"The concept of clinical dilemmas in psychotherapy has been difficult to conceptualize because of their nondiscrete quality. The varieties and range of clinical dilemmas in psychotherapy challenge attempts at taxonomy and categorization. In part, because of the inseparable and inherently interpersonal character of psychotherapeutic treatment, clinical dilemmas are ever present within the psychotherapeutic context, regardless of the type of therapy or theoretical framework being used or the availability of a therapy manual for consultation. Other theorists have also postulated concepts that have transtheoretical relevance as well. When Bandura (1977a) first advanced the notion of self-efficacy in treatment, he viewed this as a potentially unifying concept in behavior change processes. In sum, like the concepts of stages of change, self-efficacy, or the therapeutic alliance rupture, the perspective advanced presently is that the notion of the clinical dilemma in psychotherapy, whether predominantly technical or ethical or admixture, transcends the particular mode of therapy being used by the clinician (Scaturo, 2002b). Psychotherapists, regardless of their particular theoretical persuasions, frequently find themselves grappling with similar judgment calls in the treatment of a given patient or family (Scaturo, 2001). The comprehension of this complex notion, in both its technical and ethical realms, likely differentiates the professional psychotherapist from the behavioral technician and may ultimately lead to the patient's improvement and betterment." (PsycINFO Database Record (c) 2006 APA, all rights reserved)