<> Regulatory boards are the final authority on courses accepted for continuing education credit. After the initial greetings, the former patient indicates that she has finally started to write down more thoughts, memories, and recollections about her abusive experiences. Mr. Biggy pulls Dr. Smith aside and explains how he has become very attracted to a new sales representative. He feels stuck between being faithful to the patient and her needs without crossing a boundary as a treating psychologist. You arrive in the intensive care unit where the patients respiratory status is rapidly deteriorating. To use suggested categories to consider options for ethical response to the dilemma. What are the possible steps Dr. Crane can take to mitigate any potential difficulties? Third, many ethical dilemmas are usually not choices between right and wrong, but among competing ethical principles geared toward doing good. His family lives at a distance and provides minimal help. There were contentious issues dealing with the custody arrangements of the children. What are the potential pitfalls in the scenario? Dr. Tell allowed several moments to pass before asking the patient what was happening. . for this article. Case Vignettes for Review Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. The survey developed for this study consisted of vignettes based on ethical issues identified in the counseling supervision literature. In hindsight, what triggered some possible difficulties in this situation? Running Head: ETHICAL VIGNETTE. Part of her struggle is that she sees her husband as more depressed now than when he started treatment. Along with. While Chuck now lives in an apartment in town, she remembers him well. The lawyerpatient comments that this seems low. Dilemma 1: Therapist in the Middle Dilemma 2: A Suffering Caregiver Dilemma 3: A New Referral? Can the client contact Child Protective Services anonymously in this case? Dr. Joel Bishop has been conducting pre-ordination evaluations for a religious institution for many years. What obligations does the therapist have to Mr. Drapier, Mrs. Drapier, Dr. Cooper, and the public? Therapists have used the PASS-2 for psychological diagnoses and evaluations for a number of years. : Ethical and Legal Ramifications of Documentation Decisions. mh:/lIk[ R#ig#hJh@xVSP~~NP&#HC"+}C.|L.B:qe -4F[QDZuee168Ioa{ 3 m&#H7 x6}K 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. "useRatesEcommerce": false A court appointed custody evaluator performed a child custody evaluation. ~Bi"$\HM"ruGz^1C+hY>3MyO6Qd7 ;zeWz7w_:y5pF{MofM$Ql )h:K A-4 aX-tW)&"0#.tD9@d I"$aqDDW"> DDfkYHPXTDplrM_Eb'N4+m+8 nh htDiMg5O=_Tlj\^5?@taB-&r\`6XV!]m(@yI@mh(8^I.6}.jLH!n"$V8xfc?jPB[:4)u0vi{RZTfywJQTl?ThOo! Among other things, the report contained a psychological evaluation of the patient. 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. Patient contact information will be part of the administration process. The PASS-2 is administered online, from any computer, iPad, or iPhone. 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. Mr. Drapier smelled as if he had been drinking, and he admitted that his alcohol use has increased. The therapist is involved in a busy practice, specializes in treating eating disorders, and receives only occasional referrals from this physician. His attorney believes that some good, written character references will really help out with the case. They follow legal guidelines in risky situations and insist on working within their areas of competence; they are not willing to accept noncounselling tasks. If you were Dr. Goodfriend, how do you feel about the phone call? My name is Dr. 2 Print version: page 62 6 min read 0 Your browser either does not support scripting or you have turned scripting off. Plenty acting beyond the limits of her competency? A therapist receives a call from an attorney wishing to seek services for depression, anxiety and substance abuse. Standards of practice, part B.9 states that . } She has been doing much of the case management work, e.g. x#86h)Ppcc0F( k/ Harry then seeks out several other school guidance counselors in his area and asks them to meet with him to discuss how the Code of Ethics is incorporated into their practices. 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. A therapist had an intake appointment with a new client. The therapist knows that the ex-wife had been struggling with isolation and loneliness as well. It may rather be a sign that one is fully engaged in the life of a community. How would you advise Dr. Thomas to handle them? Therapy lasted about a year and focused on depression and relationship issues. 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. By Mrs. Drapiers report, he appears more stressed because of his job and is drinking alcohol more frequently. You may access the ACA Code of Ethics and other ethics code at the WEBLINKS button on this website. What are some actions that you, as the treating therapist, may have done differently? According to the therapy patient, Lyla is not aware that one of her customers is a therapist who works in another part of the same facility where she is receiving substance abuse treatment. What are the potential ethical issues with this case? The therapist expresses her concerns about working with a patient whose father is prescribing medication. 1LzLxG`kvP@>. The survey consisted of 10 vignettes based on the above ethical issues in. He indicated that Dr. Cooper recommended that he discontinue a psychotropic medication in favor of an herbal remedy. 2. Sci Rep 12, 22416 (2022). <> She stopped therapy because her insurance changed and Dr. Jordan was not an in-network provider. You have shared a couple of patients with the psychiatrist in the past and have spoken with him by telephone a few times. 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. 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 attorney-patient indicates that he earns about 2.5 times what the psychologist asked. Would your answer differ if the advanced directive was created 7 years ago or greater? During the course of their work, the patient discussed significant facts about his troubled past, numerous details about failed past relationships, and sexual fantasies. Is Dr. The therapist who received this information does not know the other therapist well, but has provided some consultation for the therapist in the past. Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. <> A therapist receives a phone message from a former patient. endobj 14 March 2022. Mr. Biggy indicates that he wants to talk more about his feelings. Buddy states that he has been feeling stressed over the last month. She was recently offered a position as a dual-diagnosis treatment counselor at a local drug and alcohol rehabilitation facility. 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. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 8 0 R/Group<>/Tabs/S/StructParents 1>> They start spending more time together. She began to provide psychotherapy to Mr. DiMencha, a 52-year-old, who suffered with depression. ; & Hartshorne,T.S. First, these vignettes are meant to be teaching tools. <> 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* 1 pages. He indicates that Mr. Biggy is a good family man. The patient is reassured, and reported less anxiety. Dr. Smith was treating Mrs. Simpson for depression precipitated, in part, by a separation and pending divorce. Prior to returning the call, Dr. Jordan reviews the patients chart. We have great data on the PASS-2 for reliability and validity in identifying primary care patients who can benefit from psychological services. Programs that do not qualify for NBCC credit are clearly identified. Dr. Bishop calls you for a consult about this situation. frequent consultation requests by the trauma service. What are some potential responses that you could offer Dr. Bishop? Jacob-Timm,S. Chuck is a 20-year old man who immediately expresses a great deal of agitation and anger. Are there additional considerations for how to approach the referring physician when calling back? Tel: 434-971-1841 E-Mail: [email protected], Knowing What We Don't Know: Meeting Our Ethical Obligation to Develop and Maintain Competence, Should I Write it Down? The ICU staff asks for your input. Book Description For undergraduate and graduate courses in Counseling Ethics, Legal Issues in Counseling; a supplement for Introduction to Counseling, Practicum, or Internship courses. When asked about the reason for the referral, she said that her physician had referred her for anxiety. Should Dr. Goodfriend call Buddy and offer a few referrals? DILEMMA ONE They have dinner as couples several times per year. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. He struggles with understanding concepts and his conversation becomes tangential during the next two sessions. Buddy also shares that he has been short tempered with his wife and kids. What are the ethical issues involved in this situation? 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. Buddy phoned Dr. Goodfriend in an apparent emotional anguish by the tone of his voice. What are potential advantages in this scenario? I encourage you to review our web site. Dr. Bishop feels uneasy about this situation, as homosexuality has not been considered a mental illness since the 1970s. He would like help to work through the issues. 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. The therapist obtains the keys and title for the vehicle. Dr. 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. Widely adopted as a textbook in graduate psychology courses in ethics and continuing education development, this innovative volume presents readers with over 100 different perspectives on crucial ethical issues and offers possible solutions from an expert ethics educator, psychologist, and former APA general counsel. She also agreed to think about the need to bring in the boyfriend, because inviting him to therapy will not necessarily help the situation. It was revealed that counsellors prioritise the students' benefit and respect students' privacy. The client continued to struggle. ocuk Koruma Kanunu [Child Protection Law]. Dr. Tell contacts you with the above scenario. There is nothing unusual that stands out about their therapeutic relationship. The mother further reports that the patients cousin has been driving the patient around town. Dr. Jordan thanked her for the compliment and indicated that he needed to think about the request. He also indicated that the relationship is taking on a more serious tone. He drives the car to a local dealer who indicated that the Explorer is worth about $3,500. 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. 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? of study and a further neglect of ethical decision making in non-Western cultures in the professional literature on counseling and ethics. You will receive a high quality report that offers diagnostic possibilities, suicide potential, and treatment planning options for new patients. At the end of the day, the therapist reflects on the interaction her new lawyer-patient. How easy or how difficult would it be to take those steps? 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. After reviewing the information presented, it is clear to the treating therapist that the other therapist breached confidentiality. 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. If you have further questions, feel free to contact me. A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. School counsellors often encounter ethically challenging situations due to contradictory values and roles. Divide and Rule? What are the potential ethical concerns about this scenario, if any? Additionally, none of the treatment issues had to do with impulse control or antisocial tendencies. (1998). 4 Ethical Vignette "School counselors should acknowledge the vital role of parents/guardians and families." (American School Counselor Association, 2010, Section A.1.d.) xVN0}-m8 Results will be available to you and the patient online. 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 . Chuck hesitated to have a face-to-face interview at the practice, but agreed only if he can talk with Sue. 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. 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. However, she begins to feel uncomfortable as she feels like they are spending too much time together. The ICU nurse asks you to offer an opinion regarding the patients capacity to accept or refuse intubation. This qualitative research aimed to define school counsellors ethical dilemmas and their responses to such situations. The therapist explains the fee structure for the initial appointment as well as ongoing psychotherapy sessions. 6 0 obj Dr. Smith politely explains that he feels uncomfortable with them discussing his more personal marital issues. She calls you for an ethics consult. Dr. Tell worked with a woman for several months on issues related to depression, anxiety, and relationship issues. With her husband, the patient and the ex-wife? What concrete steps might be important before calling the physician back? stream (1993). How would you feel if you were the consultant? 8 0 obj Mr. DiMencha doesnt appear to understand his legal rights or the settlement process. 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. 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. He also divulged that his risk-taking behavior has increased as well, such as speeding. What are some of the suggestions that you may have for the therapist about accepting or declining the referral? Dr. Tell agreed to contact someone to discuss whether Dr. Tell had to report this information to the police or Child Protective Services. She is also concerned about Mr. Drapiers level of depression, alcohol use, and suicidal statement. The test is designed to determine if the patient can benefit from psychotherapy, psychotropic agents, or other psychological services. If you decide to provide information, would you consider communicating with the prior patients attorney? Using a purposeful, convenience sampling method, we explored six school counselors' experiences of ethical decision making. What emotional reactions may occur for the therapist? 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 counsellor is also conscious. 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. What would be your emotional response to this situation? She stated that Dr. Jordan recommended that she write down her memories. 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.. Dilemma 20: Has the Therapist Done Too Much? 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. This vignette poses several ethical dilemmas for counselors. What clinical concerns arise for you in this scenario? 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 During this meeting, he realizes that while the other counselors generally behave in an ethical manner, they do not know the specifics of the code as well as hed like to. Dr. Popeil thinks these ideas are good. The patient was in therapy for approximately one year. The therapist, her husband, and his ex-wife are on good terms. What are the ethical issues involved in this case? If Dr. Tell is not a mandated reporter, should Dr. Tell bring in the boyfriend gather more facts so that Dr. Tell can report the alleged crime?
by 