When expertise and ethics diverge: lay and professional evaluation of psychotherapists in Israel

Do psychotherapists' unethical practices influence how they are perceived? The 202 Israeli lay and professional psychology participants rated systematically varied descriptions of effective therapists and potential clients under conditions of no difficulties (standard), practice without a license, and a previous sexual boundary violation on indexes of evaluation and willingness to refer. Participants completed a measure of important variables in therapist selection. Effective standard therapists were rated most favorably, unlicensed therapists were rated favorably, and therapists who violated sexual boundaries in the past were rated least favorably. When results were analyzed by respondent characteristics, laypersons rated unlicensed professionals (p < .01) and sexual boundary violators (p < .0001) more positively than did clinical psychologists. Men rated the violators more favorably than did women (p < .05). Factor analysis of therapist selection measures identified professional and personal factors, but only the former were associated with ratings of "problem" therapists. The results underscore the gap between ethical standards and applied decisions made by professionals and laypersons. Further investigation is needed to ensure quality care in both professional and consumer approaches to psychotherapy.