4/ Editorial introductions

Chris Stevenson concludes the second section of the text, highlighting the interplay of the themes developed thorough the preceding two groups of chapters: There has to be a personal struggle to develop an ethical practice; and one may employ specific means in order so to develop.

A patient exists as part of a family or other social system, as well as manifesting a number of internal systems such as cognitive schema, object-relational structures, endocrinological processes and so on. Clearly, a strong therapeutic prejudice by a clinician is likely to influence which part of the system is identified as well, which part is identified as ill. No doubt many of the clinician's more personal characteristics will also play a part in this ascription of health and illness. In chapter sixteen Chris Stevenson explores the ethical and practical difficulties in avoiding such prejudice and enabling truly informed choice of therapeutic approach and treatment plan by clients. Using a clinical vignette of some family work in which she has been involved, Chris explores the way systems theory can help in working with the group as a whole rather than one or another member. She discusses the advantages of this way of working. She also highlights the dilemma about whether this way of working itself allows free choice by individual members of the group, or an element of coercion. She reinforces the idea that a strong sense of openness to feedback from colleagues, in the context of a supervision group, offers some protection from ethical 'blind-spots' in this respect.