Therapeutic Boundaries

This assignment focuses on vignette analysis and direct application of course concepts to the persons, and situations presented in the vignette. All assignments MUST be typed, double-spaced, in APA style, and must be written at graduate level English. Your responses must be written in an original personal and/or professional synthesis of the text and research.
You must integrate the material presented in the assigned text.

You are also required to integrate additional evidence-based research, taken from professional journals, to support and enhance the textbook information. A minimum of 4, current, research articles are required

You must identify and cite the Code of Ethics that are relevant to each of the vignettes. The Ethics Codes are located in under Resources. If the links do not work, please copy and paste them into your browser.

You must illustrate multicultural competence. All discussions must take into account issues of culture and human diversity that may pertain to the situations presented below. Information on Culture and Diversity are covered in the course text, but you are encouraged to utilize other cultural resources to enhance your analysis for this assignment. For example, if the client in the vignette is a Native American who asks to participate in a healing ritual, you would research Native American ceremonies and the ethical issues relating to this.

Please keep your responses focused on what is presented in the vignette. Creativity is encouraged but do not add information or change the vignette.

Your response to each vignette should be approx 2 ½-pages per vignette.

Your entire assignment will be approx 10 pages total plus a title and reference page.

For each of the four vignettes presented below:
What are the ethical issues in the case? Identify the issue in the ethics code.

Did the professional act in a manner consistent with current standards and principles? If not, what other courses of action would be more ethical? Support your decision by identifying the standards and principles relevant to this case.

Are there any indications of bias, stereotyping or marginalization present?

If relevant did the professional advocate for the client?

How can colleagues and supervisors help the professional to act ethically in this situation? Please be specific.

Vignette 1
Marlene is a certified school counselor and licensed clinical counselor specializing in a faith-based approach to healing. She has spent twenty years working with adolescents in a variety of school and clinical settings and has developed extensive competency in spiritual counseling of adolescents with developmental, educational, and mental health issues. She is known in her high school as the counselor “kids can trust”. In the last year there have been numerous reports in the media about teenage girls who have hidden their pregnancies from their families, delivered babies alone, and had babies who died soon after birth, either because of the girl’s actions or independent of them. In fact, one of the more notorious of these cases occurred in the town next to Marlene’s school. As a result, the school principal has mandated that all personnel who know of or suspect a student pregnancy should immediately notify parents and the school principal. Marlene is disturbed by this edict and fears it will jeopardize her open-door policy with students. Therefore, she decides to ignore it.

Vignette 2
Linda is a psychologist who works in the counseling center of a prestigious college with a large number of international students. She says that she could never really learn enough about the varied cultures from which many of her clients come, so she relies on the clients to teach her about their cultural background. When, for example, she had a client from Indonesia, she asked that young man directly about the ways in which he thought his culture affected his thoughts, feelings, and behavior. Linda says that because her clients are all gifted students, they have good insight into their culture and she relies heavily on their interpretation of the role of culture in their lives. She is content that she needs no other knowledge base.

Vignette 3
Petra is a 27-year-old woman who is a recent immigrant from Bosnia. She lost three brothers during the war there. She lives in the U.S. with her parents and she works as a meter-reader. Over the last 6 months Petra has become increasingly depressed. Her work performance has suffered and the employee assistance program at work has referred her to Jonathan for therapy. Jonathan is an experienced mental health professional who also conducts research on the effectiveness of psychotherapy for depression. He has never worked with a recent immigrant, and he has little knowledge of the war in Bosnia. Jonathan decides to refer Petra to another clinician who is from Eastern Europe, but whose knowledge and experience in treating depression is not as extensive as his.

Vignette 4
Marvin, is 28-year-old war veteran. He was diagnosed with posttraumatic stress disorder (PTSD) after he returned from military combat. In addition to PTSD, Marvin suffers from occasional bouts of serious depression. Marvin enters graduate school in counseling, hoping to provide therapy to other young veterans who have been traumatized. Although his academic performance in graduate school is satisfactory, he has been unable to provide competent therapy to his clients in internship. He cannot separate his own experiences and emotions from those of his clients and as a result, he sometimes misdiagnoses their problems and misinterprets their thoughts and feelings. Repeated efforts to help Marvin develop better skills and insight are unsuccessful. Consequently, he fails internship and is dismissed from the program. Marvin is frustrated and calls the actions of his supervisors unethical even though he does not disagree substantially with the faculty’s assessment of his clinical skills. He asserts that his compassion for clients and empathy for their pain should compensate for his deficiencies in other areas. Eventually, Marvin finds an unaccredited degree program from which he successfully graduates after which he opens a private practice. In this practice, he offers professional services to survivors of childhood sexual abuse.

Assignment Outcomes
Consider the impact of personal values, stereotypes and biases.

Discuss culture and diversity as ethical issues.

ANSWER

Introduction

Multicultural competency can be described as the ability of a person to understand more than one culture, for instance, understanding various languages and religious practices from different parts of the world. It can also be described as the ability to understand and think in manners that depict several cultures. Ethical issues are those events that take place whenever a certain scenario or activity creates avenue for misunderstandings in reference to the society’s or organization’s set code of conduct or guidelines. This article focuses on ethical issues in various case studies in relation to multicultural competencies from various aspects.

Vignette 1

The ethical issues involved in this vignette are effective communication, upholding trust and showing an initiative without being told. The Counselor, Marlene, ought to have to have followed the directives given by the school Principal to bring forward any suspect involved in the ongoing incidents rather than ignoring the information thus jeopardizing her trust. Marlene should ensure her trust stands tall in order to ensure continuation of her profession, assuming direct orders might raise issues touching on her trust levels thereby making her a key suspect in the ongoing investigation. Finally, she ought to have played a number one role in the investigations rather than waiting to be told on what to do, her profession obligates her to be at the forefront in fighting such matters. One of the multicultural competencies displayed in this discussion is the attitude and belief; Marlene allowed her negative emotional reactions to crowd her judgment thereby making her appear unprofessional irrespective of the experience she has gathered in the same field.

Marlene did not act in a professional manner by ignoring the directive given by the school Principal hence going against the set standards and principles by the school. Her action shows traces of dishonesty and disobedient to the set regulations. She ought to have taken the initiative to do her own research and investigation on the matter at hand and bring the suspects if any for a disciplinary action. One of the codes of ethics is lawfulness, her failure to follow a direct order shows her disobedience to the set regulations and standards by the school; another code of ethic disregarded is teamwork, she ought to have joined everybody in the investigation as requested by the principal. Her actions displayed stereotyping since she assumed the directive was precisely targeted at her thereby, ignoring the safety of her clients who deserve justice and attention. The stereotyping made her not to advocate for her clients instead she kept quiet on the matter assuming she is the one being targeted (American Psychological Association 2016).

Despite her profession and experience, Marlene still requires advice and guidance from her colleagues. One of the ways in which her colleagues and supervisors can help her is through instilling a sense of responsibility and honesty in her; this would make her realize the extent of the damage she might cost if she decided to keep any vital information concerning the case. Taking responsibility of the matter does not make her guilty instead it will improve her sincerity and honesty levels among her supervisors and colleagues. Her colleagues and supervisor should also encourage her to practice teamwork thus minimizing chances of wrong decision-making in future. For instance, next time a student who is known to be a member of her class gets involved in a relatively similar unlawful action, she should be the first person to advocate for justice for her client otherwise she stands a chance of being suspected.

Vignette 2

The ethical issues showed in this vignette is showing an initiative without being told and professionalism. As a psychologist in an international college, Linda should be able to show interest in learning different cultures and religion to understand the background and history of her student clients. Developing an interest in learning various cultures, will improve her professionalism by understanding her client’s worries without necessarily having to hear it from them. Her line of work requires her to understand the cultural and religious practices of her clients otherwise giving therapeutically-related pieces of advice would be difficult. Finally, Linda should display professionalism in her line of duty (Pope & Vasquez 2016).

Professional standards in her line of work requires her to learn and understand the culture of her clients rather than asking them when they come for psychological advice. Her failure to learn various cultures might interfere with the quality of the service she renders to the students. In code of ethics, one in her profession is required to have the knowledge about their own cultural and racial heritage and use it professionally to enable those undergoing racial and cultural abuse accept their racist attitudes. Another code of ethic touched is the skills; Linda should familiarize herself with significant research and analysis on the findings on the impacts of mental disorders as a result of racial abuse, thereby being able to advise the necessary measures to damage the thinking and perspective of the students.

The professional did not act in a manner consistent to the current standards and principles. She ought to have taken her initiative to learn the cultural backgrounds of her student-clients before she books them for psychological lessons. One of the standard code of ethics policy touched in this case is the competence and accountability; her failure to do research and learn on the various cultural practices raises questions on her competency. Apparently, Linda has not shown any indicators of biasness, stereotyping or marginalization in her line of duty. In this case, Linda advocates for her client, though indirectly since she depends on the client’s information to give her psychological advice. The only way her colleagues can help her improve on her line of work is by showing commitment and competence in her line of work, this is only achievable when she starts to do background research and analysis on her clients before booking them for psychological lessons. They should encourage her to practice the ‘show initiative without being told’ ethic to boost her professionalism and competence (Pope, Reynolds & Mueller 2019).

Vignette 3

The key ethical issues in this scenario are developing professional relationships, taking responsibility and professionalism. Jonathan, being an experienced mental health professional with an extensive research on the significance of psychotherapy, should have been able to have a trustworthy and experienced colleague/professional with the ability to handle the matter at hand. His decision to refer his client to a psychotherapist who is less experienced to handle serious and critical matters like Petra’s shows how poor he is at making professional relationships. Jonathan should take full responsibility of the patient’s case due to his wise range of experience and research in the same field rather than letting her look for a professional whose chances of curbing the depression are significantly low. Finally, Jonathan ought to have shown a sense of professionalism by using his research network in line with the client’s mental depression to offer appropriate and recommended treatment to the client. In the code of ethics, Jonathan violated the ‘teamwork’ and ‘competence and accountability’ policies. He failed to demonstrate teamwork by collaborating with the appropriate professionals, thereby risking the life of the client; his competence and accountability is questionable since he fails to show the worthiness of his research and experience in the filed under discussion.

Jonathan did not act in a manner consistent to the set standards and principles. His failure to establish experienced professional relationship and inability to practice professionalism shows the extent at which his actions were not cognizant of the set standards in his field of work. The professional ought to have used his vast research and findings in mental health psychotherapy to treat Petra rather instead of referring her to a less experienced therapist. This recommendation is line with code of ethics principles like competence and accountability, respect for others and teamwork. The professional’s actions depict serious indicators of stereotyping, marginalization and bias; one would think that the professional did not care about the client due to her ethnicity or cultural or religious backgrounds. His qualifications make him the best professional to handle the patient. He did not advocate for his client and instead deserted her in her times of need thereby showing unprofessionalism. The professional’s supervisors and colleagues can help him by instilling a sense of humanity in him and encouraging the practice of teamwork thus improving on his professionalism.

Vignette 4

The ethical issues in this case scenario are professionalism, developing professional relationships and taking responsibility. The fact that Marvin is unable to control his emotions while handling his clients shows how unfit he is for the work and the high levels of unprofessionalism. It is evident Marvin does not have any professional relationships where he can acquire further guidance and advice on how to handle his clients without expressing his emotions. This makes his decision-making ability very poor hence highly susceptible to wrong results and recommendations. Finally, the professional has shown his inability to take responsibility for his actions hence jeopardizing his competency. The code of ethics principles falling in line with this case are lawfulness, teamwork and competence, and accountability. The professional did not act in accordance to the standards and principles of his work. He wasn’t able to handle his emotions and showed dishonesty and unlawfulness during his tenure practice as a professional in the institution. His decision to open a private firm for survivors to sexual childhood abuse worsens everything since he uses unaccredited degree to offer the practice, thereby proving his unlawfulness and unprofessionalism (Sommers-Flanagan & Sommers-Flanagan 2018).

The professional ought to have sought for guidance from an experienced professional to help him handle his emotions and instill a sense of professionalism in him. The relevant standards to this case are integrity and honesty, lawfulness, competence and accountability, and teamwork. Cases of stereotyping, marginalization and bias are not noted from this case study. The professional in this case had no responsibility for advocating for his clients due to his depression, incompetence and unprofessionalism. The best ways in which his colleagues and supervisors can help him are by helping him accept his depression and trauma, instilling self-belief and patience in him; finally advising him to establish professional relationships for client and personal gains.

References

American Psychological Association. (2016). Revision of Ethical Standard 3.04 of the” Ethical Principles of Psychologists and Code of Conduct”(2002, as amended 2010). The American Psychologist, 71(9), 900.

Pope, K. S., & Vasquez, M. J. (2016). Ethics in psychotherapy and counseling: A practical guide. John Wiley & Sons.

Pope, R. L., Reynolds, A. L., & Mueller, J. A. (2019). Multicultural competence in student affairs: Advancing social justice and inclusion. John Wiley & Sons.

Ratts, M. J., Singh, A. A., Nassar‐McMillan, S., Butler, S. K., & McCullough, J. R. (2016). Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28-48.

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2018). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques. John Wiley & Sons.