The Integration of Personal and Professional Ethical Decision Making Constructs in Trainee Clinical Psychologists

Abstract

Ethical decision-making is an important but challenging aspect of the role of a clinical psychologist. Little research has been conducted concerning how clinical psychologists make ethical decisions, with even less known about how trainees manage the process during professional training. The current study aimed to examine how trainees make ethical decisions, and how this process differs between more and less experienced trainees. Thirty-nine trainee clinical psychologists were recruited from a total of 17 doctoral training programmes in the United Kingdom. The sample recruited was demographically similar to the training population. A cross-sectional design was used to examine differences between first year (n = 19) and third year (n = 20) trainees. An online version of The Defining Issues Test questionnaire (DIT-2, Rest et al., 1999) was used to measure level of sophistication of ethical development, and individual face to face or Skype repertory grid interviews examined the integration of trainees’ personal and professional ethical decision-making construct subsystems. The vast majority of trainees were found to adopt a sophisticated approach to ethical decision-making, with half of all ethical decisions made from within a postconventional schematic approach. However, a small minority operated from within schemata based on maintenance of societal norms or personal interests. A deterioration in sophistication of thinking was demonstrated for more experienced trainees. Less experienced trainees were found to rely comparatively more heavily on their personal construct subsystems than more experienced trainees and vice versa. Increased integration between the subsystems over the course of training was demonstrated. The study demonstrates support for an acculturation process occurring throughout training. Implications of this and ideas for future research are discussed.