Laws, Regulations, and Ethics for Florida Psychologists, 2nd Edition _ ________________________________
4. I —Information. Information should be sought from all available sources, including literature, laws, regulations, and agency policies. The information is then applied to each possible action to highlight the pros and cons. 5. C —Calculate risk. Assessing risk involves applying that calculation to each potential participant in the action. Decreasing risk to one party may increase risk to another. By considering risk for each participant separately, the psychologist can get a better understanding of the overall risk of each possible action. 6. S —Select an action. This is the final step, when the psychologist determines the most and least ethical courses of action.
Smith was surprised when she saw Jane arrive alone at Dr. Smith’s church one Sunday morning; it was the only church of that denomination in the town. Jane approached Dr. Smith and asked to sit next to her during the service. Although somewhat startled, Dr. Smith agreed. At their next therapy session, Jane stated that she has now become a full member of their mutual church and has volunteered to work on the same outreach committee as Dr. Smith, but hasn’t attended a meeting yet. How should Dr. Smith proceed? • Is there an ethical dilemma? • What about the situation requires decision-making? • If a decision is needed, what is the best course of action for resolution? 1. Identify the problem. This may be a multiple relationship. In addition to seeing Jane in therapy, they will also see each other on a consistent basis in social and volunteer situa- tions. Incidental contact outside of therapy is not a dilemma (boundary crossing), but this situation will entail ongoing close contact in a nontherapy setting (boundary violation?). Standard 3 states the psycholo- gist does not engage in a multiple relationship if it could reasonably be expected to impair the psycholo- gist’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 Eth- ics 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 although 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. Dr. Smith could do nothing and continue as is professionally and socially.
Self-Assessment Question
2. In the ETHICS decision-making model, H-help may be sought from all of the following sources EXCEPT:
A) social media. B) an attorney. C) a risk management liability company. D) a clinical supervisor.
CASE STUDY Regardless of the specific decision-making model the psychologist chooses as a best fit for their practice, all models simplify down to the following steps: 1. Identify the problem. 2. Gather information: Review laws, rules, and codes of ethics; get consultation. 3. Identify potential courses of action. 4. Consider the potential consequences of all options, determine a course of action, and implement it. 5. Review the outcome. Apply the steps for ethical decision-making to this fictitious case example. Dr. Smith has a private practice in the small town where she lives. Jane has recently moved to the town and has been see- ing Dr. Smith for weekly psychotherapy sessions over the past two months for symptoms of anxiety with panic episodes. They have a mutually agreed goal of reducing the frequency of panic attacks to one per week. Jane is making good progress in her ability to recognize symptoms and utilize cognitive and behavioral strategies, and the frequency of panic attacks has decreased from multiple times daily to an average of three per week. As she has been feeling more in control, she has begun to reengage in activities that have provided her with support and comfort. One of these activities is church attendance. Dr.
b. Dr. Smith or Jane could find a new church. c. Dr. Smith and/or Jane could resign from the committee but continue church attendance.
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