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[ANSWERED] Upon completing the MACP program and receiving registration with CCPA six months ago, Emily Blackman

3.1. Obtaining Informed Consent

Informed consent refers to the process through which a counsellor ensures that the client is aware of the potential risks and benefits associated with therapy, assessment, research, and/or other activities in which they may engage. Informed consent means that the client voluntarily agrees to the counselling process, has a right to understand its implications, and has a free choice about participating. Obtaining informed consent is a cornerstone of conducting ethical therapy, research, and assessment, and is required by ethical codes.

Review what the codes of ethics have to say about this topic and incorporate this into your discussions:

  • Some may say that informed consent is really about protecting the professional from liability rather than respecting the client’s dignity and freedom. What are the strengths and weaknesses of this argument?
  • What should the client know and understand to make a decision that is indeed informed?

upon completing the MACP program and receiving registration with CCPA six months ago, Emily Blackman

3.2. Protecting Confidentiality

Confidentiality is the keystone of effective counselling and psychotherapy because it allows the client to freely share experiences without fear of unwarranted disclosure to others. Confidentiality refers to the ethical principle that compels psychologists to hold secret all information about a client and to keep private any information revealed by a client in confidence unless the client consents to the disclosure of the information to a third party or the law authorize the release of information without the client’s consent.

Review what the codes of ethics have to say about this topic and incorporate this into your discussions:

  • Discuss some ways in which you can prepare clients for issues pertaining to confidentiality. What could you do to educate clients about the purposes of confidentiality and the legal restrictions on it? Examine how you would do this in various situations, such as assessment, school counselling, group work, couples and family counselling, and counselling with minors.
  • During the counselling session, Paul mentions that he is sexually active, that he sometimes engages in sexual activity that could put his partner at risk, and that he has withheld from his partner that he is HIV positive. Does Paul’s behaviour constitute a threat worthy of a warning to the potential victim? As a counsellor, if you break confidentiality to warn a potential victim, what effect will that have on the therapeutic alliance with Paul and, ultimately, on Paul’s well-being? To whom you have a primary obligation—Paul or someone whom Paul might endanger?

Case Analysis II 

Instructions

Consider the following case for analysis:

Upon completing the MACP program and receiving registration with CCPA six months ago, Emily Blackman as a new counsellor decided to add telephone counselling to the services she provides to clients. One of her clients, Karen White, a 50-year-old woman who struggles with emotional and physical isolation, has a very soft voice, and Blackman has difficulty hearing her accurately even after turning up the phone’s volume. Blackman tried diplomatically to ask her client to speak louder but to no avail. Frustrated, Blackman decides to put Karen’s calls on speaker, increasing the volume to its maximum capacity. Blackman reasons that although Karen’s voice can now be heard in Blackman’s reception area, clients’ chances of hearing the conversation can be minimal because she is usually finished with Karen’s session before clients physically arrive for appointments. For this reason, Blackman decides that she does not have to inform Karen that her voice is on speaker. To do so, she believes it would be intimidating and counter therapeutic.

Answer the following questions:

  1. Discuss Emily’s decision not to inform Karen that the speaker volume is on while she talks.
  2. What are the justifications for this, if any?
  3. What are the ethical and legal ramifications of this behaviour?
  4. Discuss the suitability of using the telephone counselling or other forms of technology in counselling practice for the types of issues with which Emily is presenting.

In the assignment, you must integrate the reference to ethical principles, standards of practice, relevant practice guidelines and legislation specific to the province or territory in which you intend to practice. You may use outside research, but not to replace the material from the course. All work must be cited according to APA format, current edition. Culture/Diversity and Legal/Ethical issues must be included when relevant.  Do not type the case analysis into your assignment.

Specific requirements for formatting your Assignments #2:

The paper should be 4-5 pages, double-spaced (excluding the cover page, and the reference list), format your paper in Word (doc or docx only) and use APA style guidelines, current edition. You can write in the first person. Use the questions as headings in the assignment.

When you save your assignments on your computer, you should “save as” using the following formula: First Name Last Name -Course Number-Assignment Number (JohnDoe-PSYC6203-1).

All written assignments should have a cover page (including the title of the assignment, your name, the name of the course, and the date of submission) and be double-spaced throughout (without leaving an extra-space between paragraphs or references; make sure that the “Before” and “After” values for Paragraphs are 0 = zero).

This program uses 7th edition APA style. This is a guide for all professional communication. At the same time, please know that we have program expectations for assignments. These expectations include: 12pt text size, Times New Roman font and no running head. The reference list should only include sources that were used for in-text citations in the paper itself.

  • No abstract, introduction or conclusion sections are needed for the assignment. Please include references. Focus on using peer-reviewed journal articles to support the arguments
  • The project will be evaluated with respect to organization, clarity, and thoroughness of presentation, and justification of evaluation criteria.

Reminder: As a graduate-level course, student work should be based on critical thinking, not merely on summarizing or paraphrasing material.

Evaluation

The following rubric indicates those areas you should be focusing on in preparing your assignment, and how the professor will weigh these components relative to one another.

Criteria % of Assignment Grade
Presentation, Originality, Relevance, Insight (10%)

  • Originality, the relevance of references; insightful; clear and accurate citations and/or references; logical progression of ideas
/10
Mastery of Material/Comprehensiveness (70%)

  • Identifies Dilemma(s) (10)
  • Analyzes Alternatives and Consequences (20)
  • Identifies Appropriate Ethical Frameworks for Evaluation Alternatives (20)
  • Chooses an Action (20)
/70
Written Quality (20%)

  • Written in a clear, intelligent, and professional manner; avoid colloquialisms and texting-style shorthand – professional grammar, spelling, and style is expected; succinct; APA style
/20
TOTAL /100

Expert Answer and Explanation

3.1. Obtaining Informed Consent

To some extend I can agree that informed consent is used in protecting the professional from liability rather than respecting the client’s dignity and freedom. The strength of this argument is that the counselor will not be accountable is something goes wrong yet the clients agree to the therapy and because the patient knew the consequences. The weakness of this argument is that the counselors will not be focusing on the dignity of clients. The clients might agree to a medical process which is inhumane but because they have given their consent, the caregiver will go ahead and implement it. Therefore, it is recommended that informed consent should be accompanied by other codes, such as non-maleficence and respect of human dignity. Canadian Counselling and Psychotherapy Association (2020) note that the therapist must communicate the nature, benefits, risks, and the purpose of the therapy to the client. Other treatment alternatives (if there are any) should also be communicated to the client to improve their decision-making. The client should also know the fees for the service and the most likely outcomes of the therapy and they should also know who will see their private data. Lastly, the therapist must evaluate if the client is in a capacity to sign the consent form and clients acknowledges that they are informed for the process to be indeed informed.

Reference

Canadian Counselling and Psychotherapy Association. (2020). Code of ethics. Retrieved from https://www.ccpa-accp.ca/wp-content/uploads/2020/05/CCPA-2020-Code-of-Ethics-E-Book-EN.pdf

3.2. Protecting Confidentiality

Clients can be prepared on issues pertaining to confidentiality using a six-step ethical model. The steps include preparation, telling the clients the truth in advance, obtaining informed consent before disclosure, responding to disclosure requests, evading avoidable breach to confidentiality, and talking regarding the issues. I can lecture and discus with clients about the purposes of confidentiality and the legal restrictions on it to educate them about the issues. Lecturing and discussion can be applied in all the scenarios mentioned in the question. In my opinion, Paul’s behavior does not constitute a threat worthy of a warning to the potential victim because his partner might as well be engaging in sexual activity with other people. His partner might also be HIV positive but has kept it a secret. If I break confidentiality to warn a potential victim I will definitely loss trust of Paul and he might even decide to terminate the professional relationship. The breach can also impact his psychology because his partner might decide to leave him (Canadian Counselling and Psychotherapy Association, 2020). My primary obligation is to Paul because his secret is not lethal and does not worth breaching confidentiality with the client.

Reference

Canadian Counselling and Psychotherapy Association. (2020). Code of ethics. Retrieved from https://www.ccpa-accp.ca/wp-content/uploads/2020/05/CCPA-2020-Code-of-Ethics-E-Book-EN.pdf

Case Analysis II

1. Discuss Emily’s decision not to inform Karen that the speaker volume is on while she talks.

Emily’s decision has to deal with informed consent. Though Blackman reasons that her client’s voice cannot be heard by other people because she is always finished before other clients come for a physical appointment. There is a possibility that their conversation can be heard because of their voices and reach the Blackman’s reception area. One day, one of her clients might bump in while they are talking, and this could jeopardize their confidentiality. As a result, Blackman should give the client a chance to think and decide whether they can continue talking over the speaker despite the danger of their confidentiality being breached. Counseling is about the client and the belief that informing the client about the issue is intimidating and counters therapeutic makes the therapy about the counselor (Canadian Counselling and Psychotherapy Association, 2020). Also, failing to inform Karen about putting her voice on a loudspeaker denies her the right to make decisions about how her therapy should be conducted.

Blackman might face legal actions if Karen gets hurts by the therapy done on speaker volume. When asking about the client’s informed consent, Blackman should let her know why she is opting to put their conversation on the loudspeaker (CCPA, 2020). She can tell Karen that her voice is soft and cannot be heard clearly without putting the call on a loudspeaker. Blackman should also explain the consequences of putting the conversation on the loudspeaker and that it can be heard by other clients in the reception.  Blackman should also note that this can breach her confidentiality. The benefit of the action should also be explained so that the client can have a full picture of the situation. Karen should then be allowed to make an informed decision based on the information provided. If Blackman fails to tell the client of the situation, she would be breaching boundaries and risk cancelation of her license.

2. What are the justifications for this, if any?

There is no justification for this behavior. Failing to follow provided laws governing telephone counseling has no justification. The counselor is worried that informing the client will be intimidating and counter therapeutic. She is only concerned about her welfare and not that of the client. By doing this, the counselor would have gone against the following ethical principles. The first ethical principle is respecting the dignity of persons and people (Canadian Psychological Association, 2017). The client would have obtained informed consent by explaining to the client the reasons behind the decision. However, failing to do so denied the client of her freedom of consent. The psychologist also failed to address the issue of privacy and confidentiality. She should have told Karen that putting her voice on a loudspeaker could breach her privacy and confidentiality, and as a result, it seemed that Karen was not treated humanely.

The second ethical principle that is being breached in the case study is responsible for caring. Emily is not being competent by continuing with therapy, yet she knows that the client’s voice can be heard as far as the reception. As described by the National Board for Certified Counselors (2016), competence can be achieved by maximizing therapeutic benefits and minimizing harms during counseling. Emily can maximize the benefits of telephone therapy by using other alternatives, such as messaging to communicate with the client instead of putting Karen’s information at risk of being heard by unauthorized third parties. If Emily has a secretary, the secretary will hear the client’s voice in case they are in and the therapy session is taking place. Overall, based on the arguments I have raised above, Blackman is no ethical or legal justification to continue the therapy with the client’s voice on a loudspeaker.

3. What are the ethical and legal ramifications of this behaviour?

Emily’s behavior has many ethical and legal ramifications. The following are some of the ethical and legal ramifications for continuing with the therapy with the client’s voice on a loudspeaker. First, Emily might face disciplinary action if the client’s data is leaked to unauthorized people. She might be called by the National Board for Certified Counselors and asked not to conduct her duties for some time as a punishment for being careless (NBCC, 2016). As a counselor, she is expected to protect the privacy and confidentiality of the client. When she is found guilty of negligence, she might even lose her practice license and banned from practicing in the territory she is or Canada (Noroozi et al., 2018). However, she will be provided disciplinary proceedings under the health professional’s regulatory statute to give her a chance of fair trial.

The client might even decide to sue Emily if the leaked information damaged her image and reputation. Therefore, Emily might be asked by the judicial system to compensate the client for damages suffered. The client might argue that she was not aware that her voice was on the loudspeaker and she has not consented to the action. Ethically, Emily’s reputation and values might be damaged and no client will be willing to trust her again. Counseling is a profession that can only be achieved if the client trusts the counselor (Martin et al., 2015). However, if the clients lose trust in their psychologists, their relationship will be damaged automatically. Karen’s condition might worsen if their conversation leaks, and this goes against the ethical principle of not harming clients. Psychologists are required to do good and implement practices and are in the best interest of the client and avoid harming them.

4. Discuss the suitability of using the telephone counselling or other forms of technology in counselling practice for the types of issues with which Karen is presenting.

Telephone counseling or other forms of technology in counseling practice are suitable when clients cannot attend physical counseling sessions for one reason or another. Telephones are also available, accessible 24/7, and affordable compared to physical counseling. In the case study, Karen has said that she is struggling with emotional and physical isolation. In my opinion, telephone counseling will not be suitable for the following two reasons. First, when counseling a client with emotional problems, the psychologist is required to observe how the patient is behaving, her dressing code, eye contact, and other non-verbal communications (Byaruhanga et al., 2017).

However, when talking over the phone, the counselor cannot accurately measure the degree of the problem. Therefore, if I were Emily, I would select video counseling where I will see the client in more detail. Second, no seeing a counselor in person could be an issue for some people, especially Karen who feels physically isolated. Asking her to come to the therapy in person can allow her to meet friends even in the office. She can find other patients seated in the office and start bonding with them. The telephone is one of the technological elements that have improved physical isolation because instead of visiting friends, people prefer to talk through the gadget.

References

Byaruhanga, J., Atorkey, P., McLaughlin, M., Brown, A., Byrnes, E., Paul, C., … & Tzelepis, F. (2020). Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review. Journal of medical Internet research, 22(9), e18621. https://www.jmir.org/2020/9/e18621/

Canadian Counselling and Psychotherapy Association. (2020). Code of ethics. Retrieved from https://www.ccpa-accp.ca/wp-content/uploads/2020/05/CCPA-2020-Code-of-Ethics-E-Book-EN.pdf

Canadian Psychological Association. (2017). Canadian code of ethics for psychologists. Fourth edition. Ottawa, ON: Author. Retrieve from https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf

Martin, L., Shepard, B., & Lehr, R. (Eds.). (2015). Canadian counselling and psychotherapy experience: Ethics-based issues and cases. Ottawa, ON: Canadian Counselling and Psychotherapy Association.

National Board for Certified Counselors. (2016) Policy regarding the provision of distance professional services. Retrieve from https://www.nbcc.org/Assets/Ethics/NBCCPolicyRegardingPracticeofDistanceCounselingBoard.pdf

Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iranian journal of public health, 47(6), 875. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077627/

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