Expediency of Continuing Psychotherapist-Client Interaction Surpassing Limits of Counseling - Case Study Example

Ethics Case Study Assessment by The case study with Dr. Jones and Mr. Albertson is quite complicated because it involves close interaction between a psychotherapist and a client surpassing the limits of counseling. The issues that arise in the described case concern the aspects of privacy and confidentiality, education and training of the specialist, her competence, and human relations. Despite the fact that the therapist seemed to act in the patient`s best interests there appeared certain ethical problems that could only be solved with the help of Code of Conduct written by American Psychological Association. Describing the case briefly, it is necessary to mention that after a concussion the patient found himself in the condition when he could no longer rely on his cognition and needed coordination and guidance. The therapist decided to help the client and disclosed information to an attorney and a friend after signing a release with the client. The counselor also attracted other people to assist Mr. Albertson as he seemed to lose his connection with reality. Generally despite the evident fact that Dr. Jones was acting according to then Principle A of Ethical Principles of Psychologists which states that beneficence and nonmaleficence are the core aspects of work: “Psychologists strive to benefit those with whom they work and take care to do no harm. In their professional actions, psychologists seek to safeguard the welfare and rights of those with whom they interact professionally and other affected persons” (2010). The first noticeable violation concerns privacy and confidentiality. The issue is rather ambivalent because the therapist could be viewed as acting in the emergency situation trying to help the client. In most cases any intervention in a patient`s personal life is a violation but at the same time a psychotherapist is guided by the principle of beneficence of a customer and in some cases he needs to choose whether to cross or not to cross the boundary (Prasko & Vyskocilova, 2013). However, Dr. Jones made a serious and responsible decision to have the client, who was already suffering from injury and demonstrated multiple cognitive deficits, sign a release in order to be able to share his personal information with third parties. The release is quite a disputable and problematic document because it is not likely that Mr. Albertson could evaluate adequately what was going on as he had troubles understanding concepts, however, such agreements can be made only in the condition of full patient`s awareness. So the Assessment standard could also be violated to a certain extent. Moreover, further information disclosure about the patient followed initial communication with the attorney and Mr. Albertson`s friend (despite the fact that only these two people were discussed primarily). In the case study it is mentioned that Dr. Jones communicated to primary physician and others revealing confidential information about Mr. Albertson. Therefore, the principle of privacy and confidentiality was violated several times: first when signing the document and further when disclosing information to the physician and friends. While the confidentiality standard presupposes that: “Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship” (Code of Conduct, 2010). And the information disclosure is only possible: “with the appropriate consent of the organizational client, the individual client/patient or another legally authorized person on behalf of the client/patient unless prohibited by law (Code of Conduct, 2010). Thus, violation of confidentiality principle took place as the therapist should have taken into account the mental state of the patient at the time of release signing and should have been more careful disclosing information to the physician and friends of the patient. It is also a disputable question whether Mr. Albertson could asses if he needed counseling continuation at all. It is stated that his understanding of his rights was rather blurred that is why the decision to continue the therapy was probably made by a Dr. Jones. The issue of competency also attracts attention. Dr. Jones was acting beyond the limits of her competency because she did not have necessary expertise to assess the seriousness of Mr. Albertson`s injury because it belonged to the other medical sphere- neurology. Dr. Jones was more or less familiar with psychological state of the client while and should have report it to the physician and neurologist upon release. The complicated issue here is that the attorney who helped Mr. Albertson with settlement could rely only on the evidence of Dr. Jones because he did not meet with Mr. Albertson in person. Moreover, Mr. Albertson himself would not be able to describe his state to the attorney as he was injured badly. So Dr. Jones was acting in emergent situation; however she was surpassing the limits of her competency as a professional. Additionally, Dr. Joes intervened Mr. Albertson`s personal life contacting his friends and relatives. In terms of state regulations Dr. Jones did not violate the requirements of her licensing in terms of confidentiality as the purpose was reasonable. According to the Psychology Practice Act of Minneapolis if the counselor initiates the release of information with the following purpose: “to coordinate professional care with another provider, to obtain insurance payments for services, or for other specified purposes”, under condition of release as a document submitting, it is acceptable” (Psychology Practice Act, 2013). This term “conflict of interests” is used to describe the situation in which the private financial interests of a public official or fiduciary agent will benefit by the influence of their unique position of trust. In a conflict situation a person may use a professional position to enhance the private interest of a fiduciary agent. In this situation there is a conflict of interest as the attorney as well as the counselor may be considered interested in directing Mr. Albertson to the process of settlement and to receiving financial benefits for their services (Meyer, 2012). The patient did not understand what is going on and could not assess adequately his legal rights that is why it was rather easy take advantage of him. The intention of Mr. Albertson`s lawyer to arrange the compensation without assessing the client`s condition adequately and attracting the psychiatrist to this assessment can have negative legal consequences for both specialist. Despite the fact that Mr. Albertson and D. Jones signed a document explaining all the fees for additional services it is most likely that this document cannot be considered valid taking into account the state of the patient. Moreover, he actions of the lawyer and the therapist can be put under question since they both realize the mental state of the patient and continue working with him. If the patient or his relatives reveal this conflict of interest there is a possibility of a lawsuit. Moreover, Dr. Jones is combining several different roles and that can provoke problems for her as well as for the client. Dr. Jones remaining Mr. Albertson`s therapist serves as an expert for the attorney who relies on her evidence regarding the client`s state. Moreover, her involvement into Mr. Albertson private life with helping to settle down and acting as a friend is also problematic. This blending of roles can impact negatively the therapy or even make it impossible in future. There also arise legal complications in case when Dr. Jones is revealed disclosing information to the physician and other involved without permission. For assessing this situation right it is necessary to know the context of the case. The major issue, which is underlined in the case is that Mr. Albertson has no one to help him: no relatives, no close friends, and this fact forces Dr. Jones participate in his destiny. However, maybe her actions are driven by humanism and the responsibility before her client there is still a logical limit for her actions and participation marked by the Ethical Code of Conduct. In this case it is not quite clear whether Mr. Albertson does require therapy because he has serious problems with perception of reality due to his cognitive impairment. So probably it would be even more reasonable to cease the therapy until the client is able to assess the reality adequately. If the patient does require the therapy it would be logical to find another more qualified therapist who would not perform other roles except for his professional. It is the only qualified help that Dr. Jones can offer to her client without the risk of doing harm. It is necessary to cease working with Dr. Jones as she passes professional limits consulting and communicating to people connected with Mr. Albertson she is risking to make the situation worse. The intentions of Dr. Jones to help Mr. Albertson in the role of a friend has made the therapy impossible and it will be absolutely better to attract Mr. Albertson`s relatives to performing their duties. References Meyer, J. (2012). Fresh legal perspectives: Psychologists I dual relationships. APA. Retrieved from: http://www.apa.org/divisions/div12/legalper.pdf Prasko, J., & Vyscocilova, A. (2013). Ethical questions and dilemmas in psychotherapy, ANSR, 55,(1-2). Psychology Practice Act. (2013).Minnesota Board of Psychology. Retrieved from: http://www.psychologyboard.state.mn.us/docs/Practice_Act_v02112013-7.pdf Read More