It is common for clinicians to face ethical dilemmas in practice. While there are some major ethical obstacles you may encounter from time-to-time, it is more likely you will encounter more minor ethical issues more frequently. The challenge with “minor” ethical issues is they can quickly become a big problem if not handled appropriately. Select ethical dilemma and then describe how you would use an ethical decision-making model, such as the ones discussed in your readings or another professionally adopted ethical decision-making model, in the situation you choose.
Selected ethical dilemma:
• One of your former clients, someone you worked with about four years ago, sees you at the grocery store. They approach you and mention how they felt you were a close friend more than a therapist; in fact, they disclose they have always had a crush on you and ask if you would meet them for coffee or tea next week. Do you accept?
Navigating Boundaries: Ethical Decision-Making in Therapeutic Relationships
In the realm of clinical practice, ethical dilemmas are an inherent part of a therapist's journey. While major ethical obstacles may arise sporadically, it is the minor ethical issues that clinicians are more likely to encounter on a regular basis. These seemingly minor dilemmas can quickly escalate into significant challenges if not managed appropriately. One such ethical dilemma that therapists may face involves boundaries, dual relationships, and maintaining professionalism when approached by former clients seeking personal interactions beyond the therapeutic setting.
The Ethical Dilemma
Imagine you are at a grocery store when one of your former clients, whom you worked with approximately four years ago, recognizes you. They approach you and express that they felt a closeness with you akin to a friend rather than a therapist during their sessions. Furthermore, they disclose that they have harbored romantic feelings for you and extend an invitation for coffee or tea next week. As a clinician, you are confronted with the dilemma of navigating boundaries, addressing transference and countertransference dynamics, and upholding professional ethics in responding to this unexpected request.
Applying an Ethical Decision-Making Model
In handling complex ethical dilemmas like the one presented, it is paramount to employ an ethical decision-making model to guide your actions and decisions. One such model that can aid in navigating this scenario is the "Ethical Decision-Making Model" developed by Corey et al. (2015). This model comprises eight steps that can help clinicians approach ethical challenges systematically and ethically. Let's utilize this model to address the current dilemma:
1. Identifying the Problem: Acknowledge and recognize the ethical issue at hand, which involves boundaries, dual relationships, and potential ethical violations in responding to the client's invitation.
2. Identifying Potential Issues Involved: Consider the implications of meeting the former client outside the therapeutic context, including power differentials, confidentiality breaches, and the client's emotional vulnerability.
3. Reviewing the Relevant Ethics Codes: Refer to professional ethics codes and guidelines, such as those provided by the American Psychological Association (APA) or the National Association of Social Workers (NASW), to understand the standards pertaining to boundaries and dual relationships with former clients.
4. Knowing the Applicable Laws and Regulations: Be aware of any legal statutes or regulations that govern therapist-client interactions and relationships in your jurisdiction.
5. Obtaining Consultation: Seek supervision or consultation with colleagues, mentors, or supervisors to gain diverse perspectives and insights on how to navigate this delicate situation ethically.
6. Considering Possible Courses of Action: Reflect on various options, including declining the invitation, discussing boundaries with the client, or referring the client to another therapist if necessary.
7. Considering the Consequences of Each Course of Action: Evaluate the potential outcomes and repercussions of accepting or declining the client's request in terms of ethical standards, therapeutic integrity, and professional reputation.
8. Making a Decision: Based on a thorough analysis of the ethical considerations and implications, make an informed decision that aligns with ethical principles, professional guidelines, and the best interests of all parties involved.
Conclusion
In conclusion,
ethical dilemmas in therapeutic practice demand thoughtful reflection, ethical discernment, and adherence to professional standards. When faced with a situation where a former client seeks personal interaction beyond the therapeutic relationship, it is essential to navigate boundaries with sensitivity, uphold ethical guidelines rigorously, and prioritize the well-being of the client while maintaining professional integrity.
By utilizing an ethical decision-making model like the one outlined above, therapists can approach challenging scenarios methodically, ethically, and with a commitment to ethical practice. Remember that preserving the therapeutic relationship's integrity, respecting boundaries, and acting in the client's best interests should always guide your decisions as a responsible clinician.