The Psychotherapist as Researcher: Ethical Challenges of Writing About Patients in Case Study Research in the South African Context

Psychotherapy case studies have been proposed as a way of contributing to research, teaching and a practice of psychology that is more responsive to the social and material challenges faced by most South Africans, thereby responding to longstanding critiques of the discipline's inaccessibility and irrelevance and supporting efforts to decolonise it. However, this kind of research raises distinctive ethical challenges in the South African context, which this paper considers. We begin with an overview of the regulatory frameworks governing psychological practice in South Africa and highlight the dual role tensions facing the therapist as researcher. We then discuss the challenges associated with when and how to seek informed consent, which are especially acute in case study research, and in contexts where decision-making is understood in more relational terms. Next, we consider the tension between protecting patients' identities and producing useful, authentic accounts. Finally, we discuss the moral risks and possible harms of this kind of research, including its impact on the therapeutic relationship, stigma-related vulnerabilities and patient/therapist power asymmetries, all of which require careful management to safeguard patients' well-being.