The practice of therapeutic psychology is challenging. Even though the therapist has to some degree of independence, the client too has their rights and the provision of care and services is a mutual undertaking between the client and the therapist. There are various challenges that affect therapists in the practice of psychology ranging from confidentiality issues, a delegation of duties, managed care and supervision. In the exercise of these concepts in psychotherapy, one needs to consider ethical and legal issues, so that the dignity and the respect of the client are upheld. This essay discusses these concepts in relation to the legal and ethical issues attached.
Confidentiality and the privacy of a person need to be respected and held in dignity. These aspects of ethics are derived from the principle of autonomy. The question of ignoring them presents itself when the therapist is in a dilemma because of a confusing situation. An example of such a situation is where the health condition of an employee in an organization poses a threat to the other employee. In such a case, the employee has the right for information about their health being kept in secret. The employee may be suffering from a contagious disease which may affect the other stakeholders in the organization. In this case, the victim holds their legal rights to confidentiality and privacy dear. The therapist is in a dilemma. The conflict is between maintaining ethical principles and legal rights and violating the legal right and the principles to save the majority. This presents a conflict between the principle of beneficence and autonomy. The therapist will choose to go with the decision that has the best benefit to many people. In this case, the therapist will reveal the information in order to save a great majority from a disaster, which might have been brought if the information was withheld.
Managed care is a concept introduced by the business community to cut on the health costs of clients. Managed care organizations have emerged over time to do business in psychotherapy. Due to the concept of business being introduced in this sector, the concept has lost meaning. A clinical situation with the case of managed care is where a client who is covered by a managed care organization decides to have psychoanalytically informed psychotherapy. The therapist, in this case, prescribes the number of sessions that the client will have treatments. The therapist will be required to fill a form by the managed care company detailing the form of treatment and how long it is going to take. Then the client is treated with the consent of the managed care company with which the client is a member.
To the disappointment of the therapist and the client, the managed care company brings a form and decision declaring that this treatment was not necessary. The client will then be required to pay for the expenses as if they had not subscribed to any managed care company. The legal issues involved here are touching mostly on the therapist. The therapist has to provide accurate information to the managed care company. Therapists have to violate the ethical principle of autonomy and confidentiality and provide information about the client. In such a situation, the therapist has to go by the principle of beneficence and provide true information.
A situation in delegation care management is where a therapist delegates to the wrong person. For example, the therapist delegates a procedure to a staff that is not qualified and the staff harms the patient. The rights and the rules of the delegation have to be followed to avoid such a situation. A situation where a client is harmed poses great legal implications to the therapist. When delegating, the therapist has to make sure they delegate the right task and to the right person. There are staff members that will not be comfortable with particular tasks because of their passions and the level of training. There are circumstances too that are not fit for delegation. For example, a therapist may better handle by themselves a critically ill client rather than delegating such a circumstance to another person. The delegation also is accompanied by some sort of supervision and evaluation. After delegation, the therapist needs to make sure that they follow up to make sure that the task they delegated is done well.
Clinical supervision in psychotherapy is a method that facilitates dialogue between a junior and a senior psychotherapist and influences the conduct of the process. An example of a case of clinical supervision in psychotherapy is where a senior psychotherapist assigns a client to a junior psychotherapist. In this case, the senior psychotherapist evaluates the care provided by the junior psychotherapist to the client. The legal implications in such a case are the possibility for the provision of poor quality care by the supervisee. The senior supervisor has to keep on evaluating the care and following up to make sure it is of the recommended standard.
The clinical supervisor has a central role in the patients. They have to ensure that clients are assured of their welfare. The supervisor also does the role of taking the supervisee from stage to stage enabling them to grow. The process involved in the transition from stage to stage is facilitated by the supervisor. The status and the progress of psychotherapy on the part of the client has to keep on being evaluated by the supervisor.
The practice of psychotherapy in California is highly regulated. Confidentiality is assured to the greatest extent. Treatment is usually offered in an environment upholds and recognizes the privacy of clients. Whenever the therapist has intentions of violating confidentiality, the client will be informed. In cases of consultation and supervision, a therapist cannot disclose a client’s information without their consent. This calls for written consent from the client in cases where the therapist feels information has to be disclosed. The circumstances in which therapists disclose information are only those that are mandated by law. Records of treatment are maintained for a reasonable amount of time by the therapist. The assessment methods too, are kept confidential.
The duty to inform (Tarasoff) has had a great impact on the practice of psychotherapy in California. The intimate aspects of the clients’ lives have to be kept private by the psychologist. This has completely changed the conduct of psychotherapy as it was before the introduction of tarasoff.
A Professional Licensed Clinical Counsellor in California has to be a holder of masters in counseling or psychotherapy from a recognized institution. The person also has to have completed 2 years of post-degree experience and also done the required exams such as the CA jurisprudence exam. The person must satisfy the Board of behavioral sciences. A clinical counselor trainee is unlicensed and is at the masters’ level.
Due to the interaction between human beings and information objects in information technology, caution has to be practiced to ensure that ethics is upheld. Therapists have to make sure they protect the client’s information and software piracy so that the confidentiality of the client can be upheld. In the practice also, therapists have to make sure they adopt information technology gadgets that are friendly to maintaining the privacy of the clients.
In conclusion, this essay has discussed the confidentiality and privacy of clients in the practice of psychotherapy. It has touched on various areas of psychotherapy such as managed care, delegation and supervision and analyzed how confidentiality is assured. Confidentiality remains a great step in assuring patients of their getting well in the practice of psychotherapy.
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