Topics 7 & 8: Ethical Considerations and Non-Therapy Duties {by 6/30}

Based on the readings due this week consider the following two discussion points: (1) Based on Table 2.2, what best ethical practice do you think is the most challenging to uphold (either for yourself or other professionals)? Explain.  (2) What required duties beyond therapy do you find the most frustrating and/or least enjoyable?  Why?

 

Your original post should be posted by the beginning of class 6/30.  Post your two replies no later than 7/2.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

1 Comment (+add yours?)

  1. Yen Pham
    Jun 27, 2022 @ 17:30:16

    1. Based on Table 2.2, what best ethical practice do you think is the most challenging to uphold (either for yourself or other professionals)? Explain.

    For me, protecting client confidentiality is the biggest challenge because I have some concerns when I am going to work with the multi-person therapies (MPT). The MPT includes marital, family, and group therapy. I realize that in MPT confidentiality can be an issue because the asymmetry of professional duty is magnified, i.e., the practitioner has an ethical/legal responsibility while the group participants do not have a legal responsibility to the clinician or to one another. Therefore, it is hard for clients who participate in MPT to maintain their own confidentiality or the confidentiality of others in the group.

    Besides, confidentiality in group psychotherapy is more complicated than in individual therapy because self-disclosure is at the core of group therapy and there are numerous people hearing the disclosures. It is clear that absolute confidentiality in groups is difficult and often unrealistic.

    For example, confidentiality complicates MTP, especially in marital and family therapy because of some undebated questions. For example, should parents be able to sign away a child’s right to confidentiality? Often, couples may have difficulty in establishing boundaries and privacy concerning their own lives and those of their children. Adult clients can, and should, have the ability to assert privacy with respect to their marriage and to avoid burdening their children with information that may prove frightening, provocative, or simply beyond their ability to comprehend adequately. On the other hand, many attempts to maintain secrets have a manipulative purpose and do not serve the general goals of treatment.

    Therefore, at the beginning of the process to treat the MPT, I will provide informed consent about confidentiality educates group members or family members about confidentiality, and makes the discussion of confidentiality an ongoing process. I will encourage that is important for all group members to be mutually respectful of confidentiality regarding what each member says during treatment.

    (2) What required duties beyond therapy do you find the most frustrating and/or least enjoyable? Why?

    I realized that the expectations beyond counseling addressed in chapter 4 that Dr. V discussed include paperwork, case management, colleagues, supervision, managed care organizations, mental health community outreach, and professional advocacy. In my opinion, I think the most frustrating and/or least enjoyable is to work with Managed Care Organizations (MCOs) because of the is utilization review (UR) process, I sometimes feel restricted in my ability to care for my clients because I do not have full freedom to implement my treatment approaches as desired. This can put me in a difficult position because I may either need to follow the UR representative’s suggestions. I have experienced this during my internship. My agency mostly received the cases from the DCF worker, so each month we have a UR for each of my clients. This UR normally includes the DCF worker, social worker, and me. I have a duty to update in general about my process and treatment plans to the DCF as well as follow their suggestions to be closed or still open a case.

    Besides, I am not enjoyable in working with the MCOs because it sometimes impacted the relationship between me and my clients as well as some confidentiality between me and my clients too. Typically, my clients feel comfortable sharing any of their thoughts or feelings without being concerned that their information could go beyond the counseling room (unless the clients are a risk to harm themselves or others, of course). However, sometimes particularly sensitive client information may need to be shared with MCOs for treatment necessity as part of the UR. And of course, once this information is shared with MCOs, it is no longer under my control.

    Reply

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Adam M. Volungis, PhD, LMHC

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