Jun Gao

This article aims to summarize the current ethical issues in the field of clinical and counseling psychology and the process of developing professional ethical standards in China. First, through a review of the history of counseling and psychotherapy in China, general background information is provided. Important ethical issues are then discussed based on the results from several empirical studies. Finally, the process of developing the new edition of the Chinese Psychological Society Code of Ethics for Clinical and Counseling Psychology, the main contents as well as the considerations taken into account in the development of this code are presented

Background: Publication of ethically uncertain research occurs despite well-published guidelines set forth in documents such as the Declaration of Helsinki. Such guidelines exist to aide editorial staff in making decisions regarding ethical acceptability of manuscripts submitted for publication, yet examples of ethically suspect and uncertain publication exist. Our objective was to survey journal editors regarding practices and attitudes surrounding such dilemmas. Methods: The Editor-in-chief of each of the 103 English-language journals from the 2005 Abridged Index Medicus list publishing original research were asked to complete a survey sent to them by email between September-December 2007. Results: A response rate of 33% (n = 34) was obtained from the survey. 18% (n = 6) of respondents had published ethically uncertain or suspect research within the last 10 years. 85% (n = 29) of respondents stated they would always reject ethically uncertain articles submitted for publication on ethical grounds alone. 12% (n = 4) of respondents stated they would approach each submission on a case-by-case basis. 3% (n = 1) stated they would be likely to publish such research, but only with accompanying editorial. Only 38% (n = 13) give reviewers explicit instruction to reject submissions on ethical grounds if found wanting. Conclusions: Editorial compliance with the Declaration of Helsinki in rejecting research that is conducted unethically was difficult to ascertain because of a poor response rate despite multiple attempts using different modalities. Of those who did respond, the majority do reject ethically suspect research but few explicitly advise reviewers to do so. In this study editors did not take advantage of the opportunity to describe their support for the rejection of the publication of unethical research

OBJECTIVES: To compare 2005 and 1995 ethics guidelines from journal editors to authors regarding requirements for institutional review board (IRB) approval and conflict-of-interest (COI) disclosure. DESIGN: A descriptive study of the ethics guidelines published in 103 English-language biomedical journals listed in the Abridged Index Medicus in 1995 and 2005. Each journal was reviewed by the principal author and one of four independent reviewers. RESULTS: During the period, the proportion of journals requiring IRB approval increased from 42% (95% CI 32.2% to 51.2%, p<0.001) to 76% (95% CI 66.4% to 83.1%, p<0.001). In 2005, an additional 9% referred to the Declaration of Helsinki or the International Committee of Medical Journal Editors' Uniform requirements for ethical guidelines; 15% (95% CI 8.5% to 22.5%, p<0.01) provided ambiguous or no requirements. The proportion of journals requiring COI disclosure increased from 75% (95% CI 66.6% to 83.3%, p<0.05) to 94% (95% CI 89.4% to 98.6%, p<0.05); 41% had comprehensive requirements, while some addressed only funding source (6%), were vague (10%) or both (14%). Criteria for authorship rose from 40% (95% CI 30.5% to 49.5%, p<0.05) to 72% (95% CI 63.3% to 80.7%, p<0.05). Journals with higher impact factors were more likely to require IRB approval (p<0.01). Journals in anaesthesia and radiology all required IRB approval; requirements in other disciplines varied. CONCLUSIONS: Instructions to authors regarding ethical standards have improved. Some remain incomplete, especially regarding the scope of disclosure of COI. The ethical guidelines presented to authors need further clarification and standardisation

A qualitative study was conducted with 48 Chinese counselors and psychotherapists who were interviewed in 2006 and an independent sample of 50 participants who responded to a survey in 2014. This study aims to explore how the new emerging expansion of mental health practice is related to issues and challenges of dual role relationship and how the well-engrained values and social characteristics of Chinese culture influences perceptions and resolution of ethical dilemmas. The participants identified similar dual relationships in 2006 and 2014: Incidental boundary crossings, a sexual or romantic relationship, a dual social relationship, and a professional dual relationship were the most frequently reported types of dual relationships encountered by Chinese practitioners, and the socioeconomic and cultural context and the development trajectory of counseling and psychotherapy in China play a significant role in shaping practitioners’ behaviors. The comparison of the data in 2006 and 2014 indicated that practitioners in psychotherapy and counseling have an improved awareness and understanding of ethical issues, evidenced by the decreasing cases of romantic and sexual relationships and increasing cases of social dual relationships influenced by the interrelatedness of traditional Chinese culture.

The present study aims to survey Chinese mental health professionals’ attitudes toward therapeutic confidentiality with adolescent patients in specific clinical situations, and compare Chinese adolescents’ and parents’ beliefs about when most mental health professionals would breach confidentiality. A sample of 36 mental health practitioners, 152 parents, and 164 adolescents completed a survey to assess their opinions about when confidentiality should be breached in 18 specific clinical situations. Nearly half of the parents and adolescents and 78% of the therapists in our sample selected “yes” in response to the question of whether the principle of confidentiality applies to adolescents. However, 49% of parents indicated “no,” and 53% of adolescents indicated “not sure.” Compared to adolescents, parents were significantly more likely to believe that therapists would breach confidentiality for the high-breach-likelihood items. For the low-breach-likelihood items, adolescents and parents were significantly more likely than therapists to believe confidentiality should be breached. Results from this study provide data to inform the development, refinement, practical implementation, and communication of guidelines and recommendations specific to adolescents receiving psychotherapy in China.

The construal of the self is related to individuals' cognition, emotion and behavior. The aim of this study was to investigate shame in the context of interdependent-self and independent-self culture. 163 Chinese and 196 American college undergraduates completed a questionnaire about their reaction to 3 different scenarios about shameful events involving 5 different persons including self, mother, boy/girl friend, best friend and classmate. The participants reported the intensity of shame they felt in each of the situation and how close they were related to other people in the scenarios. The results demonstrated that there is a significant difference between Chinese and American participants on the levels of shame across all the scenarios, as well as for the persons involved in the scenario. It was also found that the intensity of shame was reduced as the relationship between the participants and the persons involved in the shameful events becomes remote in social distance. A significant correlation was found between closeness of relationship and intensity of shame felt. Implications for understanding cultural differences to emotions and future studies are discussed.