Ethical dilemmas regularly happen. Sometimes they pop up almost instantly and sometimes they develop slowly over time. No matter how quickly or slowly they happen, it is important to have an ethical decision-making model in place to structure information so that the dilemma can be easily resolved.   

As an educator who teaches a course in ethics, I strive to prepare students for ethical issues they will face in clinical practice.  I provide numerous and varied vignettes, and together we apply the ATCB Code of Ethics to each. We start by examining the ATCB Code of Ethics. The ATCB Preamble states “The Code of Ethics, Conduct, and Disciplinary Procedures is designed to provide art therapists and credential applicants with a set of Ethical Standards to guide them in the practice of art therapy as well as Standards of Conduct to which every credentialed art therapist and credentialed applicant must adhere” (ATCB Preamble para. 3). Also, the ATCB Code 1.1.13, states: “Practitioners of art therapy must conform to relevant federal, provincial, state, and local statutes and ordinances that pertain to the provision of independent mental health practice. Laws vary based upon the location of the practice. It is the sole responsibility of the independent practitioner to conform to these laws. Art therapists shall be knowledgeable about statutes and/or laws that pertain to art therapy and mental health practice in any jurisdiction (state, province, country) in which they practice” (ATCB, 2019). Moon (2015) addressed several topics that are common for ethical dilemmas to occur, and Remley and Herlihy (2016) discussed the importance of avoiding the “slippery slope” when confronted with a dilemma. The “slippery slope” phenomenon happens when “one begins to compromise one’s principles [and] it becomes easier and easier to slide down the slope, diminishing one’s sense of moral selfhood” (Remley & Herlihy, 2016, p. 7). Remley and Herlihy (2016) suggested having an ethical decision-making model in place so that the information can be carefully considered and examined as one begins the process of resolving the dilemma. 

Many clinicians support and advocate for incorporating an ethical decision-making model to help organize the relevant information (Furman, 2013; Remley & Herlihy, 2016; Koocher & Keith-Spiegel, 2016). This is because dilemmas can be complex with several components (Remley & Herlihy, 2016) and having an ethical decision-making model in place can act as a guide to ethically resolving the dilemma (Koocher & Keith-Spiegel, 2016).   

“Interconnected Issues” by Gloria Eslinger, ATR Acrylic on Paper 36 X36

Among hundreds of ethical decision-making models, no single model works for everyone. I encourage each person to examine resources (such as those listed in the references) to find a model that works with one’s own clinical practice and style. Two examples of an ethical decision-making model have been proposed by art therapist, Lisa Furman, and by professional counselors Dr. Barbara Herlihy and Dr. Ted Remley. Dr. Remley is also an attorney whose main focus is counseling and the law. 

The first model is proposed by Lisa Furman (2013):  

  • Pay attention to uncomfortable feelings you may be experiencing;
  • Familiarize yourself with federal, state and professional guidelines;
  • Determine if there is a conflict between personal values and professional guidelines;
  • Identify all the individuals who would be affected by your decision;
  • Determine if the dilemma has legal as well as ethical consequences;
  • Identify all the possible outcomes;
  • Assess the level of benefit or harm that may occur;
  • Seek guidance from a trusted supervisor, mentor or colleague.

(Furman, 2013, p. 25).

The second model, proposed by Remley and Herlihy (2016) includes:

  • Identify the problem;
  • Involve the client in the decision-making process;
  • Review relevant codes of ethics and professional literature;
  • Consider the principles and virtues;
  • Tune into your feelings;
  • Consult with colleagues or experts;
  • Consider the context;
  • Identify desired outcomes and consider possible actions to achieve the outcomes;
  • Choose and act on your choice.

(Remley & Herlihy, 2016, pp. 16-17).

Both models provide concrete steps that will help address the dilemma. Both models provide suggestions that will help resolve the dilemma. The strategies provided in these two models do not necessarily need to be sequential. Rather each model offers a strategy to begin the process of examining the complexity of a dilemma. 

Dilemmas can be complex in nature (Moon, 2015, Remley & Herlihy, 2016; Koocher & Keith-Spiegel, 2016; Furman, 2013). As stated previously, there is no one model that is “right” for everyone. What is important is to have an ethical decision-making model in place that provides a comprehensive, systematic and consistent way to confront, address, and resolve a dilemma.  Avoiding all dilemmas may not be realistic; Remley and Herlihy (2016) recommended three things a clinician can do to avoid problems that may result in an ethical dilemma. They are as follows:

1)   Keep current with changes to professional codes of ethics, as changes can occur which advance the knowledge and practice within the field;

2)   Stay informed of changing state and federal laws as they pertain to your practice; 

3)   Stay connected with fellow professionals. (pp. 213-214). 

Knowing and abiding by the ATCB Code of Ethics will provide guidance for potentially avoiding dilemmas. That said, if and/or when an ethical dilemma occurs, being proactive and adopting an ethical decision-making model that works for you will make it easier to confront, address, and resolve the issue ethically, thereby avoiding that “slippery slope.”


Furman, L. (2013). Ethics in art therapy: Challenging topics for a complex modality. Philadelphia, PA: Jessica Kingsley.

Koocher, G. P. & Keith-Spiegel, P. (2016). Ethics in psychology and the mental health professions: Standards and cases (4th  ed.). New York, NY: Oxford Press.

Moon, B. (2015). Ethical issues in art therapy (3rd  ed.). Springfield, IL: Chas C Thomas.

Remley, T. & Herlihy, B. (2016). Ethical, legal and professional issues in counseling (5th  ed.).  Boston, MA: Pearson.

Written by:

Katy Barrington
Treasurer-Art Therapy Credentials Board