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Ethical Decision-Making Paper PSYCH/545 Survey of Professional Psychology University Of Phoenix Instructor: Dr. Marc Miller Student: Lisa Spraggans Monday, January 10, 2011
2 In this paper the ethical dilemma in professional psychology I select is “Mandatory Reporting of Child Abuse.” I will describe my selected ethical dilemma. I will apply each one of the first fourteen steps in the ethical decisionmaking process to my selected scenario. The purpose of applying these fourteen steps is to use them systematically to arrive at the “best” ethical decision for “solving” my ethical dilemma. I will explain the importance of ethical decisionmaking in the field of professional psychology. Mandatory reporting of child abuse is mandatory in all fifty states, yet, each state’s application of mandatory reporting laws may differ. Mandatory reporting refers to a legal obligation to report suspected or known child maltreatment. Mandatory reporting legislation overrides any professional code of conduct or ethical guidelines. For example, although psychologists must maintain client confidentiality, they may break this confidentiality if a client reports that a child is being abused. Medical practitioners, psychologists, police officers, social workers, welfare workers, teachers, principals, and in many states film developers are all mandatory reporters. Several states have broadened the list of mandatory reporters to any person suspecting abuse (HealthyPlace.com, 20002010). When a report of abuse is disclosed to a person there is a legal responsibility to report the abuse to proper authorities such as the police or Child Protective Services.
3 Scenario: I am counseling a 29 year-old African-American woman named Theresa who suffers from chronic depression. One day she arrives for her session with bruises. I inquire about the bruises and eventually Theresa discloses that she is being abused by her children's father who resides with her and the children. The children's ages are 7 and 8. My concern immediately turns to the safety of the children and I inquire whether or not the children are being abused. Theresa eventually confirms that the children’s father is physically abusive with them as well. Additionally, she confides that her mate’s temper is so explosive that she fears for her life and that she is concerned for the safety of her children. I asked the client why doesn't she take the children and leave and she responds that she has no where to go and that she is afraid because the children's father told her that he would find her, take the children, and kill her. I insist that Theresa must leave this environment if only for the safety of the children. I need to figure out how I should handle this case because I fear for the safety of Theresa and her children and whether or not I should notify authorities. There are several ethical dilemmas present in this case. The ethical dilemmas are protecting the parties in danger, notification of authorities, my professional competence to handle this case, harvesting bias toward the abuser, and preserving confidentiality. Steps in Ethical Decision-Making Process 1. It is important to first understand what the dilemma is that requires ethical consideration and decision-making. The main ethical dilemma in my
4 client’s case is protecting the parties in danger. Although the main client is Theresa, the other parties involved that are in grave danger are the children. Theresa’s partner (the abuser) is also a factor, who is not in danger, but may benefit from counseling as an abuser. Other ethical concerns consist of authorities should be notified, and my professional competence as a psychologist. I am legally obligated to report the abuse of the children. 2. I need to anticipate who will be affected by my decision. In a professional capacity there are laws in place to protect the confidentiality of a patient but how the professional ethically responds may make a difference in the outcome when others may be at risk. It is my responsibility as a professional psychologist to assure the safety of all victims. I anticipate that the claim of child abuse will be investigated and if the claim is found valid, the possibility that the children will be removed from the home. 3. It should be clear who the client is so there is no conflict that might influence the professional’s judgment because there may be other parties involved taking care of the responsibility of the client’s bill. In other words, even though someone else is paying the bill, it should be established who the professional is treating and confidentiality is with the client, not with who is paying. It is clear that the client in this case is Theresa but because she has disclosed that her children are also being abused, I also have the responsibility to protect the children because now that this information is disclosed I must protect all parties in danger.
5 4. Conduct a self-evaluation of your understanding, knowledge, skills, and experience of the situation. Ask yourself is this the best course of action or if there is someone more qualified to address the situation. I have the option to refer my case to another colleague or seek consultation and supervision. Consultation is always beneficial in any case. One of the first things that I need to do as a psychologist is assess my own personal bias concerning child abuse. I must understand the cultural and ethnic background of the client. I must discuss with the client confidentiality, informed consent, and limits to confidentiality. An informed consent form must be prepared and signed by the client before counseling can proceed. 5. Review the ethical standards to make sure they apply to the situation. Question if the situation raises conflict within or between the ethical standard and other guidelines or values. Seek out if the ethical standards being applied to this situation are helpful, irrelevant, or misdirected. The ethical standard that applies to this situation is my responsibility to report the child abuse that has been disclosed to me by Theresa and to protect all who are in danger. 6. Determine whether or not those specific laws support or allow the most ethical response to the situation and if those laws work against or block the most ethical response. Mandatory reporting abuse laws are designed to protect the welfare of children. These specific laws support my most ethical response to the situation.
6 7. The individual should see whether or not there are any new developments or theories that offer additional conceptualization, understanding, or response to the situation. Mandatory child reporting laws vary from state to state and there may be updates or changes at anytime. It is my responsibility to research laws that pertain to the city and state in which I practice psychology. Prior to putting anything into motion I need to make certain that my actions comply with any new developments and bearing on my decision to report the abuse. 8. A self-check should be evaluated to see whether or not your own personal feelings, biases, or own interest might impact your ethical judgment and reasoning. Evaluating to see whether or not my own personal feelings, biases, or own interest is necessary because it could have an impact on my ethical judgment and reasoning. I need to ask myself have I or anyone I know experienced child abuse. If I have previous experience or knowledge of this type of case it could impair my judgment and this might cause conflict between me and this case. 9. Cultural, social, and religious factors should be researched because situations may be interpreted differently by another culture. Ethics differ in cultures, religions, and other societies and it is important to learn what their viewpoints are so that relevant context is not being overlooked. As a psychologist no form of harmful physical contact is acceptable, that includes and not limited to spankings. In some cultures it is accepted that physical punishment applied to children is accepted as their way of rearing
7 children to maintain control and respect. It is important that I research the culture of my client so that I am best prepared to address this situation and to help clarify and confirm the disclosure of abuse to the children. 10. Consider if a colleague or someone that is more qualified should be consulted to critique your decision that has previous experience with the situation. I would examine my competency in working with this case by consulting another colleague, a Domestic Violence Advocate, and Child Protective Services because of their specialty in this manner. 11. Brainstorm to take a look at all possible angles to respond to the situation. Seek out if there is any alternative course of action that can be taken. I need to ensure the safety of all parties involved. This can be achieved by providing a safety plan and make Theresa aware of resources available to her. I need to assess Theresa’s immediate needs and involve her in a strategy for intervention. As part of the safety plan, I should put Theresa in contact with a Domestic Violence Advocate because of its services involving children. The Domestic Violence Advocate assists victims of domestic violence in determining an appropriate course of action for her family, which may include legal, housing and/or child protection services; providing crisis intervention by linkage to Legal Services, Children’s Services, Child Protection Services; just to name a few of the advocate’s functions. 12. Evaluate the alternative course of action to show what possible impact it might have on the situation. Review the impact that the
8 decision might have on others. Review what the immediate, shortterm, and long-term consequences and implications for all parties involved including yourself, any relevant organization, discipline, or society. The risks and benefits of the situation should be evaluated. The immediate short-term consequences that I need to consider is that Theresa understands my responsibility as a professional that I must report the child abuse. Theresa should feel as though she is part of the decision-making process of what is best for her family. Theresa will need reassurance of her decision and made to feel that she and her children are safe. Putting Theresa in contact with services that will assist with addressing what her immediate needs are will also include long-term plans such as relocating her place of residence, medical (if necessary) and psychological (counseling) attention for the children, enrolling the children into new schools, and employment. Theresa and her children should be provided with on-going therapy. 13. Adopt the perspective of those who are affected by your decision. I need to envision myself in this same situation to try to experience what this person is going through. There is a possibility that this may change my perspective, resulting in changing my decision because I may now have a different understanding of the situation that results in changing my ethical decision. I envision myself in the same situation as Theresa and the thing that is most prominent is the fear I experience of the abuse of myself and my children. I place faith in my psychologist that what I am being told is for my
9 best interest and for the interest of my children. 14. Decide what to do about the situation then review that decision because there may be reason to reevaluate that decision. The first decision I am making is based on the disclosure of child abuse confided in me by Theresa who is a 29 year-old African-American woman who is being abused by her live-in boyfriend and father of her two children. My immediate concern is for the welfare of her children. It is my responsibility to report child abuse and for the authorities to validate the claim. The risk of consequences developing from reporting the abuse, and the report being investigated while the abuser is still in the home may further ignite problems within the home for both Theresa and the children. Bringing in other resources that specialize in child abuse will help to ensure the safety of Theresa and her children. Theresa needs to be part of the decision-making process which helps to ensure she understands what and why she needs to take these necessary steps. The fear that Theresa is experiencing has her paralyzed and she is afraid to leave. She has to deal with the fact that the situation of domestic abuse (since she is afraid to leave) has another factor that takes precedence over her, and that is child abuse. The importance of ethical decision-making in the field of professional psychology encompasses the psychologist’s ethical sensitivity to the consequences of choices, the psychologist having the ability to evaluate complex, indistinct and deficient facts, and the skills to implement ethical decisions effectively.
10 In conclusion, addressing mandatory reporting of child abuse cases involves a number of ethical dilemmas which must be resolved by the psychologist. Child abuse has serious and far-reaching consequences for those involved. The psychologist needs to address their personal bias, their own ability to competently handle the situation, ensure the safety of all involved, address multicultural issues, provide on-going support to the client and her family, and provide referrals where necessary. The psychologist has to address issues of informed consent and record keeping. The counselor must seek supervision and consultation where necessary.
Resources: HealthyPlace.com, (2000-2010). Mandatory Reporting of Child Abuse; Retrieved From www.healthyplace.com
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