Effects of Caregiver Stress Upon Ethics at-Risk Behavior Among Florida Licensed Marriage and Family Therapists

A critical review exploring "at-risk" ethical practice of marriage and family therapy determined that there existed no empirical literature focusing upon the antecedent, correlative, or causal factors of unethical behaviors among LMFTs. Responding to this gap, this study was designed to test the hypothesis that a significant relationship would be found between caregiver stress and at-risk ethical practice among a sample of LMFTs of Florida. Two research questions were developed to help guide an exploratory component of this study with the hope of identifying factors contributing to the understanding of at-risk practice. Surveys containing a demographic collection tool, an instrument to measure the dependent variable (at risk ethical practice), and three instruments to measure five independent variables (caregiver stress, compassion fatigue, burnout, and satisfaction with life) were sent to a randomly selected sample of one-half (n=549) of the LMFTs in the state of Florida. After a 90-day data collection window, 82 useable surveys were returned (15%). The data were found to be significantly non-normal. Upon analyses, no significant relationship between caregiver stress and at risk practice emerged; therefore the null hypothesis was not rejected. In the exploratory portion of the study, only compassion fatigue emerged with a significant predictive relationship (R2=.140; p=.002) for at-risk practice among all the independent variables and demographic data. Nearly all respondents (86.4%) identified at least one area for which they were at-risk for practicing outside the boundaries of the AAMFT Code of Ethics. The sample for this study was remarkably healthy with positively non-normal scores for caregiver stress, compassion fatigue, burnout, and satisfaction with life. The validity of this study was challenged by a very low response rate, a non-normal and very healthy sample, and unacceptably poor psychometric performance of the Ethics At-Risk Test for Marriage and Family Therapists (Brock, 1997)—the instrument utilized to measure the dependent variable. Recommendations for future research resulting from the findings of this study primarily advocate studies designed to resolve the psychometric problems of measuring at-risk ethical practice. Following the resolution of the scaling problems, a program of research that recruits larger and more representative samples of cross-discipline professionals and compares this sample with professionals who have been adjudicated for ethical violations is suggested to begin to determine the antecedent, correlative, and causal factors related to professional caregivers' practice outside the boundaries of ethical and legal constraints.