After reading this chapter, I finally saw a clearly-formulated basis of psychotherapeutic assistance for patients. One can argue about the paradigms and methodology of work, but there are no doubts about the ethical principles set forth here. The relationship of trust between patients and their therapists is the foundation of psychotherapeutic treatment. In many cases, this relationship alone helps a patient more than anything else.

I fully share the assumption that, “trust between a psychologist and a patient is a necessary part of a relationship, without which, I believe, effective collaboration is impossible.”

I consider as indispensable elements the following ethical principles (noted in this chapter) when working with patients:

1. Autonomy
2. Non-maleficence
3. Beneficence
4. Justice
5. Informed Consent

I believe that if these principles are not incorporated in the basic philosophy and approach of a psychologist’s interactions with the patients, then the approach that a psychologist takes with patients will not achieve integration and will most likely not make sense. The patient cannot be open to interventions if there is no trust or when s/he does not feel safe.

What exactly do I mean when I speak about building a relationship of trust between psychologists and patients? From the psychologists’ perspective, it includes the following attitudes:

• I am open towards my patients
• I express sympathy and compassion for my patients’ problems
• I create a safe and hospitable environment
• I show respect for patients’ feelings and ideas
• I am attentive to details
• I almost never change meeting times and I am never late
• I explain the schedules and plans of our interactions to all my patients
• I am non-judgmental and do not give voice to all my opinions and assessments about the thoughts and feelings of the client
• I try to see the essence of my patients’ experiences and positions in each phrase that they
• I maintain my borders and boundaries with the patient

In general, I consider my set of above-mentioned measures as useful and successful because so far, I have felt comfortable and confident in almost all my interactions and relationships with patients.

In addition, I agree with the following statements and approaches that can be used for preventing iatrogenic damage:

1. Therapists must avoid viewing and expressing that it was fate that had brought tragedy for their clients, thus avoiding reinforcing the patient in the role of a victim.
2. Therapists must avoid giving any negative prognosis that serves no purpose other than to only intensify the self-fulfilling and self-destructive prophecies of their patients and demobilize the defiant power of patients’ human spirit
3. Therapists must avoid giving diagnoses without explaining its significance and meaning. The client needs to know about and understand her/his illness.
4. Therapists must avoid establishing any kind of personal and/or intimate relationship with their client.
5. Therapists must make certain, at a strictly professional level, that the client understands the illness, the treatment, and the prognosis.
6. Therapists must avoid giving unconfirmed and/or careless interpretations of their patients’ symptoms

Another very important, although obvious to me, ethical aspect is that, if a person cannot be cured, this does not mean that s/he cannot be helped. Even when a condition is not curable with known medicines and therapies, s/he is and still remains a person, continues to feel the pain and continues to suffer. The therapist may look into and explain to the patient the ways in which s/he can manage the symptoms effectively to reduce the impact, pain, and suffering for the patient and those around her/him. I am convinced that psychological assistance is possible and makes sense, as long as a person lives.

In this chapter, I also found the following existential analysis and importance of integrity as important for myself as a goal underlying my work:

"The main purpose of a theory is to provide consistency and coherence in our decision making .... If we are consistent and coherent ... we will have a greater degree of internal unity and integrity”.

This is exactly what corresponds with and resonates with me the most from this chapter. People who come to consultations with psychotherapists most often need precise and holistic awareness about themselves, which, in theory, allows them to subsequently make better decisions and bear the responsibility for improving their lives.

Ethics is the basis of psychological and psychotherapeutic help and support.

At the end of this essay, I reiterate that without incorporating the underlying ethical constructs and aspects raised in this chapter in therapeutic help to patients, I consider working with a patient meaningless.