Psychotherapy is a commonly used word in today’s world since many people today are seeking therapeutic advice because of the life hassles that people go through every day. Psychotherapy involves a trained therapist either one on one, group setting, or with couples. Through psychotherapy, one is able to look deeper into their problems and qualms. With the help of a psychologist, one is able to deal with wearisome habits including mental disorders like depression and schizophrenia. Psychotherapy is talking although are open to other methods that might help patients like music and art. Psychotherapy sessions help one to let out feelings they have either with oneself or with other people especially family. Couples are always advised to attend therapeutic sessions together even though might do so individually if the therapist feels it is the right thing to do (Nhs.uk, 2015). Marital and family therapy is always a techy issue and therapists are trained to know how to handle issues in this department. It is important for a specialist to know that s/he has a responsibility to make things better if presented with an issue since the main reason for such endeavors is to seek a solution and not further discord. Therapists are expected to abide by a number of ethical values in their handling of such sensitive sessions since they do so under a reason of trust by clients.
Like any other profession, therapists are guarded by a number of ethical morals and values and are expected to follow them to the latter in order to maintain professionalism. Ethics are guided by assumptions that therapists need to follow always in order to keep up with their competitiveness. Ethical awareness is a continuous and active process where therapists need to be constantly involved in constant questioning of their ability and responsibility. The continuous attention to patients’ needs, lack of sufficient support, the probability of complaints and the mind draining sequences might take the toll on a therapist and even block their personal responsiveness while at the same time dulling their sense of personal responsibility. It is therefore crucial that therapists practice continual alertness and attentive awareness of the moral consequences of what they decide to do or not (Pope, & Vasquez, 2016).
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Therapists also need to be aware of the legal standards and ethical codes even though these two cannot determine ones approach to ethical responsibilities. They are meant to inform and not determine since they cannot substitute thought and feelings in situations where one is under an ethical dilemma or uncertainty. Since every session is unique, the codes and standards can only be used to guide therapists on what decisions to make. Therapists need to also to be aware of the evolving research and theory and so it is important that therapists take note of some of the published claims with informed and careful questioning. The only reason people visit therapists is because they see them to be trustworthy caring and dedicated people who are committed to their ethical behavior. But truth be told, these people are just as human as their clients and so it would be infallible for anyone to think that they are immune to mistakes (Pukay-Martin, 2008). They can also overlook some important things as well as work from a limited perspective where they can end up making wrong conclusions or choose to stick to a particular belief even though misguiding. And so it is important that therapists question their integrity and decision making time after time in order to come up with a feasible conclusion.
Through their work, therapists cannot question the ethics of other people or their clients since they also stand vulnerable of their own beliefs, actions and assumptions. Therapists who spend time pointing out any supposed weaknesses of others than they spend challenging themselves in a positive and productive manner are but raising a red flag against themselves. Such energy needs to be invested in oneself in a bid to awaken their possibilities and perspectives so as to serve better their clients. Sticking on the same point, people find it easier to question themselves in areas that they are uncertain and therapists are no better. But just how much do they question things that they seem so sure of? If a therapist feels that a certain solution is the best for a client, then it is correct to ask just how often they think about the same. It is worth taking a risk to do so even if it would sound as if they are psychologically wrong or don’t want to feel shortchanged in front of a client. In their line of work, one thing therapist will not go without experiencing is the encounter of ethical dilemmas without any clear or easy answer (Pope, & Vasquez, 2016). Therapists’ bout with underwhelming requirements incomparable with sufficient resources, and conflicting duties that seem difficult to bring together which leads to a frustrating level of limits to their intervention and understanding of issues. Therapists are readily available to help persons who approach them because they are aching and in need, or because their desperation has left them alone and have no one to turn to. It is impossible that therapists can avoid such ethical struggles since it is part of their work. Therapists dealing with couples in a marital depression or families are more likely to face such issues and it is just important to try and figure out what kind of issues they are and how they can be handled (Vetter & Pope, 2017).
Family therapists can face complex ethical issues especially if the case in point involves members who have conflicting needs. This means that therapists can handle such sessions with the use of diverse procedures and formats (Sexton & Datchi, 2014). They can choose to deal with individuals then the family as a whole or vice versa. Or even sub-units of the family if it means getting a solution to the issue at hand. During the sessions, it becomes evident that moral issues differ in their significance depending on the layout used. Some of the issues encountered are as explained in the text.
Responsibility
A therapist has a primary responsibility which is to protect the rights and serve the interests of all their clients. This can however, bring along a dilemma where in as much as a decision might sound fair, it might just end up not serving the needs or interests of some individuals especially in a situation where one client’s best interests are counter therapeutic to the other. Take for example a marital therapy example where a wife wants to vanquish her fears and thoughts of terminating a marriage while her husband is more interested in maintaining the status quo. The two might have conflicting goals but the approach in which to attain the goals might be the real issue. A couple might visit a therapist because they want to improve communication in their home but as one advocates for complete openness and honesty, the other proposes a hardened disclosure (Sexton & Datchi, 2014). The work of a therapist in this case is to ensure that the neither couple is advantageous at the end of the session at the expense of the other. Such scenarios are no different in individual therapies either as an individual may make changes that are not of the same preference with the other members. The therapist’s role is to advise the client on other amicable ways of approaching the issue at hand without necessarily causing harm to others.
A family therapist in such a situation is more in a difficult spot since they are able to assess the reactions and how their behavior affects the rest of the family. They are tasked with ensuring that everyone is taken into consideration. The best way to deal with such a situation though is through adopting the family system as an agent of negotiation and not the choice of backing certain individuals. If the therapist needs to define a problem, they can do so basing on the family system and how important it is. This just makes sure that every family member feels involved. The same applies for relationships and what it all means is that a therapist has to be smart enough to find the appropriate balance between the point of conflict and the expectations of all parties, including the therapist. In such conflicts, a therapist cannot afford to pursue a blind lead that might end up conflicting the antagonistic parties even more.
Confidentiality
It is the therapist’s responsibility to conceal their client’s information if the said information took place in a therapy session; unless such circumstances are initiated by unavoidable circumstances that include danger to the client or if ordered by law. This means that the responsibility upon which such happens rests solely on the therapist. It is also of essence to note that the criteria with which a therapist ensures the confidentiality of a client’s information varies on both fronts of a therapeutic relationship and family members. That is to say that if a family member were to call a client on a private call, then that conversation is supposed to be treated as one from a different client and so not eligible to be shared with the others. Although some therapists prefer not to hide information from other family members, just in case it is used for the benefit of bias. A communication could be made however to let everyone know that as a family, confidentiality privileges do not apply while the client has the right to request that certain information be kept confidential and the therapist has to comply with such request. A therapist who does not wish to maintain confidentiality should however provide assurances that certain information will not be divulged to the others. For example if during a couples session, one of them reveals that they engaged in extra-marital affairs long ago, the therapist has no reason to bring up such an issue if it does not help the situation and that all is at their discretion (Pukay-Martin, 2008).
Confidentiality can be complicated if a client for example shares information in an individual session and the therapist remains in a difficult situation wondering how to share the same information in a marital therapy. If s/she has to, then they have to seek permission from the particular client to disseminate such information. If the client does not give permission, then the information cannot be given away. Therapists should take it upon themselves to state the terms of confidentiality to clients especially at family therapies so they can know how much to say. The therapist is also supposed to tell other members of the family that they are not at liberty to share any information revealed to them by individual members (Eddington & Shuman, 2008). The therapist as the right of whether to retain or share information and both options limit their decision making with other family members. If in a marital therapy a husband and wife decide to get back together if the husband stops her extramarital affair, and seven months later the husband reveals to the therapist how he has gone back to this act. The therapist may find themselves in a situation where they are torn in between bringing the issue to the session and help the wife make her decision or keep it under confidentiality. Both options are ethically correct but reverting to either of them might affect the relationship between therapist and clients.
Confidentiality at family level needs the therapist to ensure the confidentiality of the couple’s issues from their children. If a couple has difficulty setting boundaries around their relationship, they should properly be guided on how to establish privacy in the marriage and how to mince information that might turn out not to be good from their children. Confidentiality issues arise when a therapist gets t have sessions with the children and parents want to know what they shared. In as much as the parents have the right to inspect a therapists records, they have no right to force them into saying what they discussed since the child has a right to confidentiality just like adults do. Since therapists face a hard time with the issue of confidentiality at both marital and family therapies, they should be in a position where they can lay out policies to guide the sessions and communicate those policies to all parties involved (Pukay-Martin, 2008).
Patient privilege
Just like with confidentiality, there are legal constraints that permit privileged communication where a therapist may not reveal information or testify against a client if the said client has not given the privilege to do so. The law has not vividly stated what it means with privilege and so it is hard to understand whether things said in the presence of both the clients and therapist are under privilege or if things said in the presence of only the clients serves as confidential also. This can be solved by writing a written contract that none of the clients will call upon the counselor to testify (Vetter & Pope, 2017).
Informed consent and the right to refuse treatment
Family therapies are a sensitive practice and it is advised that a therapist gets the consent of everyone including those who might be involved at a later stage. It is advised that all family members be given an explanation on the procedures they are meant to follow and what purpose they play the role of the therapist and if they qualify for the said role and any benefits, risks and discomforts that are to be expected. All these guidelines apply especially for family therapy since for example if a divorce happened, then the family should have been let to know how to handle the situation. It is a common place that some members in families may refuse to take part in organized therapy sessions while others willingly volunteer. It is not a new thing and so any kind of coercion either by family members or the psychiatrist is unacceptable and wrong (Eddington & Shuman, 2008). This however does not necessarily mean that a therapist cannot encourage an individual to join the session neither does it mean that the individual should be ignored. The therapist should however create a system that tells just how long one is going to be in a particular session and under what role. It is also true that some types of marital and family therapies involve manipulation which limits true consent from certain individuals. Therapists on their part use this system to gain rewards of consent in the session (Metcalf, 2011). For example, some smart therapists may use parents concern about their stressing their children to make them strike a deal in marital therapy. It is important to note that in as much as clients need an actual sense of therapy to take part; the direct ness of the process might not be as straightforward sometimes. Some of the clients need a therapist’s encouragement and optimism about a situation and the promise that all will be well.
Children’s right to consent
Psychological therapies have been done before without any regard of the position and feelings of children who like in the case of family therapies are ones who are most affected. Today however, there is increasing lobbying that children should be allowed to exercise their own right to consent. In real sense, the parent holds all the cards when it comes to such sensitive matters (Margolin, 1982). A therapist should be sensitive enough to realize that children require more protection and that in as much as their parents intervention is well intentioned, sometimes they can’t know what is best for them (Miller & McLeod, 2001).
Therapist values
The therapist plays an important role in the therapeutic change process since their values are involved in the marital and family therapies. They are witness to personal, familial and societal values that expose sex roles, and extramarital relationships. Since they are humans, therapists find it hard to deal with these values especially when there is a conflict of values among family members (Vetter & Pope, 2017).
Preservation of the family
One would pose a question to inquire just to what extent is a therapist express personal opinion on whether a couple in marital and family therapy should divorce. The answer is found in the code of the American association for marriage and family therapy (AAMFT) which states that “In all circumstances, the therapists will clearly advice a client that the decision to separate or divorce is solely of the client.” But it’s true to say that there are times when a therapist has to make decisions on behalf of the client depending on how bad his/her marital status is. Such therapists, in order not to violate their ethical code, might give advice on a personal basis and not as a profession in order to help the distressed party. Sometimes it is hard to see one party trying too hard or struggling in marriage in the name of trying to save it (Margolin, 1982).
Other notable issues that invoke a dilemma in terms of ethical issues are sex roles and extra-marital affairs and they affect how a person conducts therapy and the effect it will have on clients’ lives. Like said before, a therapist cannot be bias enough or become such a strident advocate of any side in such matters if s/he aims to make a difference in the relationship. The therapist should also not put themselves in a position where they conflict with their own values for the sake of the family values (Metcalf, 2011). If one allows a conflict of values to take the day, then they are set to inhibit a desirable therapeutic outcome.
Ethical issues related to marital and family therapy does need a close and specialized attention. Even though therapists are guided by some of the ethical requirements for their profession, as seen in the essay, many of these guidelines turn out to be inadequate regarding the type of issues they are set to encounter in their work relations with more than one family. Even though some therapists attend training sessions to learn about this particular issue, the truth hits when they get to the field and have to encounter things like confidentiality. However, from the essay, one gets the point that a therapist should first of all separate personal intuition from decision-making at work and secondly, some of the issues discussed deserve further looking into by the profession to determine and clarify future ethical guidelines.
References
Eddington, N., & Shuman, R. (2008). ETHICS and BOUNDARY ISSUES . txcpe . Retrieved 22 April 2017, from https://www.texcpe.com/html/pdf/fl/FLETH.pdf
Margolin, G. (1982). Ethical and legal considerations in marital and family therapy. American Psychologist , 37 (7), 788-801. http://dx.doi.org/10.1037/0003-066x.37.7.788
Metcalf, L. (2011). Marriage and family therapy (1st ed.). New York, N.Y.: Springer Pub. Co.
Miller, L., & McLeod, E. (2001). Children as Participants in Family Therapy: Practice, Research, and Theoretical Concerns. The Family Journal , 9 (4), 375-383. http://dx.doi.org/10.1177/1066480701094004
Nhs.uk. (2015). Psychotherapy - NHS Choices . Retrieved 22 April 2017, from http://www.nhs.uk/conditions/Psychotherapy/Pages/Introduction.aspx
Pope, K., & Vasquez, M. (2016). Ethics for Psychologists: 7 Steps . Kspope.com . Retrieved 22 April 2017, from http://kspope.com/kpope/ethics.php
Pukay-Martin, N. (2008). Ethical Considerations in Working with Couples: Confidentiality Within the Couple . National Register . Retrieved 22 April 2017, from https://www.nationalregister.org/pub/the-national-register-report-pub/the-register-report-fall-2008/ethical-considerations-in-working-with-couples-confidentiality-within-the-couple/
Sexton, T. L., & Datchi, C. (2014). The development and evolution of family therapy research: Its impact on practice, current status, and future directions. Family Process , 53 (3), 415-433.
Vetter, V., & Pope, k. (2017). Ethics & American Psychological Association . Kspope.com . Retrieved 22 April 2017, from http://kspope.com/ethics/ethics2.php
