There is an increasing amount of discussion about poor psychotherapeutic practices, the absence of clear legislation, and influencer-style marketing of private practices. However, far less attention is given to the fundamental postulates and principles of ethical codes, which actually provide solid and, to a certain extent, clear guidelines in all of this.
Ethics is not just a cliché. Ethical principles are clearly defined. Both service users and laypeople benefit from knowing them, as this is one of the ways they can protect themselves. I strongly support the promotion of mental health, and I am genuinely glad that psychological difficulties carry less stigma today. At the same time, I have the impression that the popularization of this topic, combined with technological advancement, has led to a lack of clarity, space for manipulation, and potential misuse. People self-diagnose. Undereducated yet self-proclaimed “experts,” or self-“healed” individuals, confirm these diagnoses. This creates a general relativization of serious psychological and neurological conditions, or, on the other hand, the pathologization of normal human experiences, emotions, and states.
I understand that this is a global issue, but I will focus on Serbia. I will repeat something that, over the past months, probably already makes you want to roll your eyes when you hear it: there is no psychotherapy law, which means that legally it is not clearly defined who is allowed to practice psychotherapy.
Here is where “recipes” come in:
For those of us working in mental health: responsibility, which includes ethics + transparency. Ethics is not self-explanatory and must not be treated as an outdated norm. It must guide practice. Transparency refers to clearly presenting formal academic education, as well as further training and professional development.
For users: being informed about what is acceptable and what is not in the work of mental health professionals. There is information that a practitioner must provide, and information they are not required to provide.
For example, it is completely appropriate to ask about the therapeutic orientation or completed degrees; these are pieces of information that must not be withheld.
On the other hand, whether a practitioner is married or single is not information they are obligated to share. This depends on their personal boundaries.
Of course, it is not forbidden for them to share personal information or experiences, but such disclosures must never be used to misuse the session or shift focus onto the therapist’s needs.
While we remain in a constant state of transition and provisional solutions, relying on personal responsibility, let us go through the basic rules of ethics, because they protect mental health.
In the following text, I will use the term psychotherapy, partly because it is a gray zone, but here I include all forms of counseling work, psychological and psychiatric practice. Keep in mind that some professions that are regulated by law, such as psychiatry and psychology, are legally bound by certain ethical principles, for example confidentiality of your data. Unfortunately, those that are not regulated by law are, in theory, bound only by personal moral standards and integrity to adhere to ethical codes. When ethical codes are violated in such cases, consequences are usually internal to the profession (e.g., loss of certification or membership in an association, which does not prevent the person from continuing to work), while legal responsibility arises only when general laws applicable to all citizens and professionals are violated.
So, as you already understand, one of the principles is confidentiality (privacy of data). Exceptions exist in specific cases where there is serious risk to life or safety, when there is violence against children or vulnerable persons, when a court orders disclosure of information, or when the client gives explicit consent.
Alongside confidentiality and its clearly defined exceptions, the ethical framework of psychotherapeutic work rests on several principles most clearly visible in the therapeutic relationship itself. First, there is respect for client autonomy. Therapy is not a space where someone else makes decisions for you, but a process through which you come to your own informed choices by understanding yourself better. The psychotherapist helps the person gain clearer insight into their internal decision-making space. Alongside this is the principle of acting in the client’s best interest: the idea that any intervention is justified only if it truly serves the person in therapy, not the therapist’s needs, interpretations, or personal framework.
In practice, this means continuously returning the focus to the client and asking: does what I am doing actually help them, not me?
Equally essential is the principle of non-maleficence. It does not mean that mistakes must never happen, but that the therapist has a duty to recognize them, understand them, and minimize their consequences. In practice, this means careful interpretation, pacing that follows the client, and constant checking of how the work affects the safety of the relationship. It also means that the client has both the freedom and the safety to say when something does not feel right, when a certain approach does not suit them, or when discomfort arises. This becomes a space for exploration if both client and therapist agree. Sometimes such moments lead to profound sessions; sometimes, unfortunately, they do not—and that is acceptable, because there may be another professional who is a better fit.
A special place belongs to the therapeutic relationship and its boundaries. This relationship is close, yet clearly structured; precisely this boundary makes it safe. It does not exist to create distance, but to protect the space in which the client can explore themselves without pressure, role confusion, or misuse of power.
Here we encounter something that, at least in my practice, often arises: requests from friends or relatives to begin therapy. That trust can feel flattering, but working in such cases would be unethical because it compromises a neutral therapeutic space. This also includes situations where there may be conflicts of interest or overlapping roles. It goes without saying that if a psychotherapist flirts with you or enters into a sexual relationship with you, they are seriously violating all principles of practice. The therapeutic relationship, while striving for equality, is in essence quite one-sided. The therapist has a great deal of information about you, possibly more than your partner or best friend, while you know very little about them. Therefore, even if you feel you have fallen in love with your therapist, it is likely due to other mechanisms—but you should still feel free to address it, so it can be explored and the possibility of continuing the work can be evaluated.
The principle of fairness and non-discrimination is based on the idea that access to and quality of support must not depend on a client’s personal characteristics. In practice, this also means ongoing professional responsibility to recognize one’s own biases and ensure they do not shape the therapeutic process. It is also important to note that this does not mean a therapist must work with someone toward whom they hold strong biases; on the contrary, it may be more appropriate to refer the person elsewhere while those biases are worked through.
Finally, but no less importantly, marketing in psychotherapy is ethical when it informs, educates, and clearly presents the therapist’s way of working, without manipulation or creating fear or a sense of being “inadequate.” It is unethical to use guilt, intimidation, false promises of quick “cures,” to casually assign diagnoses online, or to build dependency through a cult of personality. The goal of responsible presentation of therapy is not to pressure people into thinking they “must” go to therapy, but to provide a safe and transparent space in which a person can freely decide whether they need support.
I have worked with many clients who were witty, intelligent, and creative, and who felt like they could have been excellent friends. We shared value systems and did meaningful work together. And yet, they never became my friends—not even after the process ended. It is not about you; it is about ethics.
Every small step toward improving practice matters, especially in times of transition.