If you were facing a difficult ethical dilemma, after identifying the problem and the potential issues involved, what would be, using Corey's model, one of the first places that you would look for assistance in the resolution of the dilemma She began to provide psychotherapy to Mr. DiMencha, a 52-year-old, who suffered with depression. Dr. Thomas normally does not handle EAP services, but today several staff members are either ill or overbooked, so Dr. Thomas responds to EAP requests during the day. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. The clients boyfriend expressed that she should never discuss this with anyone. Has data issue: true He promised to call her back within a week. Dr. Jordan returns the phone call. Results will be available to you and the patient online. Dr. Smith asked if he needed to inform the patient of his impressions of the report and the seemingly erroneous conclusions. If you were the psychologist, what would be your emotion response to this situation? They developed a good therapeutic alliance. As the session winds down, Mr. Drapier spontaneously asks for a second opinion about his treatment with Dr. Cooper. A therapist had an intake appointment with a new client. endobj However, Cynthia also realized that she didnt have much training or experience working with clients with eating disorders, so she decided to attend a week-long seminar on the treatment of eating disorders offered by the local community mental health center. View all Google Scholar citations Standards of Practice, B. Counselling Relationships, Confidentiality. To provide hypothetical vignettes based on ethical/legal dilemmas in my own practice. Since the web developer/consultant wants to get that page up and running, he suggests that they use some positive ratings and responses from Angies list and several other online rating sites that tell positive stories and experiences with Dr. Popeil. The attending psychiatrist concurs with the discharge plan and advised Dr. Solomon not to worry about it. In fact, the psychiatrist encouraged the psychologist to omit any reference to the patients comments about the neighbor in treatment summaries or clinical notes as hysterical nonsense.. The most frequent ethical dilemmas involved the limits of confidentiality, confusion about counsellors' professional roles in school settings, uncooperative behaviours among stakeholders, and . Looking through his files, the therapist cannot find his file, so it must have been more than five or six years ago. Dr. Tell agreed to contact someone to discuss whether Dr. Tell had to report this information to the police or Child Protective Services. The attorney-patient indicates that he earns about 2.5 times what the psychologist asked. How would you feel if you were the consultant? During the current session, the confides that he has made a new female friend. iRE]7*ZG; K5|h{. In the process of conversation, Dr. Thomas realizes that Chuck is the son of her next-door neighbors. Feeling somewhat uncomfortable with the medication management issue, the therapist indicates that she will have to look at her schedule and call him back. The survey consisted of 10 vignettes based on the above ethical issues in. Simultaneously, he strongly believes he made the right decision. The therapist is involved in a busy practice, specializes in treating eating disorders, and receives only occasional referrals from this physician. Ethical dilemmas are important puzzles with no easy answers but are fun to contemplate. Encourage the client to file a complaint with the State Board of Psychology. Finally, since these are teaching tools, any teacher, supervisor, or mental health professional can use these vignettes as part of ethics education. After you finish you can compare your response and rationale with our response and our rationales for each of these vignettes. What are the potential pitfalls in the scenario? Buddy adds that he has had trouble sleeping, has stopped exercising, has little energy, and fleeting thoughts of hurting himself. Not knowing what to do, and realizing that the next patient is in the waiting room, the therapist takes the cash and sets up another appointment. Dans vision is that the group would meet periodically to provide one another with support, to do problem solving, to share information and personal struggles, and perhaps to provide some psycho-educational work on campus. Identifying, addressing, and resolving ethical dilemmas is a dynamic process that requires counseling professionals to do more than simplistically apply the codes with respect for the uniqueness of each situation or circumstance. The EAP service provides a solution-focused, three-session benefit for companies within Virginia. What, if anything, should the therapist do? During one session, the patient indicated that her boyfriend has lost interest in sex and became more involved with online pornography. Dilemma 35: Initial Telepsychology Session for Free? As the session progressed, he revealed that the source of his depression was the death of his mother one year ago. Mr. DiMencha demonstrates a variety of cognitive deficits. In the midst of all of this activity, the psychotherapist contacts you for an ethics consultation. } Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. She reports that the husbands treating therapist, Dr. Cooper, has allegedly advised him to discontinue his medication in favor of an herbal remedy (St. Johns Wort). Dr. Smith is a therapist who has worked with a young woman for about 9 months. Some of the sessions focused on a sexually abusive relationship between a basketball coach and the patient when she was age 13 to 16. Can the therapist continue the treatment relationship with the patient? of study and a further neglect of ethical decision making in non-Western cultures in the professional literature on counseling and ethics. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> ; & Hartshorne,T.S. Along with. T. he counseling field is rich with ethical issues (American Counseling Association [ACA], 2014; Bodenhorn, 2006; Herlihy & Dufrene, 2011), so counselors have to be knowledgeable about current ethical and legal topics and attentive to their day-to-day clinical work. She eventually blurted out that, during a heated discussion, her boyfriend indicated that looking at online pornography was not as bad as what his uncle did. Several weeks after beginning to go on sales calls, your patient reports that Mr. Biggy is complimenting her on the way she looks and her ability to make the sale. However, after the session, the therapist feels uneasy about what his patient revealed. After a patient completes the assessment, an email will be sent to you (based on the security code) and the patient within 24 hours, providing a secure link to review the results of the PASS-2. Of course, they exist in all forms of counseling, from short-term advising . Dr. Popeil thinks these ideas are good. of family ties, but counselors in many other specialties will run into these issues too. Dr. Jordan is a therapist who typically works with a wide variety of patients. The patient reveals that he became aware of that information after several dates and recently felt comfortable revealing this to the therapist. One day, Dr. Bishop receives a phone call from his contact at the institution. His attorney believes that some good, written character references will really help out with the case. She is struggling that the situation is not right and feels very uneasy about the arrangement that the lawyer-patient foisted upon her. Dr. Tell contacts you with the above scenario. P. (1996). What are some potential responses that you could offer Dr. Bishop? Ethical dilemmas. for this article. However, upon his arrival in the emergency department, the medical record quotes the patient as saying, This wasnt supposed to have happened.. He will likely need to go into an assisted living facility. 3. What suggestions or recommendations would you offer to the therapist? After her 6 weeks of training, the company assigns her to a regional director that the therapist knows personally. A therapist receives a phone call from a well-known internist in her area. xVN0}-m8 Ethical Vignette Paper # Jodi Walters Liberty University. The therapist pulls the former patients chart. In a group setting, clients may no longer feel estranged from society or alone in their challenges, and instead view themselves as part of a community of people with shared experiences. Plenty engaging in a multiple relationship role in Mr. DiMenchas care? Ten minutes prior to the next scheduled appointment, the patients mother calls the therapist on the phone. Uncertain, she calls you for an ethics consultation. Dr. Smith was treating Mrs. Simpson for depression precipitated, in part, by a separation and pending divorce. What are the options for the therapist for both his relationship with his patient and his relationship with Mr. Biggy? Fowers and Davidov (2006) link the "multicultural movement" to classical writings about ethics in the philosophy literature,contrasting "virtue ethics"with merely following the rules. Both therapists are of the same profession. Dr. Tell explained that the alleged perpetrator was several times removed from their sessions and she did not believe that she had the obligation to report it. The physician wants the psychologist to treat his 17-year-old daughter . Applicable State Codes/or Mental Health Laws Under the legislative information system code, it explains the standards of practice by counselors. Dr. Goodfriend speaks with Buddy about once every six to nine months. Group of answer choices Growth in . The therapy focused on depression and anxiety related to work-related issues, interpersonal limitations, and relationship difficulties. White Plains, NY: Longman. Dr. Bishop calls you for a consult about this situation. While Tara is regarded as an excellent counselor by her clients and colleagues, she realizes that her skills are limited by the lack of variety in her training and experience. One afternoon Taras supervisor approached her and asked her if she would be interested in facilitating a group therapy session once a week at one of the centers other branches. Dan recently came out to his parents, who were accepting of his gay orientation and lifestyle. A physician requests a psychological evaluation of a 46-year-old man who attempted suicide via overdose of prescription medications along with alcohol. Chuck hesitated to have a face-to-face interview at the practice, but agreed only if he can talk with Sue. She stopped therapy because her insurance changed and Dr. Jordan was not an in-network provider. What are the ethical issues for this scenario? From a phone call with the attorney, he learns that Workers Compensation wants to work out a settlement. He struggles with understanding concepts and his conversation becomes tangential during the next two sessions. Divide and Rule? What are the possible downsides to entering the dual relationship? Learning From Ethical Vignettes This workshop is based on discussion of ethical issues raised by clinical vignettes such as those below, adapted and used used with consent from a state psychological association. We used a transcendental phenomenology research method and identified the themes of consulting, referring to ethical guidelines, documenting, contributing factors, and engaging in professional development. Patient contact information will be part of the administration process. What are the ethical issues involved in this situation? When Dr. Jordan attempts to clarify the request, it becomes clear that the former patient is not asking to return to therapy, but instead is asking Dr. Jordan to become the co-author or a consultant for the book. The client asked if she could just give Dr. Tell the information about the uncle so that she could report it to the authorities and leave her out of the situation. As social isolation, loneliness and depression are regular themes in treatment; the therapist frames this as positive progress. Also during the course of the phone contact, Chuck expresses some homicidal rage toward his parents, particularly around financial issues and early childhood sexual abuse from his father. Using a purposeful, convenience sampling method, we explored six school counselors' experiences of ethical decision making. 4 0 obj Harry then decides to attend a conference hosted by the ACA which will address the Code of the Ethics and the Standards of Practice in detail. He needs assistance and monitoring with daily tasks, such as home care, shopping, transportation, understanding the settlement process, reading his mail, and paying his bills. What should you do with this email solicitation? What are the ethical issues involved in this scenario? The therapist seeks to reassure the patient that he, the therapist, knows Mr. Biggy on a personal basis and that he is a really a good guy that seems bright, friendly, and fair. The client then asked if she could invite her boyfriend to the next session so that they could all discuss the information and the best way to handle the situation. ACE provider approval period: 3/21/2021-3/21/2024. In addition, the book focuses on working with diverse families and takes special care to emphasize multicultural issues. However, the police report indicated she has made such verbal threats in the past but also, on several occasions, has damaged her neighbors property including scratching the paint on their car and throwing rocks at their house. Copyright Center for Ethical Practice, 977 Seminole Trail, #312, Charlottesville, Virginia 22901 Third, many ethical dilemmas are usually not choices between right and wrong, but among competing ethical principles geared toward doing good. What are the ethical concerns in this scenario? She completed her practicum while working in a treatment facility for troubled children and adolescents, and her internship was done at a privately owned psychiatric hospital for adults. How easy or how difficult would it be to take those steps? As a mandated reporter, would Dr. Tell report place her clients confidentiality be at risk? Are there any ethical considerations in this dilemma? She was recently offered a position as a dual-diagnosis treatment counselor at a local drug and alcohol rehabilitation facility. The mother further reports that the patients cousin has been driving the patient around town. ev}]=h}))-mv-K4a_5@rFBPnevW :X})8Bl;%1cw'=@rw6=V|}oYdhNTJ]gIXS0f319' T8L*(xp8w}?}UD Dr. Jordan thanked her for the compliment and indicated that he needed to think about the request. New York: John Wiley & Sons, Inc. a73D%IhCTHA&:L0iAq(*p The therapist cannot remember many details about the patient. The PASS-2 is administered online, from any computer, iPad, or iPhone. The treating therapist believes the options are: What are the possible emotional reactions to this situation? Your browser either does not support scripting or you have turned scripting off. While it is not a complete assessment, it can guide patients to you for further psychological consultation. If you were a co-owner of the business, how would you feel about this situation? Does Dr. Goodfriend need to encourage Buddy to become involved in therapy if symptoms persist? They see her regularly for informal family events and do holidays together with their adult children and grandchildren. Dr. Faye Miller receives a referral for a 35-year-old female, Betty Drapier, who is feeling depressed and experiencing marital problems. A court appointed custody evaluator performed a child custody evaluation. If you were Dr. Miller, what are your emotional reactions to this situation? The therapist, her husband, and his ex-wife are on good terms. Address the matter with the other therapist directly. Chuck is a 20-year old man who immediately expresses a great deal of agitation and anger. (Log in options will check for institutional or personal access. Buddy states that he has been feeling stressed over the last month. When she asks about insurance, he indicates that he will pay in cash. An examination by parenting professionals of the concept of overparenting, Intercultural model of ethical decision-making: Addressing worldview dilemmas in school counseling, Qualitative research: A guide to design and implementation, Qualitative data analysis: An expanded sourcebook, Bir metafor almas: rencilerin rehberlik servisine ilikin alglar [A metaphor study: Students perceptions related to the guidance service], Journal of Social Sciences of Mu Alparslan University, Trkiyenin ruh sal yasas ile imtihan [Turkeys exam with mental health act], Special issue: Legal and ethical issues in school counseling, Reporting suspected child abuse: Conflicting roles for the counselor, Ethical, legal, and professional issues in counseling. Dilemma 38: Psychotherapy without Medication, Dilemma 39: Pills, Chills, and No Thrills, Ethics and Skills for Psychologist as Supervisor-Post-Doctoral Supervision - 3 part series, Library: Articles & Papers Related to Ethics Education, Time pressure reduces misinformation discrimination ability but does not alter response bias, Domestic violence hotline calls will soon be invisible on your family phone plan, The danger of absolute thinking is absolutely clear. The days allocated for her stay by her insurance are ending in two days. Others sources will also be used. During the first few sessions, Mrs. Drapier indicates that her husband, Don, is depressed and in treatment. The position pays much more than shes making at the community agency, and is within ten minutes of her home. You have shared a couple of patients with the psychiatrist in the past and have spoken with him by telephone a few times. The physician explains that he has been medicating her for about four months with Prozac and Klonopin, once he became aware of her eating disordered behavior. . Buddy also shares that he has been short tempered with his wife and kids. Dr. Tell focused the client on her dilemma as well as the relationship issues with her boyfriend. The therapist does not dwell on the situation with the patient. Dr. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 8 0 R/Group<>/Tabs/S/StructParents 1>> What would you need from the attorney? Tel: 434-971-1841 E-Mail: Office@CenterForEthicalPractice.org, Knowing What We Don't Know: Meeting Our Ethical Obligation to Develop and Maintain Competence, Should I Write it Down? Feature Flags: { Dan asked a number of faculty members to be the faculty advisor of this group. Mr. Biggy indicates that he wants to talk more about his feelings. The Clear Answers and Start Over feature requires scripting to function. It was revealed that counsellors prioritise the students benefit and respect students privacy. The patient presents with a history of rejection and abandonment as well as being abused by persons of power. Can the client contact Child Protective Services anonymously in this case? You are a therapist in a busy acute care hospital where you receive. The client, Mr. Don Tellanyone, is a 47-year-old man who is seeking services for depression. He also wondered if he should contact the patients lawyer, with her permission, to disclose his perceptions about the quality of the report and his perceptions about the conclusions. stream During some individual time, the patient indicated to the psychologist that she has had it with her neighbor and has something planned that will make you all finally understand once she is discharged. He also indicated that the relationship is taking on a more serious tone. However, he researches the APA Ethics Code and believes that he may be acting inappropriately. : Ethical and Legal Ramifications of Documentation Decisions. The former patient is asking for the therapist to be a character witness as he has an upcoming hearing for a minor criminal offense. When dealing with the EAP program, she thinks her title of doctor might put people off, so she announces herself as Sue when dealing with EAP clients. She was pleased to find that by attending the seminar, she could earn 20 CEUs that would count towards maintaining her licensure, and also gain the knowledge needed to successfully treat her new clients. He feels stuck between being faithful to the patient and her needs without crossing a boundary as a treating psychologist. From: PsychBuilder High Tech Psychology at Low Cost, Subject: Online Assessment Tool to Promote your Practice. 14 March 2022. If you have further questions, feel free to contact me. Qualitative content analysis in practice. As soon as he looked at the intake form, he realized that she is the ex-wife of his former client. By Mrs. Drapiers report, he appears more stressed because of his job and is drinking alcohol more frequently. Attempts to find social service agencies able to help him have not been successful. She also agreed to think about the need to bring in the boyfriend, because inviting him to therapy will not necessarily help the situation. endobj Dr. Smith politely explains that he feels uncomfortable with them discussing his more personal marital issues. Dr. Lilith Crane, a therapist in the counseling center of a small rural campus, calls you on the phone for a consultation. 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