Psychology for Sale: The Ethics of Advertising Professional Services

Canadian Psychology, May 2004 by Shead, N Will, Dobson, Keith S

Consumers of psychological services have unique needs that make it unlikely that all psychologists can satisfy all potential clients. Besides the obvious reason that not all psychologists possess the knowledge or skills in specialty areas to assist people with certain problems, different people just prefer to work with different types of practitioners. The quality of relationship between client and psychologist depends on the intricate interaction between a number of factors such as physical appearance, gender, speech patterns, treatment setting, values, and beliefs (Koocher, 1977). An individual with extreme shyness, for example, may prefer to work through his or her problem slowly with a therapist who emphasizes helping the client discover their relevant strengths before exposing him or her to aversive social situations. Another individual with extreme shyness may prefer a more time-oriented therapist who encourages quick resolution of such problems. For each of these individuals, his or her personal preferences and demographics will affect the quality of services he or she receive. It may be argued that effective therapists do not rigidly adhere to one style and instead alter their approaches to address the specific needs of a client. However, psychologists are generally tuned in to their own basic orientation and style of interaction.

If an individual is more likely to seek a certain type of psychological service because it appeals to him or her more than others, then that intervention is probably the most relevant to the needs and characteristics of that individual. A more appealing, and thus more motivating, intervention has an even higher likelihood of success when the type of intervention interacts with unique variables of the practitioner to suit the needs of the client. As Koocher (1977) suggests, "One client may seek a fatherly Freudian with a beard, and another's needs may be directed toward a radical feminist who's under 30" (p. 155).

The issue is not about the scientific effectiveness of the service. As the CPA Code of Ethics states, clients should be provided with the most effective treatment when there is a scientifically proven approach that is known to be better than any other treatment (cf. Dobson & Craig, 1998). But when there are several alternatives to treatment that are equally effective or when there are subtle client-therapist variables that are known to affect service outcomes, the consumer of the service should be able to consider all of this information in order to make the best informed decision possible.

Koocher (1994) contests, "...the nature of psychotherapy is such that it is not easily compared across vendors in the same way breakfast cereal...can be" (p. 322). he argues that advertising cannot provide information about the clinician's skill or competence and only colleagues should purvey this information and use their knowledge to make wise referrals (Koocher, 1994). Unfortunately, much like the providers of psychological services, referral sources are not equal in skill and competence either. Not all referral sources will have accurate information about a colleague nor will they necessarily use that information to make the best referral possible. Also, many clients seek treatment on their own. These clients may choose a practitioner on the basis of a number of factors that have little or nothing to do with competence or the type of advertising (e.g., gender, ethnicity, proximity of office to client, etc.). Howpvpr, by including claims of unique or one-of-a-kind abilities in advertisements, potential clients can base their decisions on factors that may be more relevant to treatment success rather than arbitrary variables. So although providers of psychological service cannot be easily compared, part of the reason may be that psychologists are reluctant to advertise their unique qualities to the public!