1. Dr. Charlotte Hasty had practised individual psychoanalytically oriented psychotherapy with adult clients for 10 years. After attending a continuing education programme (half-day workshop) on family therapy, Dr. Hasty began to conduct, while reading books in the field during her spare time, family therapy sessions for some of her clients.
i. Yes, this case does reflect a breach of the code.
ii. it breaches section B.1.2. (a) (competence) and B.1.1. (competence)
iii. Dr Hasty failed to recognise the boundaries of her formal training. While she has been an experienced psychotherapist, she lacked the minimum levels of competence in family therapy. It would have been advisable to rather take a conservative approach if no uniform professional standards exist. In such circumstances, it would have been best to consult colleagues competent in family therapy in assessing whether she requires additional education or training prior to applying this new technique. Her failure to recognise her inadequate training could have harmed her clients. Additionally, her lack of training could lead her into serious problems when someone would file a formal complaint against her.
2. Dr. Nardell Slo conducted a cognitive evaluation of an adult client using the WAIS-III, a full 3 years after the revised form, the WAIS-IV, had been published. When questioned on this point he noted: "They're about the same, and the new kit is too expensive."
i. Yes, this case does reflect a breach of the code.
ii. It breaches section B.13.3. (psychological assessments) and B.3. (a) (professional responsibility)
iii. Dr Slo delivered only substandard service to his client. His inaccurate rationalisation suggests an ignorant attitude, making it open to question whether his clients receive the most efficient and effective treatment. It is Dr Slo's professional responsibility to uphold the highest standards of accuracy and fairness when administering psychological assessments. Using the revised WAIS-IV could have significantly changed his client's scores, and thus may have had a substantial impact in an employment selection process. Might affect access to services
3. Dr. Kurt Mores was convicted in a State court of "fornication" after a female client complained that she had been emotionally harmed as a result of having sex with him. At an ethics committee hearing, Dr. Mores admitted having had sexual intercourse with a dozen of his female clients over the past few years. He added that extreme pressure within his marriage had caused considerable anxiety, loss of self-esteem, and feelings of sexual inadequacy. He told the committee, referring to his sexual activity with his clients: "It was good for them, it was good for me, and I didn't charge them for that part of the session." He also expressed the belief that "It's okay to ignore the ethical code as long as you think about it carefully first and talk it over with clients."
i. Yes, this case does reflect a breach of the code.
ii. It breaches section C.4.3. (a) (non-exploitation, sexual activity) and B.1.2. (e) (competence, boundaries, impairment)
iii. Being in the position of power and trust, Dr. Kurt Mores failed to recognise appropriate boundaries. His clients have been emotionally and psychologically vulnerable. By engaging in a sexual relationship, he took advantage of their vulnerabilities to meet his own needs and abused his power. His moral defenses indicate a minimum of insight into his problems. He was clearly impaired in his ability to render a professional service with competence and responsibility and should have made the responsible decision to refrain from offering his psychological service until he ….
iv. He should have engaged in self-care activities that would have helped him to avoid conditions leading to his personal distress, which impaired his judgment and harmed his clients.
Additionally, it seems that Dr. Kurt Mores has been professionally isolated. If he would have maintained regular professional interactions with colleagues, they may have brought his behaviour issues to his attention prior to committing serious ethical misconduct.
4. Jack Fury was an angry 15-year-old referred to Dr. Harold Packing for displaying antisocial behaviour, including school vandalism. After the 4th session, Dr. Packing was in an appointment with another client when they smelled smoke and discovered that a fire had been set in the waiting room. The fire was put out and Dr. Packing called Jack and his parents in for a meeting. Jack acknowledged setting the fire. When Packing expressed concern that he could have been killed in the fire, Jack replied "Everybody's got to go sometime." Dr. Packing was understandably angry and informed the Fury family that he was no longer willing to treat Jack.
i. No, this case does not reflect a breach of the code.
ii. B.11.5. (a) (termination when confronted with evidence of a problem), B.1.2 (e), (the emotional state does not impair his ability to provide a competent psychological service), C.3.1 (a) (refrain from engaging in multiple relationships) ????
iii. Dr Packing knew Jack's history of antisocial behaviour. However, we do not have information whether Dr Packing established clear professional boundaries, set clear rules regarding threatening behaviour and explained under which conditions psychological services may be terminated.
Dr Packing had no obligation to continue treating Jack when he feared for his personal safety, including the safety of other clients and his staff. Jack's anti-social attitudes posed a serious risk of harm to others, requiring him to re-evaluate the way in which psychological services should be provided. Dr Packing had to weigh up the likelihood of that harm, his responsibility toward potential victims, potential harm to his client, and also his own capacity to manage this risk. In fact, it was more appropriate to terminate the psychological service than to risk countertransference. His responsibility was to identify his feelings toward his client and to evaluate whether they could interfere with successful treatment. It may have been hard for him if not impossible to devote his full attention to such a client and may have compromised his objectivity. Dr Packing managed the termination in a responsible manner by explaining Jack and his family his concerns and the need for the termination.
5. Rita Repeata sought psychotherapy with Dr. Hy Pedestal following a breakup with the man she had been dating for 2 months. She described a series of relationships with 3 different men over the past 12 months. All followed the same pattern: casual social contacts led to sexual intimacies by the second date and a breakup within a few weeks. Each time Rita said she "felt like ending it all." She began her second therapy session with Dr. Pedestal by telling him how helpful the first session had been and what an exceptional therapist he was. She then got out of her chair and sat on the floor at his feet, looking up at him adoringly. When Dr. Pedestal asked what she was doing, Rita replied "I feel more comfortable like this." Dr. Pedestal asked her to sit in one of the office chairs and initiated discussion about breaking out of the patterns of behaviour that led her to seek therapy in the first place.
i. No, this case does not reflect a breach of the code.
ii. B.3. (g) (boundaries) and C.3.1. (b) (refrain from engaging in multiple relationships that may harm clients)??
iii. While Dr Pedestal acknowledged his client's feelings, he placed restrictions to his client's request and, at the same time, directed her attention to her issues that brought her into therapy. Dr Pedestal was aware that his client responded in ways that repeated old relational patterns from the past and that he must avoid replicating them. He understood that transference issues may be in operation, upheld the boundaries of the client-therapist relationship and was sensitive to the potential harmful effects of entering a multiple role relationships.
If the psychologist would have responded in a way that would have made her feel special, he would have raised hopes that he could replace what she has lost. This could lead to a multiple role relationships in which the psychologist is becoming her 'rescuer', a place where he does not want to be. This is a typical situation which often ends up in charges of abandonment brought by clients. I posted that on DB
6. Dr Kinder is trained as a school psychologist and has developed a kindergarten screening instrument with good reliability and predictive validity. She has appropriate information printed in a pamphlet form and mails these with cover letters offering to conduct training workshops to school counsellors and directors of special education in school systems throughout her locale.
i. No, this case does not reflect a breach of the code.
ii. B.13.1 (use established scientific procedures), B.13.6.
iii. The kindergarten screen instrument is valid for the purpose for which the test is used. Dr Kinder developed this psychological assessment within the scope of her competence as a school psychologist. By offering to conduct training workshops to school counsellors and directors of special education, Dr Kinder ensures that the level of competence required for using this test is adequate for the user to assume full ethical responsibility. Additionally, providing appropriate information
7. Dum Tweedle was pleased with his individual therapy progress and asked Dr. Janis Divide to also counsel his fiancée Dee in individual therapy. Dum eventually pressed ethics charges against Dr. Divide for contributing to their breakup, a process that began, Dum said, at the time Dee entered therapy. He contended that Dr. Divide encouraged Dee to change in ways that were detrimental to him and to their relationship. Dr. Divide contended that it was her responsibility to facilitate growth in each party as individuals, a responsibility she felt she had upheld.
i. Yes, this case does reflect a breach of the code.
ii. C.3.1. (b) (refrain from engaging in multiple relationships that may harm clients)
iii. Dr Divide attempted to treat the couple as two individuals without taking into consideration the potential for conflict of interest and the limits to her objectivity. She should have assessed the ethical appropriateness of such a relationship and the potential risk for adversely affecting her clients. It would have been prudent to seek advice from a senior colleague before making a decision to provide psychological service. Additionally, there was a high risk of unauthorised passing of information shared in confidence. A couple therapy would have been preferable to understand the full picture of each client's contributions to each other's emotional distress.
When she started therapy with Dee she had extra knowledge about her fiancé
Individual therapy for Dum Tweedle
Also counsels his fiancée Dee in individual therapy
Presses charges – contributed to their breakup when Dee entered therapy
Dr Divide argues, she had the responsibility to help Dee to facilitate growth
Conflict of interest?
Unauthorised passing of information shared in confidence
Need to assess thoroughly the relationship between the potential client and the referral source, the context in which the established client and the referred client know each other, and the motivations of the client making the referral
c.3.1b (
Adina thinks this is great)
8. Dr. Bizzie was about to leave for the weekend when he received an emergency call from a client who claimed to have taken a number of pills in an attempt to kill herself. Bizzie told her to contact her physician and come in to see him at 9:00 am on Monday morning. He made no other attempt to intervene. The client died later that evening without making any other calls for assistance.
i. Yes, this case does reflect a breach of the code.
ii. B.3. (c) and section B.3.(b) in order of relevance.
iii. Dr Bizzie's professional responsibility was to take reasonable steps to prevent harm occurring as a result of their conduct. Instead, he behaved in an unethical and negligent manner. Any other person would have not stayed inactive in the face of such a risk. Reasonable steps such as trying to learn her location so that he could make sure that help would reach her quickly. Only a foolish and insensitive person would ignore the call for help.
Dr Bizzie should have rather assumed that the threat may be real and imminent.
Why has he got the phone number?