the decision process. In discussing the potential courses of action together, they considered multiple factors. Would it be possible to continue with therapy and not interact socially? What would be the consequence of terminating therapy? Is it in Jane’s best interest to terminate therapy? Did Jane know that Dr. Smith was on that particular committee? If so, what was Jane’s motivation for joining it? Dr. Smith voiced her uncomfortableness with the potential self-disclosure and her difficulty remaining objective in therapy if the choice was to do nothing. She felt that the choice to do nothing had too much risk to do harm. Neither wanted to find a new church, since this was the only one of that denomination within a reasonable distance and both were very comfortable there. However, the risk of accidental disclosure was great if they continued to serve on the same committee. If therapy was prematurely terminated, there was the potential for Jane’s panic episodes to increase in frequency and again become debilitating. Jane stated that when she volunteered for the committee, she did not realize Dr. Smith was also a member. She was comfortable joining a different committee. After discussing all of the potential options, they mutually agreed to terminate therapy. Jane had made significant progress, was almost at goal, and felt confident that she could apply the techniques she had learned to control panic when it arose. Dr. Smith gave Jane the name and contact information for three qualified providers in case Jane felt she Practical tips to avoid common ethical dilemmas The APA’s Ethical Principles of Psychologists and Code of Conduct document strives to help the practicing psychologist navigate the many ethical complexities and nuances of the psychology profession. Smith (2003) of the APA Monitor offers the following practical tips to avoid ethical situations and complaints: 1. Understand what constitutes a multiple relationship. Avoid any relationship that could impair professional functioning or harm the client. When weighing the pros and cons, consider the following three factors: a. Power—How much of a power differential is there? b. Duration—Will this be a brief or continuous relationship? c. Termination—Has the therapeutic relationship been terminated? 2. Protect confidentiality. Be clear about disclosures, even seemingly minor ones such as information to insurance companies. a. Discuss limits of confidentiality at the onset of treatment. 3. Respect people’s autonomy. Provide clients with the information they need to make informed consent at the onset of treatment. a. Limits of confidentiality b. Specifics of record-keeping c. The psychologist’s scope of practice d. Estimated length of therapy, fees, billing practices e. Emergency procedures b. Ensure safe storage of records. c. Obey mandatory reporting laws.
needed to return to therapy in the future. As part of termination, they also discussed how future interactions would be handled. They would both stay in the church and although they would acknowledge each other, they would not sit together. Since Jane had not attended any committee meetings yet, she agreed that she would join a different committee, since she had other interests. 5. Review the outcome. Dr. Smith documented in Jane’s chart the decision- making process, the different possible courses of action, their mutual discussions, and the final decision on an action. They were able to continue in the social situation with minimal contact, and Jane had resources available if she felt the need to reengage with therapy in the future. Different professionals may have chosen a different course of action for the same dilemma. There is rarely only one right answer when faced with an ethical decision. However, if a decision-making model is followed, the professional is in a better position to be able to explain and justify the course of action taken. Pope (2022) provides an extensive list of links to ethics codes and practice standards developed by professional organizations from numerous therapy, counseling, forensic, and research organizations. Reviewing sections applicable to one’s own practice can provide invaluable guidance when one is faced with an ethical dilemma. 4. Know your supervisory responsibilities. Supervising psychologists should continually assess supervisees’ competence to make sure appropriate treatment is being given. a. Have specific processes for feedback. b. Outline the structure of the supervisory relationship at the beginning. c. Document supervision dates and discussions with supervisees. d. Explain to clients that the supervisee is in training and give them the supervisor’s name and contact information. 5. Identify your client and role. This is crucial when the psychologist works for an organization or with groups of individuals. a. Couples therapy b. Family therapy c. Services at the request of a third party, for example, a court d. Confidentiality limits 6. Document all interactions. Follow APA’s record-keeping guidelines (APA, 2007) and document all services, interactions, and communications. a. Identifying information and first contact b. Relevant history, risk factors, and medical factors c. Dates of service and fees d. Diagnostic impressions, assessments, treatment
plans, consultation, testing reports, progress notes; document treatments chosen and those considered and rejected
e. Informed consent documents f. Telephone calls g. Follow-up contacts for no-shows
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