Vignette Analysis

Vignette analysis: a code of ethics for psychology
Student
Institution

Ethics stands for values and behavior that guide professional conduct. Ethics becomes practical when applied in particular demanding work oriented situation when handling an ethic related issue, or an issue that could be rated as a moral dilemma as shown in Knapp & VandeCreek, (2006 pg. 3). The American Psychological Association sets the standards and guidelines required for solving ethical concerns faced by a psychologist in the line of duty. From a voluntary personal perspective, ethical decisions can be made by choosing to do the right thing in a given situation motivated by intrinsic moral standards one possess. For psychologists, the APA (American Psychology Association), has set the minimum standards to guide the performance but it important to go beyond the minimum standards in delivering the services. The application of positive ethics can help psychologists to be able to put a balance of the needs of their patients, their family members, and help to determine the extent of support they need to avail for their clients Knapp & VandeCreek, (2006 pg. 13). Through positive ethic, psychologists can recognize and appreciate the regulations set by APA. For instance, it gives a guideline on avoiding numerous harmful relationships, upholding patients information confidentiality, and the sexual involvement with patients are all designed to keep the patients safe.

In some situations, there are too many ethical decisions to be made in an individual case, and the APA helps in such circumstances In biomedical ethical consideration, four principles are actively in play Knapp & VandeCreek, (2006). They include justice, autonomy, beneficence, and the last one is non-maleficence. The following vignettes will be analyzed in consideration of the related ethical issue and how to solve the problems presented, which require the psychologist to take a professional ethical choice.
Vignette (1)
A colleague refers his sister and her fiancé to you for pre-marital counseling. This is a requirement of their Christian faith. Your colleague tells you that you are one of the few approved providers on his sister’s managed care contract in the area. He tells you that he knows this situation might be ‘sticky’ but asks you to see the couple as a favor to him, promising to be mindful of professional boundaries and ethical considerations.
1. What boundary issues and therapeutic concerns do you see?
The boundary issue in this context is the religious nature of the patients, which will have a strong implication on how to counsel such couple. The therapeutic concern may be that the religious affiliation of the patient may be outside the American society religious mainstream. And this will mean that the patients and the psychologist will take time before they develop trust and their ideas synchronized VandeCreek, (2006 pg. 60). For the session to be fruitful the patients will be required to be ready and willing to listen and have a positive attitude that will accept the therapies provided for the counseling on premarital issues. On the other hand, religion is a vital platform to understand the patients to view on world issue around them in designing an effective psychotherapy techniques VandeCreek, (2006 pg. 61). With this knowledge, the psychologist may understand even the right religious ritual to incorporate in the psychotherapy to facilitate the acceptance of the therapeutic measures by the patient.
2. How would you go about your decision-making process?
In such situation, a problem for making the right decision will precipitate. APA have provided a six steps model to help address the problem. The first step is the identification of the problem that we have already done above. The second step is coming up a hypothesis of the cause of the problem. The third step is coming up with options to help solve the problem and analyzing them accordingly. The step number four is to take action based on the best option for the analysis of some them. The last step involves the evaluation of the results after the implementation of the best course of action. All the action should be based on the beneficence and non-maleficence principle, which emphasis of not harming but benefiting the patient VandeCreek, (2006 pg. 89).
3. Would you seek supervision and why?
Seeking supervision is vital since, it will prevent me from crossing boundaries in the professional handling of clients. When a psychologist acts professionally with crossing boundaries, they are considered competent in their line of duty. The supervisor will help guide in places where unethical moves have been performed. For instance, the supervisor will help ensure I do not involve my personal concerns in serving the patients, since it will lower the quality of services I will be rendering VandeCreek, (2006 pg. 94) Also the patients since they are aware that I am an acquaintance of their reference they may tend to cross boundaries, sometimes with my knowledge, and this is the time the supervisor has to remind me to be more vigilant lest I lose my professionalism and hence not considered competent VandeCreek, (2006 pg. 95).
4. What documentation and record keeping issues arise?
The documentation and record keeping issue arising is that the fee and the billing agreement should be available reflecting the agreement between the psychologist and the patient. In the record the standard fees that the psychologist charge should be documented on the receipt after the agreement Fisher, (2013pg 151). Record keeping brings up the issue of confidentially of the information collected for the patients. In this case, a coding technique to conceal their identity will be preferred, which is also part of the ethical responsibility that a psychologist is expected to fulfill Fisher, (2013 pg. 156). Also, documentation and recording record keeping will arise due to the process of transmitting the information documented on paper to electronic-based storage. This may pose a security problem to the patient’s information, but psychologist is encouraged to improve the electronic health record management bases to improve the security Fisher, (2013 pg. 157).
Vignette (2)
You are a male therapist scheduled to teach an Introduction to Psychology course at a local community college. On the first day of class, you notice a young woman smiling at you in the front row. You recognize her as a young Asian-American woman that you did an EAP intake assessment with last week. During the intake assessment, you found this woman to be emotionally fragile and covertly seductive in body language and posture. You referred her to a female colleague for ongoing individual therapy.
1. What boundary issues and therapeutic concerns do you see?
The boundary issue present is the fact that the psychologist and the patient had a prior encounter in a social context that induced a sexual tension moment, and now that will hinder an effective therapeutic moment. The psychologist would probably be nervous considering that the client seems to be more interested in the social relationship than the psychologist, which could affect his competence at his work VandeCreek, (2006 pg. 92-33). The patient may not get the standard therapeutic services that will be interpreted to failing to uphold the codes of ethics that guided the practice of psychologists. Also, in this situation, the psychologist never anticipated an encounter with the patient, hence caught by surprise total impairs his ability to deliver quality services.
2. How would you go about your decision-making process?
In this context, I would try to resolve the conflict of interested by talking to the patient to allow professionalism to control the relationship and avoid the involvement of the social relationship in the work environment. Since the patient may forget they can be reminded from time to time during the therapy to help, they stay focused to ensure the therapy has a positive outcome. The informed consent rule best fits the situation, where the patient should accept the therapy from the person they had met before but still respect them as their therapist in this context VandeCreek, (2006 pg. 93). In the informed consent situation, the patient is in charge in ensuring the relationship with the psychologist if appropriate to enhance the therapy.
3. Would you seek supervision and why?
Yes, I would seek for supervision. The patient at hand has clearly indicated that she is sexually attracted to the psychologist and as a human being feeling may disorient a person and end up into sexual involvement with the patient. This act will be termed sexual exploitation. The supervisor will ensure that I don’t violate any ethics that keep me from being competent in my line of duty VandeCreek, (2006 pg. 106). Sexual involvement with the client will automatically lead to poor services hence the principal of beneficence and non-maleficence compromised, by unethical conducts Fisher, (2013 pg. 21).
4. What documentation
Since there were a prior encounter and a level of intimacy was ignited between the patient and psychologist, the payment of fees before the therapy starts may be difficult. The patient is likely to take it personal not pay as one of the formal procedures, and the psychologist is most likely not going to ask for the payment. This will bring documentation and record-keeping challenge. The situation should be formalized by taking down the patients personal details just like any other patient and settle the required fee, and be issued with a receipt as stipulated by the organization the psychologist is serving under Fisher, (2013 pg. 114).
In conclusion, all the vignette cases studies above have been used to show that the fours principles that are justice, beneficence, not- maleficence, and autonomy, guides the practice of psychology. At all-time patients’ interest are the ones that matter but still the APA have guidelines that protect psychologist from abuse by patient. It places a limit of what a patient can receive from the practitioner. Those psychologists who strive for excellence, are at risk of work-related stress and trauma.
Reference
Fisher, C. B. (2013). Decoding the ethics code: A practical guide for psychologists. Sage Publications.
Knapp, S. J., & VandeCreek, L. D. (2010). Practical ethics for psychologists: A positive approach. American Psychological Association.