DIRECTIVE OR NEUTRAL PSYCHOTHERAPY? A QUALITATIVE RESEARCH ON CLINICIANS’ BELIEVES AND INTERVENTIONS REGARDING PATIENTS’ PERSONAL AUTONOMY

The definition of patient personal autonomy and its violations in clinical practice is understudied and relatively absent topics in professional codes of ethics. "is multidisciplinary research (clinical psychology and moral philosophy) aims to investigate the role of the psychotherapist and his interventions regarding patient autonomy. A semi-structured interview was constructed, exploring: episodes in which clinicians took a directive position; whether clinicians considered such interventions in continuity with their theoretical models, and; clinicians’ opinions on the topic of autonomy. Interviews’ transcripts have been analyzed with Consensual Qualitative Research method. 45 psychotherapists were interviewed (mean age = 41.8). Several themes emerged, and psychodynamic therapists seems to show a moral dilemma related to maintaining a position of neutrality and a need to assume paternalistic a!itudes (which are common and egosyntonic among cognitive behavioral therapists) in extreme circumstances. Results are discussed according to the main orientations of moral philosophy on the concept of personal autonomy (internalist, externalist, expressivist), referring to their declinations in the field of bioethics and medical ethics.