Clinical psychologists encounter situations for which no prescriptive professional standards exist, necessitating therapists’ judgment to determine an appropriate course of action. This study examines the first step of therapists’ decision-making process—recognition of the potential for a nonsexual multiple relationship. Based on the existing literature and previous empirical findings, our hypotheses are that (1) therapist sex (female), higher scores on the PAQ Expressivity (femininity) scale, higher scores on the VIA-IS-V3 Self-control scale, and participants’ ranking Nonmaleficence as the most important ethical principle would be significantly (positively) predictive of Recognition scores, (2) higher scores on the PAQ Instrumentality (masculinity) scale, higher scores on the VIA-IS-V3 Inquisitiveness scale, and male (sex) participants who are presented with a vignette describing a potential nonsexual multiple relationship with a female client would be significantly (negatively) predictive of Recognition scores, and (3) PAQ Expressivity and Instrumentality scale scores would explain more unique variance in Recognition scores than therapist sex. An ordinal logistic regression analysis was used to investigate variance in therapists’ first step in the decision-making process. Findings indicated that our overall model did not fit the data and there was no significant difference between the baseline model and the final model. However, examination of individual predictor variables revealed that the female therapist and female client vignette combination was a significant positive predictor of Recognition score. Furthermore, exploratory analyses found that therapists who had the least clinical experience had less than expected Recognition scores of 0 (no recognition of an ethical issue) and therapists who had the most clinical experience had more than expected Recognition scores of 0. Overall, the findings of this study suggest that the influence of therapist and client factors on the decision-making process may be more salient to in later steps of the ethical decision-making process. The process at the immediate, reactive level (recognition) may be distinctly different from those at the levels of moral reasoning, establishment of moral intent, and/or engaging in moral behavior (Rest, 1979). With this, future studies should examine later steps of the therapist ethical decision-making process when confronted with a potential nonsexual multiple relationship with a client.

LLU Discipline





School of Behavioral Health

First Advisor

Janet Sonne

Second Advisor

Hector Betancourt

Third Advisor

Whitney Braun

Fourth Advisor

Jennifer Weniger

Degree Name

Doctor of Psychology (PsyD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Psychotherapists -- Professional ethics; Decision making -- Moral and ethical aspects; Professional-Patient Relations -- ethics; Interpersonal Relations


Doctoral Project

Page Count

ix, 129 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Psychology Commons