Ethics in Psychotherapy
learning outcomes :-
On completion of this unit, students will be able to: a) analyse codes of ethics, legislation, moral discourse, values and ethical principles in relation to ethical decision making in their field of practice
b) describe, identify and critique ethical and legal responsibilities inherent in providing professional services in their field of practice
c) analyse the influence of professional and social power upon professional and social relationships and the limitations of ethical principles in creating fair and just societies
d) identify appropriate actions in circumstances of risk to self and others
Ethics in Psychotherapy
Ethics are fundamental in the psychotherapy field. It is through the emphasis on ethics that patient-counselor trust is heightened. The film Lantana presents an in-depth analysis of the concepts of ethics that circumvent healthcare provision as pertains to access to patient information. Through the intricate plot development of the film, there are various aspects of ethics in psychotherapy such as personal, professional conflict and accessibility to patient information by third parties.
Case Study Summary
Lantana is an exhilarating film whereby the main characters are floundering in their relationships. Through the director, there is the development of various elements of emotions, ethics, and conflicts. The men in the film are viewed as less expressive of their emotion. Psychiatrist Valerie enjoys a marriage to John Knox an academician (Goldner, 2004). Their relationship only endures as a result of the grief they share as a result of the murder of their daughter. On the other, Valerie has a patient, Sonja, an unhappy wife to a detective Leon. Despite the two couples having children, there is no passion and majority of their relationship exudes emotional numbness. Sonja’s suspicion of her husband’s infidelity with Jane is valid. Jane’s neighbors are Nick, who is unemployed and Paula, his wife who is a nurse. As a stay at home dad, Nik observes the ongoing in the neighborhood and is bothered by Jane’s sexual escapades with Leon. In the film development, the disappearance of Valerie translates into them being drawn together and it is assumed that there may be foul play. As Leon conducts the investigations, there are extensive interviews that reveal various details about Valerie and the diverse characters of the film. Access to the sessions between Leon’s wife and Valerie form the platform whereby Sonja raises the issue of personal space, and requires such an issue be addressed promptly (Goldner, 2004).
Social Legal and Ethical Issue Raised in the Film
Confidentiality is an aspect of concern raised in the film. As such, patients in most instances share personal information with their psychiatrists. If the prospect of confidentiality regarding the information is not protected, it will translate into the eradication of physician-patient relationship (Shaw & Carroll, 2016). Therefore, patients would less likely be open to sharing their sensitive information. There is a legal and ethical issue raised by detective Leon’s unwarranted access to the psychiatric recordings of his wife’s sessions with Valerie. Accessing the sessions and diverging information without the authority to do so results in a breach of the social, legal, and ethical duty, considering that he is a law enforcement officer. From the research undertaken by Reamer, (2017) the obligation of confidentiality prohibits law enforcement officers, counselors, and health care providers from disclosing of personal information without permission. Due to Valerie’s inability to handle her marital issues, there is a clash between her work and emotions that translates to poor judgment and ultimate death. Accordingly, Bond, (2015) emphasizes that despite Valerie remaining ethical throughout her conduct; there is the issue of the records being accessed by the law enforcement officers and revealed to the public. On the other hand, Valerie’s grief becomes extensively influential on her conduct as a psychiatrist. As such, the extreme grief that she handles leads to her ineptitude in offering viable counsel to her patients. The level of influence of her grief on her counseling process is evident by the tone she adopts towards listening and speaking to her patients (Deane et al., 2015). Reamer, (2017) emphasizes that there are anger and resentment in how she communicates with her patients.
Intervention Plan Based on Code of Ethics, Professional Standards, and Legislation
There is the set code of ethics about the access of patient information by law enforcement officers. There is the need for the law enforcement officers to conform to the legally set procedures to ensure that there is no breach of patient confidentiality (Goss & Anthony, 2015). Despite Valerie recording the sessions ethically and legally, there is the outright breach by Leon in accessing his wife’s recording (Hofmann, 2017). As such, in accessing the patient records, among the various law enforcement officers, there are the standards of practice set forth to ensure legality and dissuade breach of confidentiality. Therefore, an intervention plan for mitigating the issue includes:
- Ensuring availability of a psychiatrist during the access to the patient records
- Focus on the prospect that confidentiality between husband and wife or doctor and patient is under privileged status. Therefore, the information is protected as evidence
- Ensuring that media presentations are both accurate and in accordance to the ethical platforms in the counseling process
- Ensure that Leon does not use the recorded sessions by his wife
On the other hand, in the analysis of Valerie, there is an evident conflict of interest emanating from her conflicts between her personal and professional life. The adoption of an intervention plan should be geared towards the development of an environment whereby there is focus on both her mental and health status (Bond, 2015). She exudes fear, depression, and torment over her daughter’s death, which calls for an intervention plan that comprises of:
- Encouraging Valerie to seek professional help
- Communicate with patients to adopt a transitional process for third party therapy sessions
- Ensure that Valerie is within the confines of what was documented from her previous therapy sessions
Professional Challenges faced in Working with the Issue Provided
Counseling is an ethical profession that is geared towards empowering individuals from different social environments to ensure meaningful lives prevail. From the analysis of the case, there are diverse professional challenges that may emerge in the evaluation of Leon and Valerie. First and foremost, from the analysis of Leon, there is the professional challenge towards educating the law enforcement officer on the need for adopting ethical standards in accessing patient recordings (Davis, 2014). The recorded sessions are a representation of personal lives and secrets should be private. Hence, Leon faces various professional challenges such as:
- Educating him on the need to conduct himself ethically while investigating access to the recorded sessions
- Ensuring that there is a mechanism for accountability and transparency in the evaluation of the sessions
Valerie, on the other hand, exudes conflict between the personal and professional life which translates into dire consequences on her performance. The prospect of personal trauma translates into the need for her to seek counseling sessions. However, the prospect that she is a psychiatrist may prove a professional challenge. In reference to Brown, (2015), psychiatrists in most instances exude reluctance in seeking personal help from fellow psychiatrists despite the outright problems they face.
Personal Challenges faced in Working with the Issue Provided
Personal challenges will mainly emanate from the analysis of the case involving Valerie. From her evaluation, various personal conflicts are negatively impacting on her output as a psychiatrist (Hofmann, 2017). Therefore, in the analysis of her case, fundamental issues are circumventing ethical principles of psychiatry that may pose a challenge towards effective management of the issue. Among the ethical principles that may pose a daunting environment includes:
- Communicating with her on the need to respect and promote value in her work in the instance that her personal life becomes a problem
- The need to recognize and preserve the rights of the patients and ensure informed consent prevails in executing her roles
- The emphasis on the most fundamental steps towards maintaining and developing competency throughout the service delivery process
The ethical issues circumventing Leon and Valerie presents a challenge towards encompassing the code of ethics and ethical principles. The code of ethics is applicable in evaluating Leon’s conduct. The code of ethics, as per Psychotherapy and Counseling Federation of Australia (PCFA), establishes the right approaches towards handling recorded sessions of patients. There is the emphasis on the need for transparency, accountability, permission, and conformity to the set procedures in handling private sessions (Shaw, & Carroll, 2016). As such, Valerie had recorded the sessions as per the legal stipulations and mandate of PCFA (Hofmann, 2017). Therefore, the right remedy for the case would have been the involvement of lawyers and counselors in the evaluation of the recorded sessions to ensure that breach of confidentiality does not prevail. On the other hand, from the evaluation of Valerie, the ethical principles play a critical role (Ivey, 2014). In her conduct as therapists, there were various instances in which her personal life had a negative implication on her professionalism. Conformity to the ethical principles would have called for her to take some time off to handle her trauma (Shaw & Carroll, 2016). The interventionist approach should have played a critical role in reminding Valerie of her ethical duty.
In conclusion, ethics play a fundamental and connective
role in the professional field of psychotherapy. The above analysis reveals the
elements of ethical principles and code of ethics that help shape the operational
mandate of the health care providers. Valerie and Leon depict two characters
that exude forms of breach of conduct in their service delivery. Therefore,
through the two characters, there is the portrayal of the need for the code of
ethics and ethical principles in psychotherapy.
Bond, T. (2015). Standards and Ethics for Counseling in Action. London: Sage.
Brown, J. (2015). Specific Techniques vs. Common Factors? Psychotherapy Integration and its Role in Ethical Practice. American Journal of Psychotherapy, 69(3), 301-316.
Davis, A. W. (2014). Ethical Issues for Psychologists using Communication Technology: An Australian Perspective on Service Provision Flexibility. Professional Psychology: Research and Practice, 45(5), 303.
Deane, F. P., Gonsalvez, C., Blackman, R., Saffioti, D., & Andresen, R. (2015). Issues in the Development of E‐supervision in Professional Psychology: A Review. Australian Psychologist, 50(3), 241-247.
Goldner, V. (2004). Review Essay: Attachment and Eros: Opposed or Synergistic? Psychoanalytic Dialogues, 14(3), 381-396.
Goss, S., & Anthony, K. E. (2017). The Development of Ethical Guidelines for Online Counselling and Psychotherapy. In Web-Based Behavioral Therapies for Mental Disorders (pp. 212-240). IGI Global.
Hofmann, S. G. (Ed.). (2017). International Perspectives on Psychotherapy. Springer.
Ivey, G. (2014). The ethics of Mandatory Personal Psychotherapy for Trainee Psychotherapists. Ethics & Behavior, 24(2), 91-108.
Reamer, F. G. (2017). Evolving Ethical Standards in the Digital Age. Australian Social Work, 70(2), 148-159.
Shaw, E., & Carroll, M. (2016). Toward Ethical Maturity in Counseling Psychology. Handbook of Counselling Psychology.
[A1]This is the Legislation part with all the relevant references for the intervention.