Ethics and Family

[LoopDaLoop]

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Ethics questions here, need feedback. If a psych professional wishes to have a private relationship with the patient, protocol is to transfer care and withhold contact for two years. However, what is the protocol for having a relationship with the current patient's cousin/ nephew? In family therapy that is a no. but when considering individual therapy, who is the identified client? and to what degree do ethical boundaries impact and professional's ability to conduct a private relationship?

 

[WisNeuro]

Is this a homework assignment?

 

[smalltownpsych]

Ethics questions here, need feedback. If a psych professional wishes to have a private relationship with the patient, protocol is to transfer care and withhold contact for two years. However, what is the protocol for having a relationship with the current patient's cousin/ nephew? In family therapy that is a no. but when considering individual therapy, who is the identified client? and to what degree do ethical boundaries impact and professional's ability to conduct a private relationship?

This isn't really accurate and I personally would question the ethics of someone who did this. Also, if by psych professional, you mean psychologist, then say it. Other mental health professionals have different codes of ethics.

 

[LoopDaLoop]

Not a "homework assignment", thanks though. The professional i speak of is not a licensed psychologist, hence why i did not say it. A doctoral student was providing clinical services as an intern. The said individual has been providing clinical services for a year to a minor. The individual went out on a date and through conversation picked up on the fact that her date was related to her client.

 

[thewesternsky]

Not a "homework assignment", thanks though. The professional i speak of is not a licensed psychologist, hence why i did not say it. A doctoral student was providing clinical services as an intern. The said individual has been providing clinical services for a year to a minor. The individual went out on a date and through conversation picked up on the fact that her date was related to her client.

In this situation, the proper thing for the clinician to do is end the relationship and not resume it. You could debate other options or try to justify other actions, but at the end of the day ending the relationship is the best option.

Also...

If a psych professional wishes to have a private relationship with the patient, protocol is to transfer care and withhold contact for two years.

No. This may technically adhere to the written ethical procedures in some jurisdictions (including the province I practice in), but it violates ethical principles anyway. Do not do this. Do not tell anyone else to do this. If someone purposely transferred a client and waited two years because they wanted to pursue a relationship with that client, I would not be surprised if they were reprimanded by the board.

 

[WisNeuro]

No. This may technically adhere to the written ethical procedures in some jurisdictions (including the province I practice in), but it violates ethical principles anyway. Do not do this. Do not tell anyone else to do this. If someone purposely transferred a client and waited two years because they wanted to pursue a relationship with that client, I would not be surprised if they were reprimanded by the board.

While I wholeheartedly agree that it should not be done in pretty much any circumstance, for a reprimand to occur, a few things would have to be proven. It's far from an automatic reprimand/censure.

 

[entitlement]

Since it hasn't been that long since I took the jurisprudence exam I have some of this information fresh on my mind.

APA Ethics Code states:

3.05 Multiple Relationships
(a) A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.
A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.
Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical.
(b) If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.
(c) When psychologists are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, at the outset they clarify role expectations and the extent of confidentiality and thereafter as changes occur. (See also Standards 3.04, Avoiding Harm, and 3.07, Third-Party Requests for Services.)

10.06 Sexual Intimacies with Relatives or Significant Others of Current Therapy Clients/Patients
Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard.

 

[entitlement]

I have cousins that I maybe talk to once in a blue moon at family gatherings so in a situation like that, I do not think that would be considered a "close relative" and you can also assume it wouldn't impair objectivity/competence/etc.

In this case though, being that this person went on one date and was already able to get information that her date was related to her client, I would say this crosses into heavy gray area zone and its probably best to just discontinue that relationship. Nothing needs to be done with the patient. The student should talk to their supervisor about this ASAP.

 

[thewesternsky]

While I wholeheartedly agree that it should not be done in pretty much any circumstance, for a reprimand to occur, a few things would have to be proven. It's far from an automatic reprimand/censure.

Oh absolutely! Sorry if that was unclear--I didn't mean that it would necessarily happen. I just meant that I wouldn't be surprised (or upset) if that were the outcome.

 

[smalltownpsych]

I have cousins that I maybe talk to once in a blue moon at family gatherings so in a situation like that, I do not think that would be considered a "close relative" and you can also assume it wouldn't impair objectivity/competence/etc.

In this case though, being that this person went on one date and was already able to get information that her date was related to her client, I would say this crosses into heavy gray area zone and its probably best to just discontinue that relationship. Nothing needs to be done with the patient. The student should talk to their supervisor about this ASAP.

This is exactly what a student should do with any ethical question. From my perspective, discussing ethical issues and how to resolve them appropriately is one of the most important aspects of clinical supervision. As a supervisee, these were some of my most memorable discussions from training that continue to inform my practice today. As a supervisor, it was my pleasure to help trainees learn to work through and resolve the issues around multiple relationships, sexual feelings, confidentiality issues, etc. Also, as a supervisor, if key information that could impact the ethical care of a patient was withheld from me, then...
😱 😡

 

[LoopDaLoop]

In regards to the importance of discussing ethical issues, absolutely! Thank you all for your input,views, and expereinces