● 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 than Dr. Smith. After discussing all of the potential options, they mutually agreed to terminate therapy. Jane had made significant progress, was almost at her goal, and felt confident that she could apply the techniques she 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 needed to return to therapy in the future. As part of the termination session, they also discussed how future interactions at church 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. 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 re-engage in therapy in the future. This example highlights the fact that seemingly benign situations can create the potential for a boundary crossing or even an unethical boundary violation. Real-life situations that the clinician may encounter are rarely straightforward, and there are multiple facets that must be considered. Different professionals may choose 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. Self-Assessment Quiz Question #6 The formal decision-making model that is chosen for use by the clinician: a. May not help the clinician identify the problem b. Should help the clinician analyze alternative courses of action c. Usually does not provide justification for any course of action taken d. Does not include evaluation of the consequences of an action Self-Assessment Quiz Question #7 The decision-making model in the case study: a. Determined a clear course of action that every clinician would follow in the same way b. Determined one clear right answer to the dilemma c. Did not consider all facets and aspects of potential consequences a. Provided an outline for an organized, thoughtful decision- making analysis
CONCLUSION
Healthcare providers have an obligation to provide safe and ethical care to their clients. It is apparent that in order to provide ethical care to clients, it is crucial for the clinician to understand the definition of boundaries. They must recognize boundary situations, distinguish a boundary crossing from a boundary violation, and have a knowledge base for evaluating and navigating boundary dilemma situations. Use of a model
or framework for ethical decision making can help the provider recognize, analyze, and navigate the complexities of ethical boundary dilemmas in order to achieve the best possible outcome for their client.
EliteLearning.com/Psychology
Book Code: PYFL4024
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