What are potential advantages in this scenario? Ethical Dilemmas in Counseling: A Case Study Examination The American Counseling Association (ACA) Code of Ethics was amended in 2014 to reflect the ever-changing social, political, and technological landscape which clinicians must navigate. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. 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. The physician wants the therapist to treat his 17-year-old daughter, who suffers with what he describes to be an eating disorder and perhaps some Borderline Personality Disorder traits. A therapist receives a phone call from a well-known internist in her area. A psychologist receives a phone call from a well-known internist in her area. New York: John Wiley & Sons, Inc. Content may require purchase if you do not have access. The therapist and patient discussed the type of job she was entering, because knew she might experience rejection from doctors, nurses, and other office personnel. Mrs. Simpson thought it would be good for Dr. Smith to review the report in order to help him with their therapy. Dr. Bishop developed a strong relationship with this religious institution and they have been quite satisfied with his work. She stated that she wanted to include some education around sexual abuse and tell her story in a healthy, therapeutic manner. During the course of their work, the patient discussed significant facts about his troubled past, numerous details about failed past relationships, and sexual fantasies. Abruptly, Mr. Drapier looks at his watch and leaves the office explaining that he is late for a business meeting. His father has declined rapidly since the death of his wife and now requires total care. Mr. DiMencha demonstrates a variety of cognitive deficits. My name is Dr. 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. He will likely need to go into an assisted living facility. She does not feel right taking a fee larger than her usual and customary rate. You will receive a high quality report that offers diagnostic possibilities, suicide potential, and treatment planning options for new patients. The survey consisted of 10 vignettes based on the above ethical issues in. While the treatment team does not share Dr. Solomons concern and has started to make discharge plans, they have not spent as much individual time with the patient as Dr. Solomon. What suggestions or recommendations would you offer to the therapist? 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. 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. How would you feel if you were the consultant? After the session is over, the therapist has time to reflect on her concerns. 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. What are some of the potential ethical pitfalls in this scenario? Published online by Cambridge University Press: She is also concerned about Mr. Drapiers level of depression, alcohol use, and suicidal statement. The Center is solely responsible for all aspects of the programs. endobj cn]JlmQSMDM>pEm+gxMU]``tQqKF V;J/$"P)T)-nC6!;D-b0 *a #Xk%u %lFhZ@=Hr|y>wtrPuDd"Q=d0bs9>CQ?Rkf-U]BFJV9>g$d\3IH:$@eU-ASq 1K [i=2y#qIg3ibct x*apx>1@y#@/#x@ s ^R9,.6^ X T9,e64vKa8%#o-%=cpi %&)}Cd$fi4/6O.FSKA^iBd<2PTG :5=@0J=kM* He explains that he recently lost his job and has been worrying about the financial impact that this is having on his family. The most frequent ethical dilemmas involved the limits of confidentiality, confusion about counsellors professional roles in school settings, uncooperative behaviours among stakeholders, and suspected child sexual abuse. Since there is rarely a right or wrong answer for most ethical dilemmas and since the cases provide limited detail, it is possible that you can validly argue for an answer and/or explanation that differs from ours. He is marginally coherent and unable to give any consistent responses. Dr. Smith also asked if it is ethical to bill the patients insurance company to review his impressions of a forensic report during a psychotherapy session. What are some actions that you, as the treating therapist, may have done differently? From: PsychBuilder High Tech Psychology at Low Cost, Subject: Online Assessment Tool to Promote your Practice. If you decide to provide information, would you consider communicating with the prior patients attorney? xWMs6W :4MNR)CWI/$@jt H oW5}TP(&P2?;*Ad{)t7lO=+v'EHQ'N}Y~Z5V(.oiExAEmH4g}?.cW,'Y0|\&A\FJtf3d_`M$ L U She began to provide psychotherapy to Mr. DiMencha, a 52-year-old, who suffered with depression. x#86h)Ppcc0F( k/ What are the ethical issues, if any, involved in this case? a variety of upgrades, the web developer/consultant suggests that he add a testimonial page where former patients describe their positive experiences in therapy. A therapist has been working individually with a 17-year-old male for issues related to depression and family dynamics. Innuendos are that she allegedly killed her neighbors pet, but this has been unproven by the police. The group is for newly diagnosed schizophrenic clients, and is meant to help them cope specifically with their auditory or visual hallucinations. If you have further questions, feel free to contact me. The results and implications for counsellors, counsellor educators and researchers are discussed. 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. Because of busy primary care practices, the PASS-2 can be completed at home, if the office does not have internet access for patient use. Mr. Drapier acknowledges many cognitive, behavioral, and physical symptoms of serious depression. Dr. Joel Bishop has been conducting pre-ordination evaluations for a religious institution for many years. As social isolation, loneliness and depression are regular themes in treatment; the therapist frames this as positive progress. 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. Feeling somewhat uncomfortable with the medication management issue, the therapist indicates that she will have to look at her schedule and call him back. endobj Ethical dilemmas are important puzzles with no easy answers but are fun to contemplate. In fact, the patient has made no such comments to anyone else other than to Dr. Solomon and has been a model patient on the unit. It was revealed that counsellors prioritise the students benefit and respect students privacy. 4 0 obj 14 March 2022. What obligations does the therapist have to the parent? What are the potential ethical concerns about this scenario, if any? Ethics Vignette #2 A local psychiatrist is referred by his attorney for neuropsychological evaluation related to possible mild head injury ( traumatic brain injury) from a MVA. His patient reveals, during the course of therapy, th A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. are Your browser either does not support scripting or you have turned scripting off. What are the potential ethical issues in this case? Important to an entrepreneurial therapist like you, this assessment bridges the gap between psychology and primary care. Dr. Tell allowed several moments to pass before asking the patient what was happening. %PDF-1.5 Ethical, Legal, and Professional Issues in Counseling Author: Theodore Phant Remley Publisher: Prentice Hall ISBN: Category : Education Languages : en Pages : 488 Get Book. The cost of the online administration is $25, to be paid by the patient. 4 Ethical Vignette "School counselors should acknowledge the vital role of parents/guardians and families." (American School Counselor Association, 2010, Section A.1.d.) For example, the psychologist might have to evict his client for failing to pay rent--or he might . The therapist knows her new boss, Mr. Biggy. You may access the ACA Code of Ethics and other ethics code at the WEBLINKS button on this website. She remembered back to her psychopathology class in graduate school, and felt comfortable running the group based on the knowledge of schizophrenia that she acquired from the class. Plenty had Mr. DiMencha sign a document explaining her fees for the additional services. 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. The patient admitted herself to the unit, with some persuasion by the local police, for making loud threats and menacing gestures in her neighbors driveway. 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. 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. Out of options, Dan is asking Dr. Crane to be the faculty advisor. View all Google Scholar citations Divide and Rule? White Plains, NY: Longman. He indicated that Dr. Cooper recommended that he discontinue a psychotropic medication in favor of an herbal remedy. Are there competing ethical principles? The ex-wife moved back to the area about six months ago. By Mrs. Drapiers report, he appears more stressed because of his job and is drinking alcohol more frequently. However, after the session, the therapist feels uneasy about what his patient revealed. The patient presents with a history of rejection and abandonment as well as being abused by persons of power. ev}]=h}))-mv-K4a_5@rFBPnevW :X})8Bl;%1cw'=@rw6=V|}oYdhNTJ]gIXS0f319' T8L*(xp8w}?}UD After reiterating the purpose of the session (which was to assess the marital situation and not to assess his current treatment), Dr. Miller states that she feels uncomfortable with the request, although she is concerned about the therapists reported behavior. How would you feel about receiving this request? The marital situation appears deteriorated and Mr. Drapier appears significantly depressed. Case Vignettes for Review Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. Programs that do not qualify for NBCC credit are clearly identified. In a therapy session in an outpatient substance abuse treatment facility, a patient reveals that an agency staff person another therapist in a different department has paid to have sex with another patient in the treatment facility Lyla, who is a prostitute. Is Dr. Mr. Tellanyone reveals that recently he had a conversation with his father in which the father commented how peaceful his wifes death was and how he hoped for a similar passing. At the end of the session, the therapist asks for the requisite fee as stated on the phone. If you were the psychologist, what would be your emotion response to this situation? As is often the case when it comes to ethics, some of the best solutions involve counselors taking preventive steps, such as being familiar with and applying the 2014 ACA Code of Ethics. stream Ethical Vignette Paper # Jodi Walters Liberty University. He indicated that Dr. Cooper recommended that he discontinue a psychotropic medication in favor of an herbal remedy. Buddy also shares that he has been short tempered with his wife and kids. Buddy states that he has been feeling stressed over the last month. A therapist receives a letter from an attorney indicating that he has inherited an old car from Frank Palmer. Refer the matter to the State Board of Psychology. Plenty without any type of testing. During the current session, the confides that he has made a new female friend. Dr. Goodfriend speaks with Buddy about once every six to nine months. After a review of the relevant counseling supervision literature, these ethical issues were selected for two reasons. of family ties, but counselors in many other specialties will run into these issues too. Dilemma 35: Initial Telepsychology Session for Free? Dilemma6: Referral and Treatment Boundaries, Dilemma9: Psychologist as Character Witness, Dilemma 10: Multiple Relationships Revealed, Dilemma 14: The Psychology of Advertising, Dilemma 15: To Evaluate or Not to Evaluate, Dilemma 18: Co-authorship with a Former Patient. What, if anything, should the therapist do? Mr. Biggy and Dr. Smith meet in an unplanned social venue. The survey developed for this study consisted of vignettes based on ethical issues identified in the counseling supervision literature. 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 Furthermore, she felt that because she was now in private practice, she could treat whoever she chose to, regardless of the specific needs of her clients. Ten minutes prior to the next scheduled appointment, the patients mother calls the therapist on the phone. He indicates that, in order for him to benefit from the treatment, he feels a need to pay what he makes an hour. ACE provider approval period: 3/21/2021-3/21/2024. The test usually takes approximately 40 to 60 minutes to administer. I need two professional journals dated within the last 5 years regarding ethical dilemmas in counseling _____has been described as the primary ethical dilemma faced by school counselors. In the code, 18VAC115-20-130. The therapist, her husband, and his ex-wife are on good terms. If you were Dr. Goodfriend, how do you feel about the phone call? Prior to providing extra-therapy support, Dr. He indicates that Mr. Biggy is a good family man. The patient is reassured, and reported less anxiety. The therapist does not dwell on the situation with the patient. The therapist ignores the comment and finishes by setting their initial appointment. After you finish you can compare your response and rationale with our response and our rationales for each of these vignettes. Can the therapist continue the treatment relationship with the patient? What are the ethical concerns in this scenario? 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. Does Dr. Goodfriend need to phone his high school friend to clarify his last comment? One day, Dr. Bishop receives a phone call from his contact at the institution. Among other things, the report contained a psychological evaluation of the patient. The therapist cannot remember many details about the patient. He recalled that he was an older person with significant depression who eventually became better. Sci Rep 12, 22416 (2022). First, these vignettes are meant to be teaching tools. The therapist pulls the former patients chart. She was surprised to find that most of the clients who came to see her were young women who suffered primarily from eating disorders and relationship problems. 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.. However, he researches the APA Ethics Code and believes that he may be acting inappropriately. The therapist then phones you for an informal consultation. Numerous patients from family practice offices can be given the internet link and a security code to complete the PASS-2. The PASS-2 is administered online, from any computer, iPad, or iPhone. She has been doing much of the case management work, e.g. Dr. Tell agreed to contact someone to discuss whether Dr. Tell had to report this information to the police or Child Protective Services. When facing uncertainty, consult a colleague, refer to APA's Ethics Code and document your decision, advised APA Ethics Committee members. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. During those calls, the conversations typically focus on careers, family members, and the whereabouts about other classmates. 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. % Mr. DiMencha doesnt appear to understand his legal rights or the settlement process. She stated that Dr. Jordan recommended that she write down her memories. Dr. This workshopis based on discussion of ethical issues In actuality, Mr. Biggys wife is a very close friend of Dr. Smiths wife. Kara, a therapist on the county hospitals psychiatric unit, is a recent graduate from a masters degree program in mental health counseling. Dr. Tell focused the client on her dilemma as well as the relationship issues with her boyfriend. Others sources will also be used. In addition, the book focuses on working with diverse families and takes special care to emphasize multicultural issues. What are the options for the therapist for both his relationship with his patient and his relationship with Mr. Biggy? A female therapist in a suburban area has worked with a male patient for about one year. We have great data on the PASS-2 for reliability and validity in identifying primary care patients who can benefit from psychological services. stream The supervisee is very worried and afraid to tell Dr. Tell contacts you with the above scenario. 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. The patient had been in treatment for about 10 months on a weekly basis. An ongoing theme in therapy revolves around his sexual orientation. Harry is a school guidance counselor who is just got a job at a large public high school. Psychological Counselling and Guidance Department, Dokuz Eyll University, Izmir, Turkey, Get access to the full version of this content by using one of the access options below. They agreed to meet weekly for the first four months of psychotherapy, and then they agreed to meet twice per month. Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. Group of answer choices Growth in . What are the ethical issues involved in this situation? You have shared a couple of patients with the psychiatrist in the past and have spoken with him by telephone a few times. She is struggling that the situation is not right and feels very uneasy about the arrangement that the lawyer-patient foisted upon her. It then provides six vignettes where supervisors are faced with ethical dilemmas. Dr. Lilith Crane, a therapist in the counseling center of a small rural campus, calls you on the phone for a consultation. 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. Running Head: ETHICAL VIGNETTE. She wants the therapist to phone the police immediately when the patient arrives and to have them arrest the cousin for unlawfully detaining the minor child. Dr. Smith also wondered if it was appropriate to bill Mrs. Simpson for his time in reviewing the report. When she asks about insurance, he indicates that he will pay in cash. The therapist phones the attorney and discovers that Mr. Palmer left him a 1993 fourwheel drive Ford Explorer. 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. Dr. Jordan calls you on the phone for an ethics consultation. Ethics and law for school psychologists . The lawyerpatient comments that this seems low. Kara then contacted the facility and let the supervisor know that she is not able to accept the position at this time, but that she plans to seek out the necessary training and supervision to work with substance abuse clients, and that she hopes the facility will consider her for the position once she has completed the necessary training. During the 90-minute call, Dr. Goodfriend tries to be a good listener, empathizes with Buddys difficult situation, offers advice on ways that Buddy can better manage his stress, provides him with general encouragement, and suggests a book that outlines stress management and anxiety reduction strategies. If you were the psychologist, how would you feel about the situation? At the end of the call, Buddy tells Dr. Goodfriend that he is feeling much better. <> Dr. Smith asked if he needed to inform the patient of his impressions of the report and the seemingly erroneous conclusions. Contemplate these 16 conundrums. : ethical dilemmas, burnout, stress, practicing counselors. Part of her struggle is that she sees her husband as more depressed now than when he started treatment. During the session, Mr. Drapier verbalized suicidal ideation in a flip manner (Sometimes I think it would be better if I just killed myself). The patient was in therapy for approximately one year. raised by clinical vignettes such as those below, Additionally, none of the treatment issues had to do with impulse control or antisocial tendencies. Dr. A survey of ethical dilemmas based on salient ethical issues in counseling supervision (i.e., dual . Dilemma6: Referral and Treatment Boundaries, Dilemma9: Therapist as Character Witness, Dilemma 10: Multiple Relationships Revealed, Dilemma 14: The Psychology of Advertising, Dilemma 15: To Evaluate or Not to Evaluate, Dilemma 18: Co-authorship with a Former Patient. outside her scope of practice? Simultaneously, he strongly believes he made the right decision. Close this message to accept cookies or find out how to manage your cookie settings. Mr. Biggy pulls Dr. Smith aside and explains how he has become very attracted to a new sales representative. Case Vignettes for Review Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. Ethical decision making for this study was defined as the degree to which decisions pertaining to confidentiality, parents' rights, and diversity and . Dr. Smith was treating Mrs. Simpson for depression precipitated, in part, by a separation and pending divorce. Using a purposeful, convenience sampling method, we explored six school counselors' experiences of ethical decision making.
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