Couple as well as family therapists can be identified as ones who encounter more ethical challenges compared to therapists that are individual oriented. In addition, some of the ethical challenges that are faced by couple therapists are incorrectly assumed that they are covered in the general principles and practices of counseling and psychotherapy. Gurman, Lebow, & Snyder (2015) also point out that the complexities of these ethical issues may increase with increase in the number of couple therapists. However, though these ethical issues have not been addressed, there are ways in which practitioners can avoid these common ethical dilemmas such as confidentiality, termination of treatment and whether to breach confidentiality.
First, the psychologist should always understand whom they are helping as well as the expectations the client may have. The therapist should be able to identify their client, the roe they are expected to play as well as be apparent about their work as well as the professional boundaries they have. The therapists should also have conversations about their confidentiality limits and also the services they are willing to offer. Furthermore, therapists must always understand what creates a multiple relationship. This notion means that the therapist should be able to identify whose needs are being met. Therapists should avert any relationships that could result in harm to the other party or impair the professional performance of the therapist. To establish this, the therapist should be able to identify the power difference between themselves and the other party. The therapist should also identify the duration and whether the contact will be brief or continuous. Furthermore, the therapist should ensure that the client is aware if the therapeutic relationship has been terminated permanently. The therapists should avoid, at any cost, having sexual relationship with the client as it is the only unacceptable multiple relationship between a client and a therapist (Smith, 2003).
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Therapists should always protect the confidentiality of their clients. Although the therapist may be asked to provide information to spouses, employers and even the school administrators, they should be careful to strike a balance on what they disclose. This balance is aimed at protecting the client’s ethical obligations of confidentiality. Therapists can also prevent more confidentiality issues through discussing the limits of confidentiality and the usage of confidential information. Smith (2003) explains that therapists should also ensure that they store confidential information safely and also create room for conversations that are confidential. However, the therapist should also obey mandatory reporting law, despite the fact that they want to maintain confidentiality of their client. Mandatory reporting law is invoked in instances such as abuse.
Therapists should respect client autonomy in such a way that they facilitate the client with information that the client needs in order to make an informed consent from the beginning. This provision enables the therapist to avoid any sticky situation, should it arise. Autonomy of the client can be achieved through discussing the limits of confidentiality, estimated length of the therapy session, alternative service or treatment approach and the client’s right to terminate the therapy sessions. The therapist should also address the fees and identify the client’s emergency contacts. Most importantly, the clinician should explain what they cannot or will not be able to do for the client as well as the areas where the clinician is not trained on. In situations where the client is not competent to make independent decisions, the person who is in charge is to be provided with similar information (Smith, 2003).
The clinician should be aware of their supervisory responsibilities in such a way that they are responsible for the actions of those who are under their watch such as interns and administrative assistants. Therefore, supervisory therapists should ensure that the supervisees are under continuous assessment in order to ensure competence in performance. Supervisors should establish specific times and processes for giving information or feedback and avoid delegating work to people who might have multiple relationships with the client that would result in the loss of objectivity for the supervisee.
It is important for therapists to make documentation of the clients including the relevant history, service dates and fees, diagnostic impressions, treatment plans and assessments of the clients. The documentations should also include treatments that the therapist has suggested and those that the client has rejected. The therapist should also include any follow-up efforts made if the clients drop out of sight. Clinicians should never alter a record after it has been made since it is illegal (Smith, 2003).
Therapists should always remember to practice in the field where they have expertise. This notion can be addressed is through keeping in touch with the profession through continuing education, consulting with colleagues and also through conferences. Furthermore, the clinician should know the difference between abandoning a client and terminating the therapy sessions. The therapist should provide pretermination counseling and make suggestions on alternative service providers. The pretermination counseling helps the client to identify the advantages of new services. The client is also able to understand why the current sessions are not helpful. The therapist should involve the client in the termination plan as well as empower the client to feel confident and competent enough to accept the termination.
The therapist should be accurate in billing patients as well as insurers for the services they provide. To avoid ethical complications, the therapist should only bill for services they have provided. The clinician should also use the correct billing processes. To ensure accurate billing, the client should list the dates that they treated the patient. In addition, the therapist should be honest in their work. For instance, the clinician should be honest in instances where the client asks for less diagnosis because they are afraid that others may find out. The clinician should also discuss the billing practices at the beginning of therapy. Finally, the therapist should be cautious about collecting fees especially when the client stops paying their fees (Smith, 2003).
In conclusion, although the therapists may face many ethical dilemmas, there are some practices that can help them to avoid such dilemmas. Above all, the therapists should always remember to be the best practitioners they can be. This notion will help them uphold transparency while at the same time provide commendable services to their clients.
References
Gurman, A. S., Lebow, J. L., & Snyder, D. K. (2015). Clinical handbook of couple therapy .
Smith, D. (2003). 10 ways practitioners can avoid frequent ethical pitfalls. PsycEXTRA Dataset , 4 (1), 50. doi:10.1037/e300062003-027
