Ethical Consultation, Decision-Making, and Self-Awareness in Clinical Practice The American Psychiatric Association (APA) Code of Ethics (2002) is the foundation for psychology’s professional practice and ethical responsibility. Although it is important to know the ethical standards, professionals must also apply them into practice. The current case example examines the importance of professional consultation, when faced to identify ethical dilemmas in clinical practice, make ethical decisions, and gain insight into self-awareness. This case also highlights the importance of implementing self-care in clinical practice, especially when treating patients who present with severe symptomatology. Ethical Dilemma An ethical dilemma occurs when moral obligations clash, and may pose a challenge when faced to define which course of action is right or wrong. In the current case, Ashley, an advanced doctoral student is faced with a challenging ethical dilemma at her current practicum site. The ethical dilemma became complex and multi-layered, prompting Ashley to seek peer consultation in efforts to make sound and professional decision making when faced to determine the course of action. Specifically, Ashley who is treating two teenage adolescents (patient A, patient B) from the same H.S. is made aware of private information concerning patient B, from patient A. Patient A is considered to be more “high-risk” due to the recent tragic death of her parents, suicide attempts, and chronic suicidal ideation with plan. Ashley fears that the information she holds may trigger patient A into depression and suicidal ideation. In addition, Ashley is conflicted that withholding the information from her patient may do equal damage, and sever their relat... ... middle of paper ... ...s that may contribute to VT: • Personal victimization history that is unresolved. • Lack of experience/novice. • Lack of coping skills, excessive demands from self, others and/or work. • Current personal stress experience. • Low level of subjective personal accomplishments/low fulfillment of goals. • Unrealistic expectations about patient recovery. • Excessive time in the same job. Linehan (1993) states that working with high-risk patients, and/ Axis II symptomatology can cause frustration, disappointment, and other negative reactions in therapists. Linehan (1993) emphasizes the importance to elicit peer supervision and professional consultation for overall support. In addition, the mindfulness of one’s reactions to challenging patients is crucial. Furthermore, it is important to maintain an objective and scientific approach to clinical care (Linehan, 1993).
One of the most complex, ever-changing careers is the medical field. Physicians are not only faced with medical challenges, but also with ethical ones. In “Respect for Patients, Physicians, and the Truth”, by Susan Cullen and Margaret Klein, they discuss to great extent the complicated dilemmas physicians encounter during their practice. In their publication, Cullen and Klein discuss the pros and cons of disclosing the medical diagnosis (identifying the nature or cause of the disease), and the prognosis (the end result after treating the condition). But this subject is not easily regulated nor are there guidelines to follow. One example that clearly illustrates the ambiguity of the subject is when a patient is diagnosed with a serious, life-threatening
The phrase primum non nocere (‘‘first, do no harm’’) is a well-accepted ideology of the medical and mental health professions. Although developing research data indicate that several psychological treatments may produce harm in significant numbers of individuals, psychologists have until recently paid little attention to the ethical issues of hazardous treatments. The Ethics Code of the America...
When it comes to mental health and diagnosing there is many challenges that a therapist or clinician could encounter. In any professional occupation one has to consider all of the ethical principles put in place as well as the legal laws; if one is incompliant to these ethical guidelines in a mental health field, in varying circumstances, failure to comply with these codes could involve legal issues which could even result in lose of licensure. Common ethical issues involved in the mental health field could include: misdiagnosis or missed diagnosis, legal incompetence, and health care fraud (misdiagnosis for insurance reimbursement).
In the mental health profession of counseling, therapy, psychology, psychiatric and social services ethical dilemmas are faced primarily on a daily basis. Being that mental health professionals are working with clients who are often fragile and vulnerable, they must develop an intense awareness of ethical issues. On the other hand, mental health professionals would never intentionally harm their clients, students or colleagues and others whom they work with. Unfortunately, good intentions are not enough to ensure that wrong doings will not occur and mental health professionals have no choice but to make ethically determined decisions. Depending upon the experience and expertise of the professional determines the outcome of the ethical circumstance. For example, if you were practicing mental health professional and had a friend who’s a licensed psychologist, who is invited to attend the wedding of a patient that she has been seeing in court-ordered therapy for a year; what advice would you give your friend?
Positive ethics allows a psychologist to be aware of potential ethical dilemmas they face while striving to achieve their best in clinical practice. Positive ethics allows me to think through difficult situations that may arise and resolve ethical issues that may occur. For this reason, a clinician must be able to describe how they will apply positive ethics into their decision-making process. From my perspective, I plan to apply the five general ethical principles into my decision-making process because they share a set of core values. Principal A is Beneficence and Nonmaleficence meaning psychologist will strive to benefit those whom they take care of and do no harm. By applying this principle into my decision-making
In the medical field, there are many ethical dilemmas that a person could face. One of the major dilemmas in the medical field comes from being a doctor. While attending to a patient/ client the doctor may not know the best treatment or course of action to take because of the many options there could be. The values and beliefs of a doctor can’t interfere with the treatment of a patient/client. Their job is to be honest, benevolent, respectful, and to maintain confidentiality of the patient/client.
...ate with their therapists. “A systematic relationship between the therapists' personal reactions to the patient and the quality of their communication, diagnostic impressions, and treatment plans” (Horvath & Greenberg, ). While positive attitudes from the therapists are more likely to result in a successful treatment, negative attitudes will not develop the necessary cooperation from the clients side to successfully reach the goal of the therapy.
When one initially chooses a career path, one rarely looks at all the negatives that may be associated with that choice. Most career paths have some negatives associated with the field, but few face the moral dilemmas associated with modern healthcare. Those who choose to be in the healthcare profession today are faced with moral and ethical dilemmas that would make King Solomon tear his hair out. In many cases, doctors, and sometimes nurses, are faced with life and death decisions without the benefit of knowing the patient’s, or the patient’s family’s, wishes. However, aside from those tragic times when a patient’s wishes are unknown, healthcare professionals must always put their own morals aside, and act
Part of the ethical code for a professional counselor involves education about current research developments and trends in the field of mental health (Linde, Erford, & Cheung, 2010). Psychopharmacology is an example of such advancement that would require attention. As noted by King and Anderson (2004) the failure to recommend an evaluation for medication as a viable option when appropriate can lead to liability issues. A lack of knowledge in this area would not absolve the counselor of this responsibility.
The Ethical Decision Making Model is an ethical guideline that is useful in ethical dilemmas and what course of action to take. It’s a framework that allows professionals to analyze and make ethical decisions to the best of their ability. It gives counselors a protocol to determine the appropriate course of action when faced difficult challenge. These decisions are taking into account; reflect a concern for the interests and the well-being of all clients concerns. Counselors should keep in mind the Golden Rule: “Do onto others as you would want onto you”.
According to The American Psychological Association's (APA) Ethical Principles of Psychologists and Code of Conduct, psychologists must comply with the standards of the APA Ethics Code as well as the rules and procedures used to carry them out. Having a lack of understanding of the ethical standards is not an acceptable cause to operate in an unethical manner. Furthermore, even though a specific regimen is not mentioned within the APA guidelines this does not exempt an unjust behavior (American Psychological Association [APA], 2010). The same rules apply to Dr. Betsy Jones, a small-town practicing psychologist unsure as to whether her actions would be considered ethical, so she reaches out to a professional colleague for guidance.
Sunil, a fifty-three-year-old male, entered the social worker’s office accompanied with his son, Arun, and his daughter-in-law, Julia. Sunil is an immigrant, originating from Calcutta, India, and has been adapting to living in New York for five months. Julia and Arun, referred Sunil to a counselor following the death of his wife. Julia marks that she has been noticing changes in his hygiene, sleep and eating habits. Arun addressed that ‘his father is suffering’ from the the loss of his wife and might be having trouble adjusting to New York. Julia and Arun felt that Sunil would benefit from speaking with a professional. Currently, Sunil lives with his son and daughter-in-law and their two children.
Ethical dilemmas occur when there is no simple right or wrong answer and come in many forms. Characteristics of a dilemma include having multiple courses of actions with certain and uncertain consequences to those choices. These decisions can involve such things as when to break confidentiality, who to discuss assessment results with, dealing with dual-relationships, etc. Often times that choice to break confidentiality or whom to discuss assessment results with are clear, sometimes they are not. A key component in determining if a behavior is ethical, other than the ethical guidelines themselves, is the context in which the decision is being made. For example, confidentiality should never be broken, unless the client who in this example is suicidal expresses that they are a danger to themselves or someone
Ethics in the counselling and psychotherapy protects the client and the therapist involved in the therapeutic relationship and the therapeutic process as a whole; with the concepts that act as a guide for the therapists in provision of good practice and care for the client. The framework is built on values of counselling and psychotherapy; principles of trustworthiness, autonomy, fidelity, justice, beneficence, non-maleficence and self-respect, and provides standards of good practice and care for the practitioner (BACP, 2010). Ethical framework contributes to the development of the therapeutic relationship and process by assisting therapist’s decisions, and guides their behaviour and proceedings within their legal rights and duties. The ethical frame is structured on the boundaries of the therapeutic relationship and the therapists should be aware of their categories and be responsible for their forms. Monitoring and being aware of what goes on in and out of the room physically, emotionally and psychologically is primarily the duty of the therapist.
In today’s society, individuals face various ethical dilemmas every day, whether it is deciding to lend a hand to a stranger who has fallen or getting involved in a bullying scenario. We consistently make decisions that correspondence with our morals and values. Ethical dilemmas follow the nursing profession where nurses have to decide what options will benefit and provide their patient’s the absolute best care. The question of honesty comes into play when the nurse has to convey unsettling news of cancer to his/her patients. Is honesty the best policy, should a patient know everything about his/her conditions in spite of how severe it may be? There are many factors to consider when making an astute decision. The patient, family members, physician and nurse viewpoints are to consider for the most appropriate solution.