Ethical Dilemma & Issues in the Psychotherapy Case Study Example, Ireland
The following case study work shall highlight the meaning of the ethical dilemmas, principles of bioethics and psychotherapy, and ethical dilemmas and issues in psychotherapy.
Psychotherapy is a practice of providing therapies to patients with psychological issues and who are in dire need of such treatment. This practice comprises of various ethical dilemmas which emerge out of the concept of the therapeutic relationship between the client and therapist and psychological treatment.
However, there is a professional code of conduct and ethical guidelines in the healthcare units that do not cover ethical dilemmas emerging within the therapeutic space.
A therapist who is well informed of his professional ethics will be approaching psychotherapy with the help of ethical codes focusing on the desire of the client.
The common ethical concerns are related to psychotherapy which shall include confidentiality, professionalism, and therapeutic boundaries.
The therapeutic aspects of psychotherapy with ethical dilemmas can be resolved with the help of principle-based medical ethics which can be an effective tool. Ethical dilemmas can include the issues of confidentiality, dual role in psychotherapy, sexual relationship between client and a therapist.
Principles of Bioethics and Psychotherapy
Psychotherapists can apply the principle-based approach to ethical dilemmas with the help of self-reflection of other ethical theories and analyzing the social and clinical aspects of an ethical dilemma.
Some of the main principles of bioethics are:-
Psychotherapy and Autonomy
An important aspect of psychotherapy is making a client self-reliable and autonomous in nature. Supporting the development of an autonomous individual is the ultimate aim of psychotherapy.
For example – A client with a major mental health issue for a lifetime shall remain dependent upon the therapist and his treatment until the end of his life. Psychotherapy to a client in his dying phase helps him to feel autonomous. It might be even a partial autonomy.
Psychotherapy and Justice
Efficacy and price could be important ethical problems in therapy. If the therapy is for a very prolonged period of time but short term therapeutic approach could be helpful but the therapist willing to continue with the therapy to earn money is a serious ethical issue
Psychotherapy and Beneficence
Psychotherapy is questioned in a scenario where the many psychotherapeutic approaches were not tested to their effectiveness in research done in a scientific manner.
Even if such clinical intervention was tested of his effectiveness does not mean it was necessarily an accepted addition to the treatment system.
Ethical Dilemmas and Issues in Psychotherapy
We shall discuss some of the most important aspects or areas of psychotherapy which has ethical dilemmas and issues that can be resolved through effective clinical intervention.
They are dual role dilemmas in psychotherapy, confidentiality in psychotherapy, ethical dilemmas with suicidal clients, therapist-client sexual relationship, and therapist-client boundaries.
Dual Role Dilemma in the Psychotherapy
In the practice of psychiatry, there is a dual role dilemma as it is linked with obligations of beneficence towards the clients by therapists and conflicting obligations to society, third parties, and other healthcare providers.
The ethical character of dual relationships overlapping each other and ethical boundaries in modern psychotherapy are dilemmas in healthcare. If a dual relationship exploits boundaries it is called a boundary violation which is abusive and improper.
It is being prohibited by the code of ethics in psychotherapy. If a therapist behaves with integrity and responsibility following the principles for reaching the goals of psychotherapy then a dual relationship in psychotherapy can be considered ethical.
Confidentiality in the Psychotherapy
Confidentiality is an important aspect in the relationship of client and therapist as it ensures protection to the psychotherapy notes of the client.
If the mental health information of the client is leaked into the public then it can be very harmful for the privacy and reputation of the client which makes him reluctant to seek for further sessions of therapy.
It is an elementary idea which can be applied to the therapeutic practice. The confidentiality issue is a serious ethical dilemma for the psychotherapist.
So therefore, building privacy and security information system in the healthcare will boost the level of confidence in such systems leading to it’s implentation.
The question of privacy can be resolved with the help of a comprehensive structure that can implement the principles of privacy by adopting the safest network practices by establishing supervision and responsibility.
Ethical Dilemmas with the Suicidal Clients in the Psychotherapy
Suicide of a client who was dealing with severe mental health issues is a matter of major concern for the therapists as it creates a considerable emotional impact.
There are many strategies to cope up with the suicide of a client through training programmes and group support which teaches the therapists lessons from such events.
Ethical Issues in Therapist Client Boundaries
The ethical approach under the therapist client boundary is linked with a rule based view to ethical decision making. Non sexual boundary can weaken the therapy by causing a disruption in the therapist client relationship.
When there is a boundary violation therapists can provide steps in deciding whether to cross a boundary or not and to make errors while decision making.
Most of the therapists are against having sexual relationship with the present and former clients, supervisees and students etc. While the clients have less rules regarding the boundaries and have different ethical norms than the therapists.
Ethical Issues in Therapist Client Sexual Relationship
The psychotherapists have an ethical obligation to maintain clear therapeutic boundaries. Sexual abuse in psychotherapy is a valid problem and it is considered to be violation of the professional ethics and conduct. It is the considered as the professional failure.
The relationship of a client and therapist are unequal from the very beginning as the therapist has an advantageous position over the client.
The therapist needs to put the needs of the client above his own needs as he is educated to understand the issues of the client. Sexual relationship after the end of the treatment is considered unethical and a violation of professional conduct.
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