ABSTRACT

Malpractice issues in psychotherapy and psychological treatments refer to the unethical behavior of a psychologist or psychotherapist toward the patient. The current study reviewed complaints directed at psychologists and psychotherapists in Sweden with regard to possible incidents of malpractice. Eligible cases were retrieved from a database managed by the Health and Social Care Inspectorate [Inspektionen för vård och omsorg (IVO)], an administrative authority responsible for the safety and quality of healthcare and social services delivery. These cases were analyzed using thematic analysis. In total, 33 complaints matched the keywords proposed by IVO, and were scrutinized in detail. The cases primarily involved psychiatric care by a psychologist in outpatient settings, although many cases comprised multiple healthcare providers responsible for the patient’s care, or targeted the healthcare unit as a whole. The results demonstrated that different forms of malpractice occur, and can be classified in two general themes, Incorrect administration and implementation and Attitude and behavior, which involve organizational aspects as well as examples of malpractice and unethical behavior. Implications for clinical practice and future research include further training in ethics and malpractice, video recording or auditing sessions, routine outcome monitoring, and providing patients with information on how to file complaints.

摘要

心理治疗和心理治疗中的渎职问题是指心理学家或心理治疗师对患者的不道德行为。目前的研究审查了针对瑞典心理学家和心理治疗师可能发生的渎职事件的投诉。符合条件的病例是从卫生和社会保健检查局管理的数据库中检索到的 [ Inspektionen för vård och omsorg(IVO)]，一个负责医疗保健和社会服务提供的安全和质量的行政机构。这些案例采用专题分析法进行分析。共有 33 起投诉符合 IVO 提出的关键词，并进行了详细审查。这些病例主要涉及心理医生在门诊环境中的精神科护理，尽管许多病例包括负责患者护理的多个医疗保健提供者，或针对整个医疗保健单位。结果表明，存在不同形式的渎职行为，可分为两大主题：不正确的管理和执行以及态度和行为，其中涉及组织方面以及渎职和不道德行为的例子。对临床实践和未来研究的影响包括道德和医疗事故、视频记录或审计会议、常规结果监测以及为患者提供有关如何提出投诉的信息的进一步培训。