Episode 24: The Nudge in Ethics, Psychotherapy, and Public Policy

Nudge theory has gained popularity in behavioral science, mainly in the field of behavioral economics. The theory broadly indicates that indirect suggestions or contextual changes can influence choices or compliance with healthy behaviors or decisions. Nudge theory contrasts its approach with direct suggestions, instructions, and education. In psychotherapy, we nudge patients frequently. Sometimes we do it consciously, other times unconsciously. Because of this potentially powerful influence over our clients, we must remain vigilant about our nudges in the form of soft paternalism or projecting our values onto our patients. Psychologists must be mindful of the power imbalance in the psychotherapy relationship and our duty to respect client autonomy.

John’s guest is Dr. Jennifer Blumenthal-Barby, Associate Professor of Medicine and Medical Ethics, Center for Medical Ethics and Health Policy, Baylor College of Medicine, located in Texas.

At the end of the podcast, the participants will be able to:

1. Describe what “Nudge Theory” is;
2. Explain how Nudge Theory applies to ethics in the psychotherapy relationship;
3. Name two ways that psychologists can use nudge theory to promote healthy behaviors.

References

Blumenthal-Barby J.S., Burroughs H. (2012). Seeking better health care outcomes: the ethics of using the "nudge". American Journal of Bioethics. Volume 12(2): 1-10.

Blumenthal-Barby, J.S. McCullough, L.B., Kreiger, H. and Coverdale, J.C. (2013). Methods of Influencing the Decisions of Psychiatric Patients. Harvard Review of Psychiatry, Volume 21 (5), 275-279.

DeAngelis, T. Coaxing Better Behavior. (2014). The Monitor on Psychology. Volume 45(11): 62.

Barkan, R. Ayal, S. and Ariely, D. (2010). Ethical dissonance, justifications, and moral behavior. Current Opinion in Psychology, Volume 6, December 2015, 157-161.

Sunstein, C. R. Fifty Shades of Manipulation. (2015). Journal of Behavioral Marketing.

Sunstein, C. R. The Ethics of Nudging. (2014). Social Science Research Network.