but this situation will entail ongoing close contact in a nontherapy setting (boundary violation?). Standard 3 states that the psychologist does not engage in a multiple relationship if it could reasonably be expected to impair the psychologist’s objectivity and effectiveness. Can objectivity in therapy be maintained? Can confidentiality outside of therapy be maintained? 2. Gather information: Review laws, rules, and code of ethics; get consultation. There are no laws that address this situation. Per Ethics Standard 3, Dr. Smith has a primary obligation to Jane as her client and must resolve the situation in Jane’s best interest and minimize or do no harm. Standard 4 states that she has an obligation to protect Jane’s confidentiality, which would be difficult in this situation. Consistent social interaction may prevent her from staying objective in her treatment with Jane. Jane is still an active client and though she has made progress in therapy, she has not yet reached their agreed upon goal. Standard 10 states that therapy should be terminated if the client could be harmed by continued services. Is that the case here? Is this an avoidable multiple relationship? What is the potential for inappropriate therapist transparency and self-disclosure in the social settings? 3. Identify potential courses of action. a. aSmith could do nothing and continue as is professionally and socially. b. Smith or Jane could find a new church. c. Smith and/or Jane could resign from the committee but continue church attendance. d. Therapy could be terminated, and Jane could be referred to another therapist. e. Therapy could be terminated. 4. Consider the potential consequences of actions, determine a course of action, and implement it. Dr. Smith discussed the ethical issue and her concerns with Jane at their next therapy session, since the client should be actively engaged in 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 consequences of terminating therapy? Is it in the client’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 volunteering? Dr. Smith voiced her discomfort 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 woman 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 moving to 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 learned to control panic when it arose. Dr. Smith gave Jane the names and contact information for three qualified providers in case Jane felt she 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 as well. Review the outcome. Dr. Smith documented in Jane’s chart the decision-making process, the different possible courses of action, and their mutual discussions and 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 when faced with 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. 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 recordkeeping c. The psychologist’s scope of practice d. Estimated length of therapy, fees, and billing practices e. Emergency procedures 4. Know your supervisory responsibilities . To make sure appropriate treatment is being given, supervising psychologists should continually assess supervisees’ competence. 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.
PRACTICAL TIPS TO AVOID COMMON ETHICAL SITUATIONS
The APA’s Ethical Principles of Psychologists and Code of Conduct document strives to assist 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.
b. Ensure safe storage of records. c. Obey mandatory reporting laws.
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Book Code: PYFL2024
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