Ethical and Legal Considerations in Therapy Vignette 1

Ethicaland Legal Considerations in Therapy


Inthe agency, there a problem with record keeping whereby there is alay-man method of keeping the files there is increased exposure ofclients files and this contravenes the confidentiality code thatshould be observed according to the California Association ofMarriage and Family Therapists (2015) practitioners have aresponsibility of safekeeping the clients files, transfer them ordispose them in the most professional way. As an employee who havereported this matter to the supervisor and with no action beingtaken, there is another step I can take to enforce the safe recordkeeping.

First,the supervisor seems reluctant to initiate and enforce proper recordkeeping of clients’ files. Since this is an internal affair, I canput a reminder to the supervisor with the presumption that he mightgather his professionalism and enforce the safe-keeping of records. If this does not work out, I can forward the petition to the seniormanagement who handle enforcing the ethics on the employees. To backup the claim, I will need supporting evidence to show that theinformation extracted from the clients is at risk of being accessedby other parties (CAMFT, 2015).

Underthe scope of competence as indicated by the California Association ofMarriage and family therapists, (2015) practitioners should alwaysact professionally in treatment, education, and supervision. It isunethical for the supervisor to act oblivious to the fact that theconfidentiality of the client’s information is at risk. Since theallegation is not frivolous, there is every reason to let themanagement know of the behavior of the supervisor since it is athreat to the whole institution. The code requires him to actprofessionally toward his duties and his supervisees (CAMFT, 2015).


Dr.Linwood has a responsibility as a supervisor to mold Jay into acompetent professional under his care. The AAMFT code of ethics(2012) requires him t dispense his duties as a supervisor in the mostcompetent way. When Jay reports that he is color blind, and he cannotdifferentiate between whites and non-whites, it is not a professionalmove towards cultural competence. His non-discriminative behaviordoes not emanate from his professionalism but rather from hisinability to differentiate the colors (AAMFT 2012) Linwood shouldrespond by taking it lightly and see it as a step towards culturalcompetence. However, he should intensify his efforts to mold Jay inseveral ways.

First,cultural competence is one of the core considerations during thetraining of Marriage Therapists. Linwood should explain thatdiscrimination in not only a subject of color. It can emanate fromsexual orientation, race, ethnicity, religion, and gender or healthstatus (AAMFT 2012) Jay may find himself practicing discriminationeven among the whites.

Secondly,as a supervisor with a duty to act professionally towards hi juniors,Linwood has the mandate to oversee that Jay implements the advice.Linwood also has a duty to expose his juniors to the rightenvironment so that they can cope with the different challenges. Inthis case, he should expose Jay to the various clients visiting theinstitution and get a feedback from his experiences (AAMFT 2012). Jayshould also make a personal effort of revisiting his notes and readwidely on how to be culturally competent because his supervisorcannot develop all the qualities in him. The internship should onlyconfirm the learned attributes and provide the right environment forpractice. Interns should not take it as a platform to start theirprofessionalism. It should only strengthen it.


Marcieis at risk of committing suicide and as a professional, there areseveral things that I could do to change her attitude towards herlife. First, there is a need to understand the instigating factorsthat make Marcie contemplate suicide. Being an Asian-American may beone of the things since she may be feeling out of place in the midstof people who come from a different background. As a receptionist,she comes across a lot of people, and she might be facingdiscrimination. Secondly, her relationship with the married man doesnot work out properly, and it is one of the leading factors to hersuicidal behavior. Another factor to consider in the process is theavailability of means to end her life. Marcie possesses a gun, andthis is one of the swiftest way to end her life. She may becontemplating suicide. Another important actor of this assessment isthe client’s unchangeable biological makeup (Reamer,2013). Her body characteristics are not changeable, and she has to livewith it.

Dueto the extent of the risk, the supervisor advises a referral to alocal psychiatrist in a nearby hospital. However, Marcie does notwant her accompanying mother to know what is going on with her.Confidentiality crops as another important consideration. Respect forthe client’s autonomy is of importance. Since she does not want hermother to know what is happening to her, there is a need to assureher of confidentiality since she is not beyond help (Reamer,2013). Secondly,she has the right to access quality care, and the institution willconnect her with a psychiatrist who will act in the best interest ofthe patient. In doing these things, I will be complying with mysupervisor’s directions as part f my professional practice.


Leannepresents us with a complicated case that requires immediateattention. She comes from a Muslim-American family, and this meansthat her family is subject t part of Muslim culture that may havehindered her to seek professional advice or withhold someinformation. In dealing with her case, it is imperative to considerthe implications of bringing the matter to light to the family.Although she claimed that her father ceased to abuse her sexually,the marks on her hands reveal otherwise. However, even going by thepast cases of abuse, it is to hand her father to the legal bodies. Inarticle 5 section 704 and 705 of the family act, professionals have aduty to report incidences of child abuse even if they happened longago. The law explains that it is even to report such cases even ifthe perpetrator is no longer living.

Therequirements of this section will override the confidentiality of theinformation on the basis of the adverse effects they have on thefamily. Leanne is living with a stepmother and two siblings. She isat risk of being sexually abused by the elder step brother. On thesame note, her younger sister is also at risk of being sexuallyabused by the father. Reporting the case to the authorities will savethe situation. The Muslim culture is also a factor to consider inthe assessment. Children look upon the elders with respect, but thisdoes not grant the elders a chance to exploit sexually the young. The treatment of a minor requires the consent of the parent, but itmay not be necessary for sensitive issues. The prospects of this caseare that the parent may decline to avoid getting caught. As aprofessional, I would consider this as a sensitive issue whereby theconsent of the parent may not be necessary.


Billis in a tricky situation. His client informs him that his father hasabandons his duties, and the mother does all the work to take care ofthe children. The mother wants Bill to testify in court that she is agood parent. Bill’s witness may lead to the court allowing her toget custody of the children.

Billcannot refute the subpoena, and he has to go to court and testify.However, he has to stick to the code of conduct regulating theprofession. He errs when he goes to court without legalrepresentation. The complaints lawyer may take him in turns until heagrees that the mother is a good parent. In matters involving the dueprocess, is advisable for professional to seek legal representation.

Goingby the client’s information, it is likely that the children maysuffer at the hands of the father. However, the opinion of the rightparties would be necessary. The Latino-American culture places a lotof importance on family responsibility. The father the head of thefamily and the mother occupies an inferior status the case can beculture conflicting if the allegations do not turn out to be true. As a profession, I would only give truthful information that isrelevant to my position as a counselor. I would have no mandate toterm one parent as better than the other because this does not fallwithin my jurisdiction. Secondly, I would have sought legalrepresentation to shield me from guiding questions that wouldcontravene the laid down ethics in the profession. According to theCAMFT (2015) a professional cannot give an opinion on a subjectunless he encounters him in fruitful sessions.


Counselorsshould not act in any discriminative way towards any patientregardless co their background. To deal with issues of culturalincompetence, the exposure both in class and during internshipdevelops a sense of cultural tolerance in professionals. However, mysituation as a newly licensed practitioner and the middle-Easternmale provides me with a difficulty and in my opinion, I cannot handlehim comfortably. The nature of his suicidal behavior requires afruitful session, and that is why I resort to referring him toanother practitioner. According the California Association of Familyand Marriage Therapist (2015) a practicing professional may seekconsultation from another licensed professional or make referrals forthe benefit of the client.

Althoughthe client is reluctant to see another practitioner, I will have toensure him that it is for his benefit. The Board of BehavioralServices (BBS) (2015) allows the practitioner to disclose hisbackground to the patient to gain their trust. Assuring him thereferred practitioner will handle him in a better culturalenvironment than I will back up my efforts. In doing so, I will becareful not to create a conflict between the natures ofmiddle-eastern relationship development. A client with thisbackground tends to develop a strong relationship with onepractitioner depending on the context. They would rather haveprofessional attending to their needs. However, their health is thepriority. The other option is to familiarize myself with theirculture through the involvement of other professional with from thesame background and create a rapport with my client.


Jim’sparents seem to have a pre-conceived idea that their child issuicidal. They only want me to confirm their fears. However, after asession with the child, it appears that there is no risk of him beingsuicidal. The parents want to know the credentials and also have asession together with Jim. The ethical and legal issue at stake hereis confidentiality in consultations. Every patient should be attendedto individuality unless it is a group therapy. Secondly, if in theopinion of the professional that the presence of another party may bebeneficial to the patient, then they might be accepted (AAMFT, 2012). It can only take place after consulting the patient to understandthe implications of bringing in another party. If they refuse theprofessional from doing it, then he has to stick to seeing thepatient alone.

Iwould dissuade the parents from being present during session withtheir child by explaining to them the implications of their presence.I would as well explain the guiding ethics it is probable that thechild may withhold some information in the presence of the parentsthat might be vital in his treatment. The ethics allow me to disclosemy qualifications to the parents for them to have confidence in myservices. It will include the licensure that is only available forqualified family therapists.

Workingwith the disabled child will require the application of the learnedskills as well as contextual knowledge. It will be easy to determinemy competence from the outcomes of the sessions. Disability is one ofthe factors leading to depression in the child. If it does not emergeas a major factor at the end, that is, having been subdued, then Iwill know that I have made a great step towards working with thedisabled. In dealing with the cultural background, theNative-Americans need a lot of rapport building to building trust.They require personal space and ample time to respond to issues.These will be some of m guidelines as I work with Jim and hisparents.


Lilly’scondition prevents her from working since she worries abouteverything. The Employee Enhancement Program can be beneficial forher is all the sessions become fruitful. During hr sessions, there sone ethical conduct that s at a risk. The presence of her husband mayinterfere with the confidentiality of the information. His presence not necessarily out of Lilly’s consent, but it is because he is theinsured party. Confidentiality of consultation is not in place(CAMFT, 2015). Although the South-Eastern culture allows the man tohave the honor of a woman, the consent of the subject as well as theimplication on the clinical session will be a consideration.

Thediagnosis made on Lilly appears to miss n something very importantabout her past. We cannot rule out the effects of her childhoodtrauma in this scenario. The Generalized Anxiety Disorder occurs forsix months or more and individuals become worried about anything intheir environment. Panic disorder is more serious than GAD, and oneof its causes is the influence of traumatic childhood moments. Aspart of the competency requirements, the practitioner should have puther childhood into consideration.

Asher therapist, I would use the cognitive behavioral treatment itinvolves the use of mechanisms to reduce the stressors that emanatefrom the triggering environments. I would target the areas where shehas immense fear and help her to overcome them one by one. Thetherapy will help her to hold whenever anxiety threatens to strike. Iwill have to see the patient at least three hours every week for theprocess to be fruitful.


AmericanAssociation of Marriage and Family Therapy. (2012). Code of Ethics.Retrieved from

CaliforniaAssociation of Marriage and Family Therapists. (2015). Codeof Ethics.Retrieved from

CaliforniaBoard of Behavioral Services. (2015). Statutesand Regulations Relating to Family Therapy, Professional ClinicalPractice, Educational Psychology and Clinical Social Work.Retrieved from

MentalHealth, N. (2013). Treatment of Panic Disorder. PsychCentral.Retrieved on June 22, 2015, from

Reamer,F. G. (2013). Social work in a digital age: Ethical and riskmanagement challenges. Socialwork,swt003.