Ask a room of counselors how they feel at a mandatory ethics workshop and you'll hear what Dr. Dan Rose told me on the latest Got Therapy?: "one of two things." Either "a sense of fear and dread because the things they're talking about are going to get me destroyed," or "I'm bored to tears." Dan once got through a workshop by writing haikus.
That is an indictment of how we teach ethics, and our profession should take it seriously.
Here is the position: ethics training should build the clinician's capacity to stay steady and think inside an ethical dilemma — not just their memory of the code.
Fear-based training produces a predictable clinician. Dan supervises them. A client asks a beginning therapist's age, and the therapist cites a code section. A client brings a cupcake, and the therapist refuses it on principle. The question Dan puts to them — "What is the optimal response if someone brings you a cupcake, right?" — is one many of them have never been invited to ask.
The by-the-book refusal feels safe. Often it isn't safe for the client. For someone who came to therapy lonely, a reflexive no "in a capital T therapist way" can be "a subtle or not so subtle rejection" — one more in a lifetime of them. Dan's diagnosis of why we do it is uncomfortable and, I think, correct: "we often follow the rule books because of the disturbance. It is a defensive way to be safe. It is an intervention that's really about us and not our patient."
None of this is an argument for loosening the codes. The bright lines stay bright. As Dan put it, "the reason you don't have sexual contact with your patient is because it's bad for them." The codes exist to protect "the individual in your care so you can help them." The argument is that clinicians must understand that purpose well enough to apply it when the situation isn't on page 22 — and most situations aren't.
Dan's alternative draws on Epicurus. Begin from ataraxia, "a state of pleasurable balance and peace of mind," and ethics "becomes a verb. It becomes something you do." A clinician working from that base can feel the disturbance a client provokes, pause — "let me take a moment to think and feel my way through this event" — and choose the response that serves the client. Dan even argues that some treatments "require ethical dilemmas": "that's not a bug. That's a feature."
What would change? Ethics CE would spend less time on cautionary tales and more on rehearsing hard moments. Supervision would routinely ask whom a boundary decision protected. Graduate programs would treat the capacity to tolerate ethical tension as a competency, built over years — a friend once told me it "takes eight to ten years to make a counselor" — rather than a test score.
Dan hopes clinicians will stop getting "lost in ethical dilemmas simply being dilemmas" and start seeing "them as opportunities." That won't happen while we teach ethics as something to be afraid of.
Got Therapy? is hosted by Michael Baltimore Ph.D. and Dan Rose Psy.D.