Development of Ethical Dilemma Distress Scale for Mental Health Practitioners (EDDS-MHP)

An ethical dilemma arises when a psychologist encounters a situation where it is unable to find an immediate resolution. In psychotherapy, this situation can act as an "ethical canary," similar to a canary in a mineshaft serving as an early sign of trouble. This study aimed to create a scale for measuring the ethical dilemma distress that is experienced by mental health practitioners when dealing with ethical dilemmas in their practice. The study was conducted in three phases: Phase I involved generating items, followed by Phase II, which encompassed constructing the scale, and in Phase III, the scale underwent reliability and validity analysis. Expert review was sought from 8 experts on 75 items developed in the item generation stage. The assumptions for factor analysis were satisfied as KMO and Bartlett's test of sphericity were significant and significant correlations were found within the items. An exploratory factor analysis (EFA) with principal component analysis (PCA) was conducted on 27 items, employing Promax rotation. EFA suggested the retention of four factors, which included ethical distress in clinical practice, ethical quandaries concerning professional boundaries, ethical disclosure dilemmas, and conflicts of values leading to distress. The Ethical Dilemma Distress Scale for Mental Health Practitioners (EDDS-MHP) was thus found to be a reliable and valid tool for the assessment of ethical dilemma distress among mental health practitioners. The instrument developed can be a crucial step in timely and accurately assessing ethical dilemma distress among mental health practitioners. It may also help to develop a tailored ethical training program as well as design interventions to inculcate ethical decision-making skills.