Ethical Issues
In this vignette, Dr. Smith is a psychologist who has worked with a young woman experiencing rejection, abandonment, and misuse from those in power. The doctor has worked with the woman for nine months. The woman has currently received a job as a sales representative for a pharmacology company and the patient discussed with the doctor that she fears rejection and misuse in her new job post. Dr. Smith knows the young woman's employer and claims that he is a good man who is more family-oriented. However, Mr. Biggy, the woman's employer starts sending controversial messages to the woman, admits to Dr. Smith that he would want to have an affair with the sales representative in his workplace, and requires Dr. Smith's help to handle the entire situation. The ethical dilemma presented in this case is the fact that a psychologist is not allowed to have multiple relationships since Mr. Biggy is associated with the young woman that Dr. Smith has a professional relationship with.
In most cases, a psychologist should refrain from having multiple relationships especially in a case where the various relationships could affect the competence, objectivity, and effectiveness of a doctor. Besides that, various relationships could risk the exploitation to a person with whom a psychology has a relationship. In this case study, Dr. Smith risks causing harm to the young woman that he counseled when he agrees to mentor Mr. Biggy, a family friend, in his issues, which concerns the young woman in a professional relationship with Dr. Smith. The fact that Mr. Biggy wants to open up his points to Dr. Smith will affect the effectiveness of the psychologist since Dr. Smith knows the issues that have affected the young woman in the past since she claimed that she had experienced issues of misuse by the people in authority.
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Dr. Smith, once he agrees to take Mr. Biggy as his client, is likely to make an objective decision to protect the young woman, which is unethical in counseling. Importantly, multiple relationships that are not expected to cause any harm or exploitation are not immoral. Psychologists are governed by the APA ethics that requires them to uphold confidentiality. With the intention of helping the young woman from sexual exploitation, Dr. Smith is likely to get tempted and tell Mr. Biggy regarding the issues that surround his employee who happens to be Dr. Smith's patient. This will be an infringement of the code of ethics governing the psychologists. The APA Ethics guides the psychologists making it clear that multiple relationships require being avoided apart from the relationships that are not likely to lead to objectivity and judgment of the psychotherapist. As seen in this case study, this could be quite challenging to the psychologists.
Besides that, the social relationships with clients tend to interfere with the therapeutic relationship with the psychologists. Some people could object to the statement above by claiming that counselors can handle a relationship with the clients on the basis that their relationships are clear. Such people argue that social contacts could be appropriate if the clients have no annoying issue and if they seek personal growth. However, most of the practitioners take the position that friendship and counseling should not be mixed. It would be difficult for DR Smith to counsel Mr. Biggy who is his friend and knows the relationship they have with the wife.
When the young woman came to consult Smith regarding her new job, Smith told the woman that Biggy was a good man. Smith may not be considered liable to the actions undertaken by Biggy, but it was wrong for him to tell the woman good things regarding Biggy with the intentions of putting her at ease. The friendship that Smith shares with Biggy may have contributed to the clouding of the doctor’s judgment about Biggy leading Smith to tell his patient that he and Biggy were good friends. Smith tried to tell Biggy that his actions were wrong and he did all he could to avoid him. The fact that Smith’s actions brought harm to a client undergoing therapy, Smith could be held accountable for that.
Besides that, Biggy is involved in sexual harassment. Because the woman is in therapy, she is in a vulnerable position. The therapeutic bond was broken because of Biggy’s sexual advances. Smith not only disclosed his relationship with Biggy but vouched for him as well in an attempt to pacify his client’s anxiety. Smith made her therapy about him, wanting to appease this woman’s concern. Despite Smith backing out, further damage can be done to this woman psychologically. Her therapist said it was ok for her to work there, and put in a good word for his friend. In addition to her employer became sexually inappropriate, Smith’s actions influenced her decision to work there. This was a violation of her trust in Smith since he was the one who suggested she work there in the first place.
Giving employment advice is considered outside the scope of practice for therapists (Sue & Capodilupo, 2015). Therefore, it was inappropriate for Smith to suggest that it was ok for his client to accept the position. Smith’s relationship with Biggy became a dual-relationship when his client began to work there. Influencing her decision is a breach of trust. Based on the presenting issue of the client, the client’s pattern re-emerges in her employment with Biggy as her supervisor. When Smith disclosed his relationship with Biggy, Smith unconsciously undermined her presenting issue. Smith also said Biggy could be trusted and was a family man. This provides grounds for exploitation.
Biggy is already in trouble because the woman has disclosed her discomfort with his inappropriate behavior. Because Smith encouraged the relationship, although he is not liable for Biggy’s behavior, Smith is liable for failing to either refer this woman to someone else or not disclose his relationship with Biggy. Smith also failed this woman by making any suggestions about employment. This is outside of a therapist’s scope of practice. The APA only allows dual relationships in roles of performance if no other professional is available (O’Laughlin, 2001). For example, if someone needs psychiatric treatment and psychotherapy, the therapist is licensed, like both, and they live in an area was two separate professionals are unavailable, and then the therapist can serve the client as a psychiatrist as well. However, this is not the case with Smith. He committed a boundary violation that was damaging to this woman when he failed to treat this woman’s anxiety about work and her relationships with those appointed above her. Smith was not allowed to give career advice and was only limited to help this client with the presenting issues. Smith also leaves the conversation with Biggy. If Smith is ever called in as a witness in Biggy’s sexual harassment suit, Smith’s leaving could be viewed as distancing himself from Biggy’s situation in order not to be “caught.” This action could be misconstrued as mitigating responsibility and liability of wrongdoing after the fact that a legal infraction had occurred.
Actions that one would take to address this ethical issue
In solving the problem of multiple relationships, Smith could refer Biggy to a different counselor and have a talk with the woman to talk about the issues affecting her at the workplace and provide non-objective solutions to the problems. Multiple relationships involve the breaking of the professional boundaries (O'Laughlin, 2001). In this case, a psychologist should refrain from having multiple relationships especially in a case where the multiple relationships could affect the competence, objectivity, and effectiveness of a psychologist. Besides that, multiple relationships could risk the exploitation to a person with whom a psychology has a relationship. In this case study, Dr. Smith risks causing harm to the young woman that he counseled when he agrees to mentor Mr. Biggy, a family friend, in his issues, which concerns the young woman in a professional relationship with Dr. Smith. The fact that Mr. Biggy wants to open up his issues to Dr. Smith will affect the effectiveness of the psychologist since Dr. Smith knows the issues that have affected the young woman in the past since she claimed that she had experienced issues of misuse by the people in authority.
The proper way to solve this issue of multiple relationships has a good decision-making process. A good decision would also help to solve the sexual harassment scandal that is likely to victimize both the doctor and Biggy at the same time. Biggy is involved in sexual harassment. Because the woman is in therapy, she is in a vulnerable position. The therapeutic bond was broken because of Biggy’s sexual advances. Smith not only disclosed his relationship with Biggy but vouched for him as well in an attempt to pacify his client’s anxiety. Smith made her therapy about him, wanting to appease this woman’s anxiety. Despite Smith backing out, further damage can be done to this woman psychologically. Her therapist said it was ok for her to work there, and put in a good word for his friend. In addition to her employer became sexually inappropriate, Smith’s actions influenced her decision to work there. This was a violation of her trust in Smith since he was the one who suggested she work there in the first place. In this case, a good decision-making process would involve telling the woman undergoing therapy that Biggy in his actions and sexual harassment towards the woman surpassed his expectations (Stockdale, 2009). Smith should make it clear to his patient that he is not an acquaintance in Biggy’s behavior.
According to Gutheil & Brodsky, (2011), the goal of making an ethical decision is taking a position where the potential for an exploiting behavior is minimal. It is very easy for therapists to misuse the power that they have. Therefore, it is important for the therapists to consider the various influences that behavior could have on a client. In most cases, the violations of boundaries have a profound effect on the balance between the professional relationships with a client. When the young woman came to consult Smith regarding her new job, Smith told the woman that Biggy was a good man. Smith may not be considered liable to the actions undertaken by Biggy, but it was wrong for him to tell the woman good things regarding Biggy with the intentions of putting her at ease. The friendship that Smith shares with Biggy may have contributed to the clouding of the doctor's judgment about Biggy leading Smith to tell his patient that he and Biggy were good friends. Such acts could be avoided by making proper decisions that are ethical as per the APA Code of Ethics. Therefore, this paper focuses on ethical behavior in psychology and places its focus on Dr. Smith, psychologists who make several mistakes in his career that can be solved by ethical decisions.
References
Gutheil, T. G., & Brodsky, A. (2011). Preventing boundary violations in clinical practice. New York: Guilford Press. ISBN 978-1-59385-691-5.
O’Laughlin, M. J. (2001). Dr. Strangelove: Therapist-client dual relationship bans and freedom of association, or how I learned to stop worrying and love my clients. University of Missouri-Kansas City School of Law Review, 69(30), 697–731.
Sue, D. W., & Capodilupo, C. M. (2015). Multicultural perspectives on multiple relationships. In B. Herlihy & G. Corey (Eds.), Boundary issues in counseling: Multiple roles and responsibilities (3rd ed.). Alexandria,
Stockdale, K. C. (2009). Review of Preventing boundary violations in clinical practice. British Journal Of Psychology, 100(3), 620-622. doi:10.1348/000712609X447820
