During the next session, Mr. and Mrs. Drapier arrive separately, but on time. After the session is over, the therapist has time to reflect on her concerns. He also states that if she does not accept what he is offering, he will lose respect for her as a professional and probably not return for treatment. During the first few sessions, Mrs. Drapier indicates that her husband, Don, is depressed and in treatment. The therapist screens the potential patient and believes that she can help him. endstream Harry is a school guidance counselor who is just got a job at a large public high school. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Supervision Ethics Vignettes Client Worsens While Under the Care of Supervisee A 16-year-old girl who came to counseling for help with recurrent depression is exhibiting increasingly severe episodes of self-mutilation. The Center is solely responsible for all aspects of the programs. One day, Dr. Bishop receives a phone call from his contact at the institution. It was revealed that counsellors prioritise the students benefit and respect students privacy. The therapist cannot remember many details about the patient. He also indicated that the relationship is taking on a more serious tone. Dilemma 6: Referral and Treatment Boundaries. 4 0 obj The client presents the therapist with information about a well-known, local therapist who released confidential information about him to an attorney without a signed release or court order. stream The test is designed to determine if the patient can benefit from psychotherapy, psychotropic agents, or other psychological services. You have shared a couple of patients with the psychiatrist in the past and have spoken with him by telephone a few times. The prospective client was using her maiden name and gave no indication during the session that she knew about her ex-husbands treatment with the therapist. However, he researches the APA Ethics Code and believes that he may be acting inappropriately. After some other small talk, Dr. Smith leaves to mingle with other friends. If you have further questions, feel free to contact me. "useRatesEcommerce": false Apparently, no one is. The treating therapist is questioning what to do. Simultaneously, he strongly believes he made the right decision. Dilemma 4: A Psychologist in Turmoil Dilemma 5: A Tricky Situation Dilemma 6: Referral and Treatment Boundaries Dilemma 7: An Invitation to Assess Dilemma 8: A Session with the Spouse Dilemma 9: Psychologist as Character Witness After a review of the relevant counseling supervision literature, these ethical issues were selected for two reasons. 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 Cynthia, a counselor who had been successfully working as an AIDS and substance abuse counselor in a large city for several years, recently moved to a very affluent suburb and decided to open a private practice. Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. A therapist had an intake appointment with a new client. raised by clinical vignettes such as those below, Dr. Tell reminded her about confidentiality and the laws in Pennsylvania that would override it. The patient was in therapy for approximately one year. Others sources will also be used. Dr. Smith suggests a referral to a therapist, but Mr. Biggy states that he feels more comfortable talking with Dr. Smith. Some of the sessions focused on a sexually abusive relationship between a basketball coach and the patient when she was age 13 to 16. 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. Chuck hesitated to have a face-to-face interview at the practice, but agreed only if he can talk with Sue. In the midst of all of this activity, the psychotherapist contacts you for an ethics consultation. The therapist has not worked with the patient for about two years. Dr. Tell contacts you with the above scenario. Legal and Ethical Issues in Working with Minor in Schools Presented by Dr. Carolyn Stone, University of North Florida . During the interview, she was told that she would need to work independently, with only limited supervision. What are Dr. Millers potential ethical issues in this situation? 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. of study and a further neglect of ethical decision making in non-Western cultures in the professional literature on counseling and ethics. Dr. Bishop developed a strong relationship with this religious institution and they have been quite satisfied with his work. As a mandated reporter, would Dr. Tell report place her clients confidentiality be at risk? What obligations does the therapist have to the parent? The Center maintains responsibility for this program and its content. What are potential advantages in this scenario? . The days allocated for her stay by her insurance are ending in two days. Dr. Dr. Smith decided to review the report. Dr. Crane feels ambivalent because of their therapeutic relationship, but also wants to help Dan because he appears to have limited options. Dr. Smith also wondered if it was appropriate to bill Mrs. Simpson for his time in reviewing the report. Ethical issues relevant to family counseling are also included along with transcripts from hypothetical family counseling sessions throughout the book. 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. The Center for Ethical Practice is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Case Vignettes for Review Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. 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. Consider the following scenarios, presented initially in the Ethical Dilemmas column in Therapy Today. Dilemma 1: Psychologist in the Middle Dilemma 2: A Suffering Caregiver Dilemma 3: A New Referral? The mother further reports that the patients cousin has been driving the patient around town. Dr. Goodfriend receives a call from Buddy, his very close high school friend. 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. He believed that the custody evaluator had made several significant errors in the report concerning the psychological health of his patient. Qualitative content analysis in practice. What are some potential responses that you could offer Dr. Bishop? While these teaching tools have been developed by psychologists, the vignettes are likely similar to those dilemmas faced in other mental health, counseling, or helping professions. If you decide to provide information, would you consider communicating with the prior patients attorney? What are the options for the therapist for both his relationship with his patient and his relationship with Mr. Biggy? She actually attended his graduation party briefly and hired him to cut her lawn for two years. This vignette poses several ethical dilemmas for counselors. endobj At that time, Dr. Miller not only wanted to evaluate the marriage, but to evaluate how impaired the husband was, and to decide whether Mrs. Drapier had assessed her husbands depression and the marriage accurately. 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. Hence, the admission is voluntary. ethical dilemmas in counseling vignettes. As social isolation, loneliness and depression are regular themes in treatment; the therapist frames this as positive progress. The survey developed for this study consisted of vignettes based on ethical issues identified in the counseling supervision literature. Third, many ethical dilemmas are usually not choices between right and wrong, but among competing ethical principles geared toward doing good. Mr. DiMencha demonstrates a variety of cognitive deficits. An ongoing theme in therapy revolves around his sexual orientation. A therapist is treating a client who is involved in a legal proceeding. A survey of ethical dilemmas based on salient ethical issues in counseling supervision (i.e., dual . What clinical concerns arise for you in this scenario? In addition, the book focuses on working with diverse families and takes special care to emphasize multicultural issues. The Clear Answers and Start Over feature requires scripting to function. PsychBuilder Inc. developed the first internet-based administration and scoring of the Personality Assessment Symptom Scale-2, the PASS-2. The most frequent ethical dilemmas involved the limits of confidentiality, confusion about counsellors' professional roles in school settings, uncooperative behaviours among stakeholders, and . These issues included a. dual relationships, b. competence, c. informed consent, d. due process. She calls you for an ethics consult. Your browser either does not support scripting or you have turned scripting off. While confidentiality has been preserved, the dynamics of each case areisomorphicto a real clinical situation faced by a practicing psychologist. Of course, they exist in all forms of counseling, from short-term advising . They follow legal guidelines in risky situations and insist on working within their areas of competence; they are not willing to accept noncounselling tasks. 2 Print version: page 62 6 min read 0 Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. Dan asked a number of faculty members to be the faculty advisor of this group. His father has declined rapidly since the death of his wife and now requires total care. ev}]=h}))-mv-K4a_5@rFBPnevW :X})8Bl;%1cw'=@rw6=V|}oYdhNTJ]gIXS0f319' T8L*(xp8w}?}UD This qualitative research aimed to define school counsellors ethical dilemmas and their responses to such situations. How are the clients emotional and interpersonal issues related to the therapists dilemma? On that card, there will be information that explains the importance of completing this assessment, the cost, and that a licensed therapist will review the results and contact the patient by phone within 3 to 5 business days. She has been doing much of the case management work, e.g. Total loading time: 0 Buddy phoned Dr. Goodfriend in an apparent emotional anguish by the tone of his voice. However, she begins to feel uncomfortable as she feels like they are spending too much time together. 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. 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. He feels stuck between being faithful to the patient and her needs without crossing a boundary as a treating psychologist. Feeling somewhat uncomfortable with the medication management issue, the therapist indicates that she will have to look at her schedule and call him back. Dr. Bishop feels uneasy about this situation, as homosexuality has not been considered a mental illness since the 1970s. Mr. Biggy pulls Dr. Smith aside and explains how he has become very attracted to a new sales representative. 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. When returning a call from Chuck who works for a company with the EAP benefit, the psychologist indicates that she is Sue from the EAP program. 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. 6P*-45Denc \4RPG6mNruMK*glwuh]4 P. t;qH AhX`8Ng3a%[,M&;;CZ523m-CH#s?tJwzqJ@J(&,i]Kbvq"1hpuDq U9'&-|)*5Y%kP2kiT;3fz-t1#5?&mv>TDN'8kU^V3q8 At#8 dHM'IF As the conversation continues, the therapist is surprised to learn that the patients new friend is the ex-wife of the therapists husband. Tara was offered this position after successfully completing both her practicum and her internship at the center. Dr. Solomon, feeling uncomfortable with the situation, contacts you for a consultation about the potential ethical issues for this case.

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