Create a vignette (this is not a real situation but an imagi…

Create a vignette (this is not a real situation but an imaginary one) that outlines a potential ethical dilemma in family or group work. Describe in detail how you would resolve this situation and cite the specific ethical codes/ and laws of your state you would use to guide your decision. Do not simply say you would consult with a supervisor or colleague. While consultation is a good practice, you should have a clear idea of how to proceed with the situation prior to seeking consultation.

Vignette:

Imagine a scenario where a therapist is working with a family that consists of a single parent, Mrs. Smith, and her two teenage children, John and Sarah. Mrs. Smith has sought therapy for her family because she is concerned about her children’s behavior and their difficulties in school. During the initial assessment, the therapist discovers that John, the oldest child, has been occasionally using illegal substances and has been skipping school regularly. Additionally, Mrs. Smith confides in the therapist that she suspects John has stolen money from her wallet multiple times.

As therapy progresses, the therapist observes that John’s behavior improves significantly, indicating a positive response to therapy. However, during one session, John discloses to the therapist that his mother, Mrs. Smith, has been neglecting his younger sister, Sarah, which has been causing him significant distress. He claims that his mother spends most of her time out of the house, leaving Sarah alone for prolonged periods. He also explains that he has been using the stolen money to buy necessities for Sarah, such as food and clothes.

Ethical Dilemma:

This situation presents an ethical dilemma for the therapist. On one hand, the therapist has an ethical obligation to protect Sarah from harm and ensure her well-being. This includes addressing allegations of neglect by Mrs. Smith. On the other hand, the therapist must also uphold the principles of confidentiality and maintaining the therapeutic alliance with Mrs. Smith. The therapist needs to find a way to balance these conflicting obligations while making decisions that prioritize the best interests of the family as a whole.

Resolution:

To resolve this ethical dilemma, the therapist should follow a step-by-step process that includes:

1. Assess the seriousness of the potential harm: The therapist needs to gather more information from John to ascertain the severity and immediacy of Sarah’s potential neglect. This might involve discussing specific instances, duration, and any potential harm Sarah has experienced. Gathering concrete evidence will help in making an informed decision.

2. Evaluate the therapist’s competence and jurisdiction: Before proceeding, the therapist needs to consider their own expertise and whether they possess the necessary skills to intervene in cases of child neglect. If the therapist feels unsure about their competence, they should consult a colleague or supervisor who has expertise in child protection issues.

3. Consultation: Although consultation was not the first step mentioned in the instructions, it is essential to seek guidance from another professional before taking any action. Consulting with a supervisor, a colleague experienced in child protection, or an ethics committee can provide an external perspective and help ensure that decisions are well-informed and ethically sound.

4. Legal and ethical codes: The therapist should review the specific laws and ethical codes governing their practice in their state or jurisdiction. For example, in the United States, the therapist would consult state laws regarding mandatory reporting of child abuse or neglect, as well as ethical codes such as those provided by the American Psychological Association (APA).

5. Balancing confidentiality and duty to protect: The therapist must carefully consider the limits of confidentiality in this situation. While maintaining confidentiality is crucial for building trust, the therapist also has a duty to protect Sarah from potential harm. The therapist should have an open and frank discussion about confidentiality with Mrs. Smith at the beginning of therapy, explaining the limits and exceptions to confidentiality.

In this scenario, if the therapist determines that Sarah is at immediate risk of harm, the therapist would have a legal and ethical obligation to report the suspected neglect to the appropriate child protective services agency. Documentation of concerns and the decision-making process should be meticulous, providing a clear rationale for the therapist’s actions.

If the concern for Sarah’s safety is not immediate, the therapist should engage in a collaborative process with Mrs. Smith. This may involve addressing the issue directly and discussing alternative options for ensuring Sarah’s well-being. The therapist should help Mrs. Smith develop a support network that can assist her in meeting her parental responsibilities. Referrals to community resources such as parenting programs, respite care services, or family counseling might be considered.

Ultimately, the resolution of this ethical dilemma requires a careful balance between the therapist’s obligations to uphold confidentiality, protect Sarah’s well-being, and address the therapeutic needs of the family. By following a systematic process and considering relevant ethical codes and laws, the therapist can ensure a responsible and ethically informed course of action.