The therapist ignores the comment and finishes by setting their initial appointment. Because of his status as a well-known internist, he does not want to refer his daughter to a psychiatrist because he believes that he can handle the medication piece of her treatment. The psychologist is involved in a busy practice, specializes in treating eating disorders, and receives only occasional referrals from this physician. Does the therapist who hears this information have any legal obligations? 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. The patient was in therapy for approximately one year. 1 0 obj The client, Mr. Don Tellanyone, is a 47-year-old man who is seeking services for depression. B) =AiV5bAqUKxs#6{pA :)B'5-a* 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. The main therapeutic issues are depression and loneliness. Total loading time: 0 raised by clinical vignettes such as those below, Dr. During one session, the patient indicated that her boyfriend has lost interest in sex and became more involved with online pornography. Hopefully, the teacher will use the Acculturation Model to help blend professional, ethical obligations with personal values and beliefs. His father has declined rapidly since the death of his wife and now requires total care. 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. Dr. Smith suggests a referral to a therapist, but Mr. Biggy states that he feels more comfortable talking with Dr. Smith. (Log in options will check for institutional or personal access. The PASS-2 is administered online, from any computer, iPad, or iPhone. First, these vignettes are meant to be teaching tools. 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A psychologist works in an outpatient substance abuse treatment facility. Dr. Crane is questioning the pros and cons of being the therapist and the faculty advisor. He complains loudly about his parents and his girlfriend. Are there any other concerns about the web developer/consultants strategies? The Center is solely responsible for all aspects of the programs. 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. What are some likely emotional reactions would you have in this situation? Can the therapist continue the treatment relationship with the patient? ; & Hartshorne,T.S. 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. While Chuck now lives in an apartment in town, she remembers him well. 2 Print version: page 62 6 min read 0 Okul ruh sal hizmetlerinde yaanan sorunlar: Psikolojik danmanlarn grleri [Problems encountered on school mental health services: School psychological counselors opinions], Role stress among practicing school counselors, Ortaretimde grev yapan retmen ve okul yneticilerinin okul gvenliine ilikin alg ve beklentileri [Perceptions and expectations of teachers and school administrators working in secondary education regarding school security], It just doesnt feel right: A mixed methods study of help-seeking in Irish schools, Advances in School Mental Health Promotion, The need for ethical code of conduct among school guidance counsellors in Obio/Akpor local government area, International Journal of Innovative Legal & Political Studies, Okul psikolojik danmanlarnn kullandklar unvann mesleki kvan, psikolojik danman zyeterlii ve baz zniteliklerle yordanmas [Predicting the professional title of the school counselors with the professional pride and counselor self-efficacy], Psikolojik danmada etik ikilemler: Etik karar verme sreci [Ethical dilemmas in psychological counseling: Ethical decision making process], Eurasian Journal of Educational Research (EJER), An ethics challenge for school counselors, School counsellors attitudes and beliefs about child sexual abuse, Ethical dilemmas in college counseling centers, Okul psikolojik danma hizmetlerinde mesleki etik ihtiyalarn belirlenmesi [Determining the professions ethical requirements in school psychological counseling services], At risk of harm? She is not sure that he completely understands what is happening or understands her version of informed consent for the additional services. 2 0 obj As a mandated reporter, would Dr. Tell report place her clients confidentiality be at risk? His impairment is noticeable by Dr. She also agreed to think about the need to bring in the boyfriend, because inviting him to therapy will not necessarily help the situation. Content may require purchase if you do not have access. Would your answer differ if there were no advanced directives? This has caused both his physical and The test is designed to determine if the patient can benefit from psychotherapy, psychotropic agents, or other psychological services. In actuality, Mr. Biggys wife is a very close friend of Dr. Smiths wife. Plenty acting beyond the limits of her competency? endstream A therapist receives a phone call from a well-known internist in her area. Prior to returning the call, Dr. Jordan reviews the patients chart. He thinks that she is young and impressionable. My name is Dr. If you were Dr. Miller, what are your emotional reactions to this situation? During the last two years, she required total care. He promised to call her back within a week. 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. It was revealed that counsellors prioritise the students benefit and respect students privacy. Qualitative content analysis in practice. A physician requests a psychological evaluation of a 46-year-old man who attempted suicide via overdose of prescription medications along with alcohol. As social isolation, loneliness and depression are regular themes in treatment; the therapist frames this as positive progress. The therapist knows that the ex-wife had been struggling with isolation and loneliness as well. 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. The therapist and the attorney-patient meet for the initial session. My wife told me that I should see a therapist but I told her that I could talk with you and that it would be much cheaper.. Consider the following scenarios, presented initially in the Ethical Dilemmas column in Therapy Today. This vignette poses several ethical dilemmas for counselors. 1. Has data issue: true White Plains, NY: Longman. He does not view it as a therapy group. (1998). At the end of the day, he listens to voicemail messages to learn that a former patient is reaching out to him for a request. There is nothing unusual that stands out about their therapeutic relationship. School counsellors often encounter ethically challenging situations due to contradictory values and roles. Published online by Cambridge University Press: She recently received an offer to become a sales representative for a pharmaceutical company. While you are there, a family member arrives with a copy of a notarized advance directive, created within the last year, which specifically outlines the patients wishes not to be placed on a ventilator or any artificial life support. 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. Ethical Considerations for Group Counseling Group counseling can be an effective form of practice with several intuitive benefits. Refer the matter to the State Board of Psychology. To use provided clinical vignettes to practice how to recognize the ethical and legal issues. They developed a good therapeutic alliance. 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. Harry is a school guidance counselor who is just got a job at a large public high school. Some of the sessions focused on a sexually abusive relationship between a basketball coach and the patient when she was age 13 to 16. He indicated that Dr. Cooper recommended that he discontinue a psychotropic medication in favor of an herbal remedy. In this new edition, Dr. Welfel provides the most current information on the market, including up-to-date coverage of the newly adopted ACA Code of . They see her regularly for informal family events and do holidays together with their adult children and grandchildren. 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. His attorney believes that some good, written character references will really help out with the case. endobj are The survey developed for this study consisted of vignettes based on ethical issues identified in the counseling supervision literature. American Counseling Association Ethical Dilemma "Counselors may be faced with a conflict between their duty to protect confidentiality, to . Dr. Smith asked if he needed to inform the patient of his impressions of the report and the seemingly erroneous conclusions. In the context of counseling, family includes people related through . 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. Dr. Crane applauded and appreciated the students energy and creativity, but indicated some concern about dual role with the student. The patient reveals that he became aware of that information after several dates and recently felt comfortable revealing this to the therapist. The patient presents with a history of rejection and abandonment as well as being abused by persons of power. 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. Cynthia had already invested quite a bit of money into her private practice, and was determined to make it work, regardless of the type of clients she had to treat. Important to an entrepreneurial therapist like you, this assessment bridges the gap between psychology and primary care. 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 Group of answer choices Growth in . Dan recently came out to his parents, who were accepting of his gay orientation and lifestyle. Programs that do not qualify for NBCC credit are clearly identified. What problems may occur as a function of Dr. His mother had suffered from a combination of severe respiratory problems and Alzheimers. Twenty-seven school counsellors in Turkey were asked to respond to 13 vignettes with ethical dilemmas. She has been doing much of the case management work, e.g. The patient has never met the attorney face-to-face, only by email and phone contacts. Additionally, Dr. Smith believed that some of the conclusions were in error, and had little support for those opinions in the body of the report. Dr. Smith is now worried about the entire situation. Along with the initial anxiety of the new job, her territory, and her boss, she reports a fear of failure and other anxiety related symptoms. How would you feel if you were the consultant? A female therapist in a suburban area has worked with a male patient for about one year. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. She actually attended his graduation party briefly and hired him to cut her lawn for two years. What factors make this situation potentially easy for you as a therapist? The therapist screens the potential patient and believes that she can help him. Dilemma 20: Has the Psychologist Done Too Much? In this paper I will discuss the ethical vignette as it deals with confidentiality and ethical dilemmas that counselor's face. As the conversation continues, the therapist is surprised to learn that the patients new friend is the ex-wife of the therapists husband. 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. Dr. Jordan thanked her for the compliment and indicated that he needed to think about the request. Feeling guilty, the therapist calls you on the phone to discuss his feelings and any possible ethical concerns. The clients boyfriend expressed that she should never discuss this with anyone. What are the possible downsides to entering the dual relationship? There were contentious issues dealing with the custody arrangements of the children. The therapist remembers the former patient as a likeable person. endobj A therapist receives a letter from an attorney indicating that he has inherited an old car from Frank Palmer. 14 March 2022. What are some actions that you, as the treating therapist, may have done differently? When asked about the reason for the referral, she said that her physician had referred her for anxiety. 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. a variety of upgrades, the web developer/consultant suggests that he add a testimonial page where former patients describe their positive experiences in therapy. The treatment notes indicate that she dropped out of therapy about one year ago. 2. Dr. Goodfriend is unclear whether Buddy is serious or joking. In the midst of all of this activity, the psychotherapist contacts you for an ethics consultation. A psychologist receives a phone call from a well-known internist in her area. Mr. Tellanyone goes on to explain that he is now caring for his father in similar circumstances, although there is no dementia. 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. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. What are the possible steps Dr. Crane can take to mitigate any potential difficulties? After her 6 weeks of training, the company assigns her to a regional director that the therapist knows personally. If you were Dr. Goodfriend, how do you feel about the phone call? Copyright Center for Ethical Practice, 977 Seminole Trail, #312, Charlottesville, Virginia 22901 Ethical issues relevant to family counseling are also included along with transcripts from hypothetical family counseling sessions throughout the book. The most frequent ethical dilemmas involved the limits of confidentiality, confusion about counsellors' professional roles in school settings, uncooperative behaviours among stakeholders, and . outside her scope of practice? 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. a73D%IhCTHA&:L0iAq(*p 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. What should you do with this email solicitation? The therapist expresses her concerns about working with a patient whose father is prescribing medication. Most issues do not produce ethical dilemmas, but some do. One day, Dr. Bishop receives a phone call from his contact at the institution. You may access the ACA Code of Ethics and other ethics code at the WEBLINKS button on this website. Dr. Tell allowed several moments to pass before asking the patient what was happening. He revealed that she had been suffering greatly and, out of compassion for her, he gave her an excess dose of her sleeping and pain pills. A therapist receives a call from an attorney wishing to seek services for depression, anxiety and substance abuse. What are the ethical issues, if any, involved in this case? adapted and used used with consent from a state psychological association. ethical dilemmas in counseling vignettes. } Does Dr. Goodfriend need to phone his high school friend to clarify his last comment? However, the attorney has little awareness about how impaired Mr. DiMencha is. Mrs. Simpson read the report and admitted that she did not understand some of the psychological jargon used in the report and had difficulty understanding what the conclusions of the report were. The therapy focused on depression and anxiety related to work-related issues, interpersonal limitations, and relationship difficulties. 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. During the session, Mr. Drapier verbalized suicidal ideation in a flip manner (Sometimes I think it would be better if I just killed myself). How would you advise Dr. Thomas to handle them? A survey of ethical dilemmas based on salient ethical issues in counseling supervision (i.e., dual . 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. 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. 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.. 5 0 obj Dilemma 1: Therapist in the Middle Dilemma 2: A Suffering Caregiver Dilemma 3: A New Referral? Prior to providing extra-therapy support, Dr. She calls you for an ethics consult. A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. Sci Rep 12, 22416 (2022). Standards of practice, part B.9 states that . stream The Center for Ethical Practice has been approved by National Board for Certified Counselors (NBCC) as an Approved Continuing Education Provider (ACEP No. How would you feel about receiving this request? Dilemma 20: Has the Therapist Done Too Much? Ethical Vignette Paper.docx. Are there any ethical considerations in this dilemma? As the session winds down, Mr. Drapier spontaneously asks for a second opinion about his treatment with Dr. Cooper. You are a therapist in a busy acute care hospital where you receive. Mrs. Simpson thought it would be good for Dr. Smith to review the report in order to help him with their therapy. Review each of the scenarios and indicate whether you agree or disagree with the counselors action. 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 lawyerpatient comments that this seems low. Running Head: ETHICAL VIGNETTE. Dr. Goodfriend speaks with Buddy about once every six to nine months. Approaching ethical dilemmas. Is the goal of therapy to help the client manage the situation or is the responsibility now on the psychologist to gather more information about the possible crimes committed with children? The purpose of these psychological evaluations is to identify individuals who have gross psychopathology, strong personality disorders, or other characteristics that would make them incapable of performing their religious duties adequately. She stated that Dr. Jordan recommended that she write down her memories. <> They follow legal guidelines in risky situations and insist on working within their areas of competence; they are not willing to accept noncounselling tasks. Mr. Tellanyone is feeling quite guilty about his mother. He would like help to work through the issues. Mr. Drapier smelled as if he had been drinking, and he admitted that his alcohol use has increased. This particular vignette, Swenson said, may well fail the two-prong test. She is also concerned about Mr. Drapiers level of depression, alcohol use, and suicidal statement. Simultaneously, he strongly believes he made the right decision. 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. If you were a co-owner of the business, how would you feel about this situation? Prior to their next session, Dr. Smith calls you for a consultation. She was recently offered a position as a dual-diagnosis treatment counselor at a local drug and alcohol rehabilitation facility. of study and a further neglect of ethical decision making in non-Western cultures in the professional literature on counseling and ethics. Mr. Biggy pulls Dr. Smith aside and explains how he has become very attracted to a new sales representative. Mr. DiMencha doesnt appear to understand his legal rights or the settlement process. xVN0}-m8 Address the matter with the other therapist directly. In the code, 18VAC115-20-130. Dilemma 1: Psychologist in the Middle Dilemma 2: A Suffering Caregiver Dilemma 3: A New Referral? My company has developed a unique opportunity for you and your associates. From a phone call with the attorney, he learns that Workers Compensation wants to work out a settlement. P. (1996). What are the ethical issues involved in this case? While it is not a complete assessment, it can guide patients to you for further psychological consultation.