However, when one party has status as the identified client, our primary obligation will focus on that individual. Consider the following situations. Lucy Lastic, Ph. Fuss wondered whether Dr. Lastic could see the two of them together to help improve their relationship.
Lastic agreed to see them, but matters soon worsened. Fuss had expected Dr. Lastic to take her side, and get Mr. Snice to behave differently. Snice brought up many ongoing issues of his own that he had hoped to get help with, including chronic problems with anger management and alcohol dependence. Billy Go, age 6, had begun treatment with Wyatt B. Hoovesya, LPC for oppositional behaviors at home and school.
Hoovesya saw Billy weekly for 40 minutes, spending another ten minutes with his mother, Frieda Go, offering parental behavior management guidance. At the end of the fourth session with Billy, Mrs.
Go comes into the office and begins to sob. She has reached her limit in coping with a number of life stresses and is having passive suicidal ideation. She begs Mr. Hoovesya to help her cope. In both of these cases the therapists encountered unpleasant surprises that they might have taken steps to prevent. Perhaps Dr. Lastic had no inkling of Mr. Fuss and Mr.
Snice in advance. If Dr. Lastic had intended to switch from individual to couples therapy, she should first have thoroughly discussed the role change, expectations and potential consequences with Ms. If her intent was to only to briefly include Mr.
Snice as a collateral participant to assist Ms. Fuss in her treatment, that role should first have been clarified with Mr. Snice, who seems in need of his own individual therapist. With respect to the Go family, Mr. Hoovesya may have explained to Mrs.
Ethical Issues in Genetic Testing
Go at the beginning of treatment that his focus was on Billy and that his meetings with her were merely for parental guidance. When she presents as clearly needing treatment of her own with some urgency, Mr. Hoovesya finds himself needing to do some emergency triage and referral with a woman who may believe she is already in therapy with him. When dealing with any kind of collateral clients, ethically sensitive therapists grasp the importance of clarifying their role and establishing the boundaries of a professional contract at the start of the interaction.
Such participants in therapeutic activities also need to understand that information provided in such contexts is confidential, but may not be privileged. Another important issue involves avoiding potentially detrimental boundary crossings with individuals known to be close relatives, guardians or significant others of current clients e. Terminating therapy for the purpose of circumventing this policy would also qualify as highly inappropriate. As noted earlier, the ethics codes of professional associations and a number of state and federal laws now make it clear that the therapist must begin obtaining informed consent at the start of a professional relationship APA: 3.
Clients may need reminders or updates as the professional relationship progresses. This forms the heart of a therapeutic contract with the couple or family. One can only give consent for oneself, and doing so implies a competent, knowing, voluntary act. That means the person giving consent must have the legal and mental competence to consent, have access to the information they need in an understandable format, and make the decision on a voluntary basis.
This is sometimes referred to as proxy consent. In some cases, the incompetent individual is also asked for assent, meaning that they may veto their own participation. Thus, parents may insist that their reluctant minor child participate in family therapy. What about the situation in which the goals and values of the family, identified client and therapist are not completely aligned? Issues related to abortion choice, sexual preferences, religion, and family values are among the potential conflict areas.
The therapist must assume responsibility for avoiding the imposition of personal values on the client while striving to optimize quality of care. Arnold Polite, age 14, is referred to Frank Facilit, Psy. Facilit finds Arnold to be somewhat inhibited by the close, and at times intrusive, ministrations of his parents while Arnold struggles to develop a sense of adolescent autonomy.
Over several months, Facilit sees good progress in his work with Arnold, but then he begins to get telephone calls from Mr. Polite, who express concern that Arnold is becoming too assertive and too interested in people and activities apart from the family.
In this instance, the progress of the client toward more developmentally appropriate behavior alters his relationship with his parents, and they may not care for the new behavior. As we discuss in this section, the best interests of one client may well be antithetical to the best interests of a co-client or close family members. Facilit can work toward some accommodation by means of a family conference or similar collaborative approach, but the possibility exists that this will not prove satisfactory. Although a small number of states e.
Ethical Issues in Genetic Testing - ACOG
If a child wishes to refuse treatment authorized by a parent, there will most likely be no legal recourse, even if the proposed treatment involves inpatient confinement Koocher, ; Weithorn, ; Weithorn, Some mental health professionals have argued that the best interests of parents are not necessarily those of children, and that mental health professionals are not always able to function in the idealized unbiased third-party role imagined by the court Koocher, ; Weithorn, ; Weithorn, Jackie was seen by Amos Goodheart, Ph.
Jackie asked Dr. Goodheart discusses his options with Jackie, explaining that he cannot offer treatment to anyone under 18 years of age without parental consent. Jackie feels betrayed. Goodheart recognized two important legal obligations and an additional ethical obligation. Second, he recognized his obligation to report the case to authorities duly constituted to handle child abuse complaints.
This is a statutory obligation in all states, although it certainly would have been less than professionally responsible had he sent Jackie home to additional potential abuse and done nothing. Jack Fury was an angry year-old referred to Harold Packing, M. After the fourth session, while Dr. Packing was in an appointment with the next client, they smelled smoke and discovered that a fire had been set in the waiting room. The fire was put out, and Dr.
Packing called Jack and his parents in for a meeting. Jack acknowledged setting the fire. Whereas some therapists might have agreed to continue working with Jack, Dr. Packing was not. Packing recognized these feelings and dealt with them promptly. Psychotherapists have no ethical obligation to continue treating clients when threatened or otherwise endangered by that client or another person with whom the client has a relationship APA: After all, one can hardly devote full professional attention to such clients with threats or danger looming.
In general, the therapist should assume responsibility to provide clients with the information they need to make their own decisions about therapy. The therapist should be willing to treat each client as any consumer of services has a right to expect. Although many therapists do not use written contracts, some therapists and clients do agree to highly structured written documents outlining their relationship in great detail, particularly in certain legal e.
As the cases described earlier illustrate, it is very easy for people involved in couple or family therapy to misunderstand or become confused about various roles and obligations.
- Maktoob. From Lofoten to the Middle East;
- The Pocket Guide to Restorative Justice;
- Faculty Profile - Clinical Psychology (Psy.D.).
- Top Authors.
- Certifiably Sustainable?: The Role of Third-Party Certification Systems: Report of a Workshop!
- Abortion Counseling;
We summarize the essential elements of any client-therapist treatment agreement in Text Box 1 from the perspective of the questions clients may have in mind. Couple and family therapists should focus on the nuances that having more than one participant in the unit of treatment might involve. Who is my client e.
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