Recently "Ethics Rounds" received the following vignette and question: Several weeks ago, Dr. Alby began treating Kevin, who is 14 years old. Mr. DiMencha’s co-worker, Janet, helped him find an attorney so that his rights are protected. If you were Dr. Goodfriend, how do you feel about the phone call? While the treatment team does not share Dr. Solomon’s concern and has started to make discharge plans, they have not spent as much individual time with the patient as Dr. Solomon. You will receive a high quality report that offers diagnostic possibilities, suicide potential, and treatment planning options for new patients. She stated that Dr. Jordan recommended that she write down her memories. A therapist has been working individually with a 17-year-old male for issues related to depression and family dynamics. Mr. Tellanyone reveals that recently he had a conversation with his father in which the father commented how peaceful his wife’s death was and how he hoped for a similar passing. What are the potential ethical concerns about this scenario, if any? During the current session, the confides that he has made a new female friend. The Center maintains responsibility for this program and its content. of this, the exploration of ethical dilemmas within the curriculum should include preparation for and knowledge of realistic situations experienced in an agency setting, as well as the anticipation of future difficult circumstances (Royce et al., 2007). Abstract Consult the Code The therapist feels stuck and overwhelmed by her present situation. When she asks about insurance, he indicates that he will pay in cash. Dr. Bishop calls you for a consult about this situation. Each represents an ethical dilemma including “two or more of the values found in the ethical principles relating to conflict” [32]. Plenty had Mr. DiMencha sign a release giving consent for him to talk with the attorney as well as Janet. In the state of North Carolina Rule (NCGS § 8-53.8) states that, “No person, duly licensed pursuant to Chapter 90, Article 24, of the General Statutes, shall be required to disclose any information which he or she may have acquired in rendering professional counseling services, and which information was necessary to enable him or her to render professional counseling services: Provided, that the presiding judge of a superior or district court may compel such disclosure, if in the court’s opinion the same is necessary to a proper administration of justice and such disclosure is not prohibited by other statute or regulation. The marital situation appears deteriorated and Mr. Drapier appears significantly depressed. I provided marital counseling to a couple, and they have asked me to serve as the mediator in their divorce. Steps for handling ethical dilemmas: 1. And, Dr. Tell agreed to determine whether or not reporting this information would put her client’s confidentiality at risk. Approaching ethical dilemmas. He is marginally coherent and unable to give any consistent responses. Each vignette described a supervisor or a counselor facing such an ethical dilemma. and Family Therapy (AAMFT, 2015), American Counseling Association (ACA, 2014), and American Psychological Association (APA, 2010), serve to educate members about sound ethical conduct, professional accountability, and improved practice through mandatory and aspirational ethics. As soon as he looked at the intake form, he realized that she is the ex-wife of his former client. This will help me and others to become a better counselor. They have dinner as couples several times per year. Dr. Smith is now worried about the entire situation. Attempts to find social service agencies able to help him have not been successful. 1. 1. Dr. Tell explained that the alleged perpetrator was several times removed from their sessions and she did not believe that she had the obligation to report it. A dual relationship is when there is another role in addition to the counselling relationship. Medical personnel never questioned the death as the woman had been quite sick and “It was only a matter of time.”. She stopped therapy because her insurance changed and Dr. Jordan was not an in-network provider. Title: Ethical Vignette Abstract In this paper I will discuss the ethical vignette as it deals with confidentiality and ethical dilemmas that counselor’s face. Just as he is about to hang up, Buddy says, “Thanks. He thinks that she is young and impressionable. By Mrs. Drapier’s report, he appears more stressed because of his job and is drinking alcohol more frequently. Plenty acting beyond the limits of her competency? And, how would you, as the treating therapist, deal with those emotions? Is Dr. 3. The contact is now requesting that Dr. Bishop begin to screen individuals for “homosexual tendencies” because, according to the doctrines of the denomination, such individuals are not eligible to become clergy. What are the potential ethical issues in this case? Sue schedules the appointment for early in the evening. However, after the session, the therapist feels uneasy about what his patient revealed. Dr. What, if anything, should the therapist do? A physician requests a psychological evaluation of a 46-year-old man who attempted suicide via overdose of prescription medications along with alcohol. Part of her struggle is that she sees her husband as more depressed now than when he started treatment. During the first few sessions, Mrs. Drapier indicates that her husband, Don, is depressed and in treatment. Are there additional considerations for how to approach the referring physician when calling back? During the session, Mr. Drapier verbalized suicidal ideation in a flip manner (“Sometimes I think it would be better if I just killed myself”). After her 6 weeks of training, the company assigns her to a regional director that the therapist knows personally. Uncertain, she calls you for an ethics consultation. Mr. Drapier smelled as if he had been drinking, and he admitted that his alcohol use has increased. Dan’s 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. The ICU nurse asks you to offer an opinion regarding the patient’s capacity to accept or refuse intubation. 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. The therapist screens the potential patient and believes that she can help him. 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 husband’s depression and the marriage accurately. What would you need from the attorney? Health Details: Two typical cases that might arise are presented in the case vignettes. What obligations does the therapist have to the parent? From: PsychBuilder – High Tech Psychology at Low Cost, Subject: Online Assessment Tool to Promote your Practice. Identify some of your own deeply held beliefs and values and describe how they might influence a counselling situation. He believed that the custody evaluator had made several significant errors in the report concerning the psychological health of his patient. With her husband, the patient and the ex-wife? She recently received an offer to become a sales representative for a pharmaceutical company. Ethical Consequences of Role Confusion in Court-Related Cases, If Only I Had Known! If you decide to provide information, would you consider communicating with the prior patient’s attorney? Dan explained to Dr. Crane that this group would be student-led and meet on campus. Retrieved from https://graduateway.com/ethical-vignette/, This is just a sample. Dr. Goodfriend is unclear whether Buddy is serious or joking. Response, My reaction to the video at first was “This is a long video” then I began to really listen to what they were talking about and reflect on what they were saying and how it applies to me right now. To provide hypothetical vignettes based on ethical/legal dilemmas in my own practice. 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. He indicates that, in order for him to benefit from the treatment, he feels a need to pay what he makes an hour. One day, Dr. Bishop receives a phone call from his contact at the institution. Ethical issues in counseling generally fall on the therapist. The Center is solely responsible for all aspects of the programs. Learning Objectives: CASE 24 HIV+ Clients You are a mental health therapist, school counselor, or social worker. Dr. Smith decided to review the report. To use provided clinical vignettes to practice how to recognize the ethical and legal issues. List the most common ethical challenges that occur when treating couples and families. Prior to providing extra-therapy support, Dr. We have great data on the PASS-2 for reliability and validity in identifying primary care patients who can benefit from psychological services. Buddy adds that he has had trouble sleeping, has stopped exercising, has little energy, and fleeting thoughts of hurting himself. Results will be available to you and the patient online. 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. Out of options, Dan is asking Dr. Crane to be the faculty advisor. He also wondered if he should contact the patient’s lawyer, with her permission, to disclose his perceptions about the quality of the report and his perceptions about the conclusions. After reviewing the information presented, it is clear to the treating therapist that the other therapist breached confidentiality. The client’s boyfriend expressed that she should never discuss this with anyone. Simultaneously, the religious institution is adamant about this requirement. These case studies have been slightly altered to … Counselling Dilemmas. The therapist is involved in a busy practice, specializes in treating eating disorders, and receives only occasional referrals from this physician. Looking through his files, the therapist cannot find his file, so it must have been more than five or six years ago. She does not feel right taking a fee larger than her usual and customary rate. She told the student that she would think about the request prior to answering. His attorney believes that some good, written character references will really help out with the case. They describe relevant ethical dilemmas and their formulations, and demonstrate how a C/L psychiatrist can work through each case using the “Four Topics Method.” CASE VIGNETTE. The days allocated for her stay by her insurance are ending in two days. The Center for Ethical Practice is approved by the Association of Social Work Boards (ASWB) to offer continuing education for social workers, through the Approved Continuing Education (ACE) program (ACE provider #1287). Dr. Faye Miller receives a referral for a 35-year-old female, Betty Drapier, who is feeling depressed and experiencing marital problems. You are a therapist in a busy acute care hospital where you receive. The patient presents with a history of rejection and abandonment as well as being abused by persons of power. 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. For example, the first vignette… Select two of the attached scenarios to analyze, and follow the steps to decide upon a course of action. Therapists have used the PASS-2 for psychological diagnoses and evaluations for a number of years. At the end of the day, the therapist reflects on the interaction her new lawyer-patient. What should you do with this email solicitation? What problems may occur as a function of Dr. During those calls, the conversations typically focus on careers, family members, and the whereabouts about other classmates. Rob West, President and CEO of PsychBuilder Inc. located in San Jose, California. You arrive in the intensive care unit where the patient’s respiratory status is rapidly deteriorating. The therapist then phones you for an informal consultation. Chuck hesitated to have a face-to-face interview at the practice, but agreed only if he can talk with Sue. Mr. Biggy and Dr. Smith meet in an unplanned social venue. At the end of the call, Buddy tells Dr. Goodfriend that he is feeling much better. What are some actions that you, as the treating therapist, may have done differently? Case Vignettes for Review. A counsellor should evaluate how the second relationship will affect the cou…