Tammera Cooke, Psy.D., is a 2018 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle

Dissertation Committee

Philip Cushman, Ph.D., Committee Chair

Mark Russell, Ph.D., ABPP, Committee Member

MiNa Chung, Ph.D., Committee Member


APA Ethics Code Standard 3.05, Multiple Relationships, Hermeneutic Study, Western Individualism

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This research followed hermeneutic tradition by examining what is often unquestioned in clinical practice as it pertains to the moral, political, and philosophical foundations that underlie the American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct (2002, 2010) and Standard 3.05, Multiple Relationships—it’s meanings and controversies. It did so in order to better understand the cultural influences reflected in and the political consequences that emanate from the Ethics Code. Data for this study were collected via semi-structured qualitative interviews with two American psychologists who lived in Washington State, experienced living and working in rural communities, and had practiced with patients from cultures other than their own. This process generated ideas about the larger picture of the social landscape in which the participants and psychotherapy in general are embedded. The interpretive method of analysis proposed by hermeneutic researchers Leonard (1993), Plager (1994), and Stigliano (1989), was used to identify key themes that arose from the data. Three over-arching themes were derived: Participants’ confused, anxious, and fearful reactions to Standard 3.05; Problems with the Ethics Code; and Defenses the Participants’ enacted to protect against their conflicts and fears. By abstracting from the themes and case-studies, two broad conclusions emerged. First, the authors and interpreters of the APA Ethics Code seem to have understated the influences of other cultures, traditions, and various ethnic understandings that run counter to Western ideas about individualism and communalism and small town/rural life. Second, the interviews contained material that indicated the proceduralism present in mainstream psychology is an impediment to a better understanding of moral issues, relational processes, and thus ethical outcomes in the work of psychologists. Reflections about possible areas for further research and unanswered questions about ethics education and training are also included. This dissertation is available in open access at AURA, Ohio Link ETD Center,



Tammera Cooke, Psy.D., 2018

ORCID Scholar # 0000-0002-0293-2288

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