreat 2000

El mar sus millares de olas mece divino.

Oyendo a los mares amantes mezo a mi niño…

Dios Padre sus miles de mundos mece sin ruido.

Sintiendo su mano en la sombra, mezo a mi niño.

Gabriela Mistral, Desolación, 1922

The sea rocks its countless waves

God rocks His countless worlds

Hearing the loving waves

Sensing God in my world

I rock my child.

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Mission/aid workers, like the people with whom they work, are a hugely diverse and culturally varied group. As mentioned in the last entry, there are about 400,000 foreign mission workers and nearly 12 million national workers, according to the estimates from Johnson, Barrett, and Crossing, in the January 2010 issue of the IBMR. We thus want to better equip ourselves to deal with such diversity and thus make member care as relevant as possible. In short, we want to encourage understanding, respect, and competency regarding human diversity and cultural variation.

Let’s have a look at one professional body’s comments on culture and gender—resolutions from the American Psychological Association (APA, 2004). There are of course similar perspectives from other fields/professional bodies and countries. It would be fascinating to review and compare many of these. It would also be helpful to use these materials as a springboard to write some trans-culturally relevant guidelines on cultural variation and diversity in member care! These guidelines would be helpful for further developing multi-cultural competence.

Keep in mind that although it is not explicitly stated in this document by the APA, much of the thinking is founded upon the 1948 Universal Declaration of Human Rights (UDHR) and subsequent human rights-related instruments. See especially the Preamble and Article 1 which recognize  “the inherent dignity" of eveyone; that "the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world;” and that “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.” These principles from the UDHR in turn can be definitely linked to core principles in Judeo-Christian thinking on the intrinsic worth of humans as beloved image bearers of God.

The Resolutions from the APA (excerprted below) are obviously very USA-centered. They are nonetheless heading in the right direction as they call to internationalize the field of psychology in general and increase the multi-cultural competence of American psychologists in particular. Note that in the entire document there are actually 26 “Whereas” statements and 12 “Let it be resolved” statements.

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Resolution on Culture and Gender Awareness in International Psychology   American Psychological Association, 2004

(Excerpts--click on the title/link above for the full version)

"WHEREAS an estimated 60 percent (or more) of the world's psychologists now live outside the US...

WHEREAS psychologists outside of the US have generated perspectives, methods and practices that correspond to the needs of the people in their societies and data that are relevant to the development of a more complete psychology of people...

THEREFORE LET IT BE RESOLVED that the American Psychological Association will:

(4) encourage more attention to a critical examination of international cultural, gender, gender identity, age, and disability perspectives in psychological theory, practice, and research at all levels of psychological education and training curricula.

(5) encourage psychologists to gain an understanding of the experiences of individuals in diverse cultures, and their points of view and to value pluralistic world views, ways of knowing, organizing, functioning, and standpoints.

(6) encourage psychologists to become aware of and understand how systems of power hierarchies may influence the privileges, advantages, and rewards that usually accrue by virtue of placement and power..."

Reflection and Discussion

1. What other guidelines/statements in this area of culture/diversity/gender are you familiar with?

2. What would be three succinct principles or areas to emphasize in a member care statement about awareness of human culture, diversity, and gender?

3. Describe how some of these principles in the APA Resolutions relate to Scripture and/or the UDHR.

4. It can be argued that it takes some professional bodies a long time to catch on to the relevance of cultural variation, human diversity and gender equality. Why is this so? Any examples?

5. How could the APA Resolutions be useful to further develop multicultural competence for you in your work and setting?

Member Care and the Hippocratic Oath, Part 10—Summary

Hippocrates as Historical Precedent:

Roots and Responsibilities

The Hippocratic Oath in Greek and Latin.

La saeta lanza

fasta un cierto fito,

y la letra alcanza

desde Burgos a Egipto.

Sem Tob, 14th century, Spain

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Translation:

Darts hit their mark when carefully thrown

Writings go far when skilfully sown.

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This is our 10th and final discussion of the Hippocratic Oath. As the above moral proverb indicates (and many thanks to you Sem Tob for your universally-wise rhymes!), the truth in skilfully written words, such as those in the Hippocratic Oath, span across continents, generations, centuries, and health disciplines. The ethical core for health practitioners in the Oath, arguably, is unprecedented as a historical foundation of good practice.

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Just one case in point among many is the current version of the American Psychology’s Ethical Principles for Psychologists and Code of Conduct (2002). This code like its “cousin codes” in related health sciences, is replete with what can only be called by this point in our discussions, "hippocratisms.” Smile. Meander through the Introduction and the Preamble, and then on to the General Principles and then Ethical Standards sections and you will quickly bump into such familiar concepts/commitments as doing no harm, responsibility, competence, confidentiality, and yes, even not having sex with clients etc. Check it out at: http://www.apa.org/ethics/code2002.html  The Hippocratic foundation is there (along with other items such as justice, integrity, and rights along with more specific, contemporary standards involving things like psychological testing, court testimony, etc.).

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Final Application

We want to summarize the 10 core principles that we have covered over the past three plus months. These principles are commitments that are explicitly embedded in the Hippocratic Oath (HO). We want to remember our roots and our responsibilties. These core priciples could be likened to being the 10 commandments for healthcare practitioners. But let’s just call it the “10 HO Commitments”. We also list the first draft of the newly condensed version (10 items now) of the “15 Commitments for Member Care Workers” (from the 2006 article “Five Stones for Member Care: Upgrading Ethical Practice).”

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx.

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Well, if this does not have your head spinning yet, then this may well do the trick: The 10 Commitments in the Hippocratic Oath will then be referenced to the 10 MCW Commitments (in parentheses)--although note there is definitely not a one-to-one correspondence. Here we go!

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10 HO Commitments (for health care workers)

1. Foundational Principle: Accountability to a Higher Power

2. High Standards: Agapeoath for Trans-Practitioners

3. Professional Obligations to Respect, Relate, and Reproduce

4. Hippocratic Heart: Dong Good and Doing No Harm

5. Respecting Human Life: Conception through Completion

6. Growing in Character and Competence

7. Prudence: No Sex with Clients

8. Confidentiality as a Lifestyle

9. Consequences of Good vs Poor Practice

10. Historical Precedents: Roots and Responsibilities

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10 MCW Commitments (for member care workers)

1. Ongoing training, personal growth, and self-care. (HO6)

2. Ongoing accountability for my personal/work life, including consulting/supervision. (HO1)

3. Recognizing my strengths/limits and representing my skills/ background accurately. (HO6)

4. Understanding/respecting felt needs, culture, and diversity of those with whom I work. (H03)

5. Working with other colleagues, and making referrals when needed. (HO3)

6. Preventing problems and offering supportive/restorative and at times pro bono services.(HO5)

7. Having high standards in my services and embracing specific ethical guidelines. (HO2)

8. Not imposing my disciplinary/regulatory norms on other MCWs. (H03)

9. Abiding by any legal requirements for offering member care where I reside/practice. (HO9)

10. Growing in my relationship to Christ, the Good Practitioner. (HO1)

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Reflection and Discussion

We hope these 10 entries since June have stimulated your thinking about new, old, and creative ways to understand member care. Take some time to identify/review three meaningful concepts for you in particular.

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I especially enjoyed the challenge of trying to relate the moral proverbs of Sem Tob and the indigenous artwork of Diego Rivera with member care thinking and the Hippocratic Oath. Perhaps you would like to have a go at some integrative member care work that includes the arts, sciences, and history etc. too.

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It has personally been a lot of work and I was not always sure where we would end up. Perhaps the same is true for you. Are you OK for example with the summary in the 10 HO Commitments?
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I am tempted to close with yet another gem from the Jewish rabbi Sem Tob in 14th century Spain. However  I want to finish now with something from an anonymous Christian monk in 8th century Ireland. This excerpt from the poem Pangur Ban (White Cat) aptly describes what this integrative journey into "Member Care and the Hippocratic Oath" has been like for me. Like the monk in this poem, I have been hunting at length for the right words to convey my thoughts and I have been keenly aware of how small my wisdom really is. Maybe you have a proverb or short poem that reflects your experience too.

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I and Pangur Ban my cat

‘Tis a like task we are at

Hunting mice is his delight

Hunting words I sit all night.

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Against the wall he sets his eye

Full and fierce and sharp and sly

Against the wall of knowledge I

All my little wisdom try.

Member Care and the Hippocratic Oath, Part 7

Member Care Never Includes Sex

Diego Rivera, Dance of Tehuantapec, 1928

Como el pez en el río,
vicioso y riendo,
non piensa el sandío
la red quel’ van teniendo.

Sem Tob, 14th cnetury, Spain

Translation:

Imprudent people like careless fish get
trapped in their folly and caught in a net.

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In every house where I come
I will enter only for the good of my patients,
keeping myself far from all intentional ill-doing and all seduction
and especially from the pleasures of love with women or with men,
be they free or slaves.
Hippocratic Oath
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As member care providers and those with member care responsibility, we are committed to the good of those with whom we work. We do good and do no harm. We enter into many types of houses so to speak (the term used in the Hippocrates Oath) during the course of our work. Houses can be literal as well as represent peoples’ lives, organizations, countries, and cultures. We are trusted guests. No matter how helpful or beautiful or fun or anything one might wish to frame such an experience:

There is no ethical context
for having member care sex.

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So chill out. Take a cold shower. Stay accountable to colleagues. Because having sexual relationships with people who receive our services–-regardless of our world views or spiritual leanings--is a no go. Just don’t do it. And don’t even think about it. But do think about and stay in touch with your own sexuality.
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The same goes for romance, as you will note in the examples below of professional principles, codes, and laws. Remember there are millions of other foxes in the lea and fish in sea besides that "irresistible" person you are trying to “help.”
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Sexual Purity in Missions (p. 249-250)
Dr. Ken Williams in Doing Member Care Well, 2002
[Note: This article is also available in Chinese, Arabic, Spanish, Portuguese, and Korean. The article also includes two helpful self-assessment tools. The English and Chinese versions are available in Section Five (Special Issues) at http://www.chinamembercare.com/]
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Being sexual and sane these days is no easy thing …We need to be just as concerned about understanding the normal and healthy aspects of human sexuality as we are about its potential dangers and downside. What a powerful and lovely gift we have from the Creator!
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Professional Therapy Never Includes Sex, 2004, (p. 5)
California Department of Consumer Affairs
http://www.psychboard.ca.gov/formspubs/proftherapy.pdf
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Professional psychotherapy never includes sex. It also never includes verbal sexual advances or any other kind of sexual contact or behavior. Sexual contact of any kind between a therapist and a patient is unethical and illegal in the state of California. Additionally, with regard to former patients, sexual contact within two years after termination of therapy is also illegal and unethical.
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Sexual contact between a therapist and a patient can also be harmful to the patient. Harm may arise from the therapist’s exploitation of the patient to fulfill his or her own needs or desires, and from the therapist’s loss of the objectivity necessary for effective therapy. All therapists are trained and educated to know that this kind of behavior is inappropriate and can result in the revocation of their professional license.
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Therapists are trusted and respected, and it is common for patients to admire and feel attracted to them. However, a therapist who accepts or encourages these normal feelings in a sexual way — or tells a patient that sexual involvement is part of therapy — is using the trusting therapy relationship to take advantage of the patient. And once sexual involvement begins, therapy for the patient ends. The original issues that brought the patient to therapy are postponed, neglected, and sometimes lost.

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Many people who endure this kind of abusive behavior from therapists suffer harmful, long-lasting emotional and psychological effects. Family life and friendships are often disrupted, or sometimes ruined.
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Ethical Principles of Psychologists and Code of Conduct, 2002
American Psychological Association
http://www.apa.org/ethics/code2002.html
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Principle A: Beneficence and Nonmaleficence. Psychologists strive to benefit those with whom they work and take care to do no harm…Because psychologists' scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, financial, social, organizational, or political factors that might lead to misuse of their influence. Psychologists strive to be aware of the possible effect of their own physical and mental health on their ability to help those with whom they work.
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3.02 Sexual Harassment. Psychologists do not engage in sexual harassment. Sexual harassment is sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with the psychologist's activities or roles as a psychologist, and that either (1) is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or (2) is sufficiently severe or intense to be abusive to a reasonable person in the context. Sexual harassment can consist of a single intense or severe act or of multiple persistent or pervasive acts.
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10.05 Sexual Intimacies With Current Therapy Clients/Patients. Psychologists do not engage in sexual intimacies with current therapy clients/patients.
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10.06 Sexual Intimacies With Relatives or Significant Others of Current Therapy Clients/Patients. Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard.
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10.07 Therapy With Former Sexual Partners. Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.

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10.08 Sexual Intimacies With Former Therapy Clients/Patients.

(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.

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(b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient. (See also Standard 3.05, Multiple Relationships.)
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Reflection and Discussion
1. To what extent do the above principles and codes (from the USA) apply to member caregivers with various backgrounds and in other countries? Can the above standards and caveats be written (or are they alredy written) in such a way as to be universal?
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2. What are some of the safeguards you and those in your setting have to avoid sexual intimicies with the people you are trying to help?
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3. What is the best way to handle a situation in which you are infatuated with a person (client, student, colleague, neighbour) and having a sexual or romantic relationship is likely although clearly not appropriate (due to marriage, the nature of your member care relationship, values, etc.).
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4. Condoms are currently handed out freely all over the globe. So will the  day ever come when it will be seen as OK or even "ethical" to give condoms to clients when they walk into our member care offices--and lives? Just in case something happens between helper and helpee?
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5. How should we respond to member caregivers who have sexual intimicies with those that they are trying to help?

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Note: This entry did not get into the topic of "intentional ill-doing" as stated in this part of the Hippocratic Oath. What would such "ill-doing" involve? Probably the exploitation of others for one's own selfish ends (e.g., overcharging, spreading gossip about a person, deceiving someone concerning credentials and qualifications, not admitting errors etc.).