● How does the therapist resolve conflicts between the parent’s values and rights and those of their minor child? ● What does it mean to respect the family’s values? ● What harm may come to the child as a result of disrupting a stable system of social support provided by the family? ● What does an individual do if he or she, as the therapist, has a conflict with the course of action chosen by a patient or a parent or, on the other hand, if the employer has a conflict with the course of action the therapist deems appropriate? (Adam, 2012) The therapist’s fiduciary responsibility consists of transparent competent care that is free of coercion. In this case, the professional duty to the client for confidentiality was in potential conflict with the duty to tell the parent the information given during treatment. Depending upon the conditions of the consent form, the therapist may have a legal obligation to inform parents but a moral obligation to protect the client’s privacy (Adam, 2012). In this case, if the parent initialed or signed consent to allow the teen to be in the treatment room alone with the therapist, there would be a case for allowing those conversations to remain confidential. On the other hand, the client is still legally a minor so depending upon the state of practice, there may be an obligation to inform the parent. States vary considerably on the age that requires consent of the parents concerning reproductive issues so the therapist would need to consult state law and other resources such as employer or agency policy. In some states the 17 year old’s communication would be protected by privacy and confidentiality law. The therapist was not obligated to accompany the client when confronting the parents about her situation. Because the parent immediately called the manager, it may be important to work on strengthening the lines of communication with the parents as well as a need to reset boundaries if this client continues to see this therapist in the future. Professionalism, Standard II: Legal and Ethical Requirements, Standard III: Confidentiality, and Standard V: Roles and Boundaries. to the HIPAA Privacy rules and the therapist’s professional standards and code of ethics. The therapist is bound to safeguard all information from the medical record to preserve the patient’s privacy from exposure to anyone even office staff. The receptionist had no need or right to know anything about the client’s condition because she was not treating him or consulting on the case as a treating professional. Also her role as receptionist did not include the transmission of information to other healthcare professionals or insurance companies as that role is assigned to another staff member. Her role did not provide her with the right to access any information contained in the medical record. In this case, the client’s right to privacy and confidentiality concerning medical information was breach because only the therapist had the right to know that information. He had the ethical obligation to protect it from all others not directly involved in his care or financial/insurance reimbursement. Review Standard I on Professionalism and Standard III: Confidentiality.
abortion. During the session, the mother called but the therapist was working with the client at the time. The therapist asked the teen how she would like her to respond to the mother’s call since it would have to be addressed that day. The client was aware that her mother knew something was wrong and recognized and that the therapist must return the call to the mother. The client promised to confide in her school counselor and to arrange to visit an obstetrician to confirm the pregnancy and start receiving prenatal care. The client hinted to the therapist that she would like the therapist to be with her when she confronted the mother. The therapist did not respond to the client’s hint. Before the therapist was able to return the call to the mother, the manager called the therapist into his office to inform him that the mother had called him directly. She was angry and believed that the therapist was interfering with the appropriate medical care of her daughter. The therapist informed the manager that the client had confided her suspicion that she was pregnant and, not being a medical doctor, the therapist was unable to confirm the pregnancy but believed the teen wanted to keep the baby and was taking the appropriate steps to seek assistance from the counselor and obstetrician. The therapist also explained the client’s fear that the parents would insist that she have an abortion .The manager, upon hearing the details and the clients plan of action, realized that the therapist had not interfered with the client’s care but was concerned about whether or not the therapist was obligated to communicate the daughter’s condition to the mother. Analysis This presents a number of potential conflicts in terms of client care, treating minors, obligation to parents, and the difference in perspectives of the client, parent, therapist and manager. This case points to the difficulty the therapist faces in practice when they must balance the confidentiality, their fiduciary role, and client rights. The pregnant teenager, even as a minor has certain mandated privileges, according to state and federal law that entitle her to a variety of medical care services without the consent or even the knowledge of her parents (Adam, 2012). Here are some questions to consider: Case study 9 A massage therapist and his receptionist were working in a small private massage and bodywork practice in an upscale community. The therapist recently began treating a major television celebrity who had a stained back due to an injury from playing golf. The receptionist asked if the client was Mr. ___, who was the star of a TV show and the therapist supplied his name and acknowledged he was the star of that show. The two discussed the fact that they were treating this star and began talking about the nature and severity of his injury. The receptionist asked how severe the injury was and how long he might continue sessions at the office. The therapist revealed that the diagnostic tests, including an MRI, indicated a moderate to severe injury that might require surgery so he would probably be visiting the office for a long duration. The two felt that it was permissible to discuss this client’s condition because there was no one else in the office to hear them. Analysis Regardless of whether or not there was anyone in the office, the therapist acted unethically and breached the confidentiality rights of the client in this case. All information related to the client’s medical file, including identifying information, is subject Reporting misconduct Many states require a “duty to report” by their licensees. If therapists believe they have first-hand knowledge of another practitioner acting unethically or illegally, they have a responsibility to report it. They should contact their state board, and the certifying organization including NCBTMB, AMTA, or ABMP.
Sanctions for unethical behavior The following information is from the NCBTMB website and listed on the reference page (NCBMTB, 2016c):
EliteLearning.com/Massage-Therapists
Book Code: MTX1323
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