Other than these principles, there are also other clauses within the Code that are material in the circumstances. The respect for a client’s dignity entails safeguarding their fundamental rights and honouring the right to confidentiality, autonomy, and self-determination (IACP n.d.). Key to the concept of confidentiality is the requirement to keep any personal information about the client, whether obtained indirectly, directly or by inference, confidential (IACP n.d.; Avashti and Grover, 2009, p.149). The IACP maps out what constitutes personal information, including biographical information, names, addresses as well as any descriptions of a client’s life and circumstances that can enable others to identify the client (IACP, n.d.). The ethics code, however, stipulates that the breach of confidentiality is permissible in cases where the client has made the threat of causing bodily harm to another (IACP, n.d.; Sullivan and Moyer, 2008, p.26).
Code of Ethics
After consulting the Code of Ethics and other pertinent laws, the next step in resolving the ethical dilemma involves conducting a detailed assessment of the rights, obligations, and welfare of the concerned parties. On my part, I had the duty to promote Ben’s right to privacy as well as safeguard the clinic’s interests. Privacy is a concept that encompasses the entitlement to limit who gains access to personal info, when others can view the information, and what details they can view. It is a safeguard against any unwanted or uninvited observation and valued highly. Bryce and Mahaffey (2007, p.3) sum up my duty toward Ben in this succinct statement, “a therapist must not disclose confidential client information.” Ben shared details about his HIV status in confidence. Such information is truly personal and revealing the same to a third party would disparage him. What this means is that I had the professional obligation to respect his dignity and treat the personal information he shared with me during sessions with confidence. What is more, there was the looming possibility of a lawsuit instituted by Ben for the violation of his privacy.
Concerning Ben, he had an interest in restricting who knows about his HIV status and who does not. Even though most, if not all, aspects of HIV/AIDs have been demystified, people living with the infection often face stigma and discrimination from their families, workplaces, and society. It is this fear of being shunned by others that forced Ben to keep quiet about his condition. As a result, Ben would find it objectionable for anyone to obtain information about his health covertly and then possibly the info shared or circulated to others. It would be a blatant invasion of his privacy. He also had the legitimate expectation that his counsellor would not breach his confidence. However, like every other citizen, Ben must observe the law and abstain from any illegal courses of action, to be precise, deliberately infecting another person. Janice’s situation was heartbreaking, to say the least. Janice had the right to know about Ben’s status before they got intimate, but Ben chose to withhold this information. Ben’s actions were malicious particularly because he was already receiving proper care, while Janice was oblivious to the fact that Ben had infected her.
After listing the responsibilities and interests of the stakeholders in an ethical dilemma, the next step is to generate a list of the alternatives. The incident fits perfectly within the definition of an ethical dilemma. An ethical dilemma takes place when a professional leaves an equally acceptable option undone, and whatever choice one makes still hurts others (Ghillyer, 2010). Furthermore, the decision arrived at contradicts a personal moral principle, and entails the abandonment of an ethical principle (Ghillyer, 2010). The circumstances fulfil all the criteria that pertain to ethical dilemmas. I faced two competing alternatives. The first one involved seeking out Janice and the police (since it is a criminal offense to infect another person with HIV deliberately) and letting them know of Ben’s actions. The second option was to respect Ben’s right to privacy. These conflicting courses of action show that no matter what I chose, I had to violate a moral principle. Safeguarding Janice’s interests meant I had to infringe upon the privacy of a client while refusing to do so meant that her health would start to deteriorate if she did not receive appropriate treatment as soon as possible.
Opportunely, one of the alternatives resolved the debacle in a purely ethical fashion. Given what was at stake (Janice’s life), I could not afford to remain silent about Ben’s health status. Ben acted unlawfully by infecting his girlfriend and the fact that he was silent about his condition placed her at a great risk of further health deterioration and quite possibly, death. I firmly believed that this situation fell under the exceptions that allow psychotherapists to report a threat to another person as related to a client. It was also my estimation that the situation warranted making a report to the police and issuing a warning to Janice, which I did. Afterward, I made it clear that I had to adhere to my professional mandate to file a report with the police as well as warn the victim under the circumstances. Finally, I took full ownership of my decision. I was deliberate in the choice I made and was more than prepared to face the full consequences of this action. The best take-home in resolving this dilemma was that the IACP’s Code of Ethics offers a useful framework for resolving ethical dilemmas.
Reflective Essay on Self-Care
I find psychotherapy highly gratifying because I have the opportunity to influence the lives of others in a meaningful way. Even so, it is an emotionally demanding profession that involves an entire suite of stressors including difficult clients, the avoidance of malpractice claims, financial concerns, dealing with ethics claims, being on-call, loads of paperwork, difficulties in obtaining reimbursement, and problems achieving progress. Personal problems are another key area of concern that can diminish a person’s welfare. All these elements can lead to distress, which often manifests in the form of emotional exhaustion, depersonalization (loss of caring, compassion, and empathy), and a reduced sense of one’s achievements. Other than that, physiological health problems may set in and diminish my ability to continue working or force me to abandon my practice altogether. It is my opinion that self-care is paramount given the magnitude of issues that psychotherapist have to juggle. Failure to attend to my personal wellness can lead to insurmountable issues that will prejudice my professional acumen. Optimal well-being is the antecedent to my ability to deliver quality care to clients. What’s more, proper self-care is a moral imperative for all counsellors as stipulated in the Code of Ethics.
Key to the occurrence of distress during practice is the way one responds to and acts upon it to mitigate any possible deleterious effects. Therefore, there are no universal self-care regimes. Self-care alternatives are often peculiar to each person, which makes it impractical to extrapolate exact regimes used by another person and then apply them. For this reason, I intend to be deliberate about the activities I choose to participate in to ensure that the match my interests and suit the demands I face in my professional and personal life. Self-care strategies can be either intrinsic or extrinsic. The former covers psychological, emotional, and spiritual steps, while the latter encompasses work-related and physical self-care measures. I believe strongly that professional self-care is mandatory for psychotherapists especially due to the dynamic and fast-paced way in which new interventions arise in the field and the ever-increasing demand placed on practitioners. My intention, as regards professional self-care, is to grow my knowledge through constant reading and research, interacting and engaging other therapists, as well as attending key seminars and workshops or joining pertinent professional groups. I also purpose to avoid work overloads. In this case, I will resist the temptation to stretch myself thin by accepting too many clients or taking up more work than I can perform comfortably. Therefore, I will set limits and abide by them, accept duties that I have a passion for, and allow sufficient time for rest.
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