Write a 3-5-page response (not including the cover page and references) addressing the errors you identify from the vignette based on Abby (Therapist) & Muriel (Client). Write this section based on the rules and regulations of the state or jurisdiction you will practice in.
Reference the AAMFT Code of Ethics and you may use the ACA Code of Ethics and other sources to supplement as needed. The paper should include at least 4 citations using APA format (no abstract needed).
Answer the sample MFT National Exam questions providing a brief (1-2 paragraphs) rationale for each of your answers.
Legal/Ethical Issue: Name of Issue (examples: boundaries, countertransference, dual relationship, mandated reporting, confidentiality, intimate partner violence, sexual misconduct, informed consent, mandated reporting, termination)
Why is this an error: Describe in terms of applicable laws and/or ethics (AAMFT) incorporating class resources & readings.
Correct Action(s) or Process: Write from the perspective of what you’d do as the therapist instead. Go into detail not just a basic statement like, “I’d follow legal and ethical guidelines for dual relationships.”
Abby is 25-years old and fresh out of graduate school and working as a therapist intern at her local high school. Muriel, a recently turned
16- year-old student, was referred to the therapy center by her teacher because Muriel was withdrawn and crying intermittently at her desk during class. Muriel comes for the initial session where Abby provides one-time crisis counseling services as permitted by the school agreement without parental consent.
During this time, Muriel is crying, and Abby assures her, it’s ok to tell her what’s going on and that whatever Muriel says in this office is completely confidential. Muriel shares that her boyfriend just broke up with her this morning and she is devastated. She shares that she met him at a party she went to over summer and that he went back to college last month, mentioning she likes to date older boys and that he just turned 21. She goes on to reveal that she had sex for the first time ever with him and she thought they were in love. Abby really felt for this girl, remembering her own high school love who broke her heart and just knew she was the one to help her through this! She remembered feeling so bad and like it was the end of the world, but it all turned out fine and she knew it would for Muriel too! She helps Muriel calm down enough to go back to class and before leaving, gives Muriel her personal cell phone number and says, “call or FaceTime me any time you need to talk, I know how hard this can be.”
Before Muriel leaves the office, Abby tells her that if she would like to keep meeting that she’ll need to get permission from her parent or guardian and Muriel says she would like to come back again to talk.
Muriel says, call my mom and ask because her dad says therapy is for crazy people. Doing as Muriel asked, Abby makes contact using the home number for mom provided on the student’s school file and speaks with Muriel’s mother, noting different phone and address for the parents. The following week, Muriel and her mother meet in Abby’s office and Abby hands the paperwork to Muriel’s mom to sign pointing out each spot her signature is required. Muriel’s mom leaves and Abby and Muriel begin talking about what’s been going on since they last talked over FaceTime two nights ago when Muriel really needed her.
Muriel’s mood has continued to deteriorate, and she comments to Abby at one point, “I just want it all to be over with, I’m so sad.” Abby feels a bit concerned about this comment but she doesn’t want to upset Muriel any more than she is already so she gets her talking about her favorite movies and distracts her talking about her friends and other stuff trying to get Muriel to cheer up before the end of the session. Besides, she remembers, she felt so devastated from her own high school broken heart and she got over it so she knew Muriel would too.
A couple of days later, Muriel’s mom calls to talk to Abby to get an update on how she is doing saying she is really worried because Muriel just laid in bed all weekend long crying and sleeping and barely talks to her mom at all. Abby reassured her that Muriel is experiencing a normal teen breakup and she’d let her know if anything alarming comes up.
At the next session, Abby checks in with Muriel about her weekend and Muriel confirms she was feeling really low, revealing she snuck some painkillers from her grandfather’s bathroom when no one was home and she has them in her room “just in case”. Abby has an uneasy feeling in her stomach about this and gets Muriel to promise that she’ll not take them and to call her whenever she needs to until they meet next session. The night before their next session, Muriel calls Abby’s phone but she misses the call and sees the voice mail two hours later. She listens to the message from Muriel who is sobbing and says, “I just can’t go on like this.” And then hangs up. Abby frantically calls Muriel back, but she doesn’t answer. Abby has no idea what to do so she just keeps calling Muriel’s phone and gives up after multiple attempts, hoping for the best and remembering Muriel’s promise when they saw each other last.
The next day, Muriel comes to session and Abby is so relieved to see her and asks what happened. Muriel replied she was just having a tough night because she saw pictures of her ex on Instagram with another girl. Abby feels angry at Muriel for making her so worried for nothing and decides to talk to her supervisor about terminating sessions with Muriel because she is too dramatic.
A couple comes to therapy for help with what they describe as “too much arguing.” They have been dating for two years and have been having trouble agreeing on things for the last eight months. Partner A is reluctant about coming to therapy, and both partners resist answering the therapist’s questions. Partner B shows up alone for the fourth session, saying that their partner couldn’t make it and that they are happy to have some private time to express some of their concerns. The therapist should:
- refuse to see the client since the contract is for couples therapy,
- see the client, but let them know that whatever is disclosed will not be kept confidential from their partner at the next conjoint session.
- see the client briefly to explore whether her concerns constitute an emergency and continue the private session only if the client is in some danger.
- set up another appointment for a private session in the future and, meanwhile, seek consultation to determine how to handle the confidentiality problem.
A couple comes to see you complaining that they have been fighting a lot. Recently the husband lost his temper and beat up his wife. They have two children and when you inquire, you find out that the husband has never physically abused the children. The wife tells you that when he was hitting her the other night, the children weren’t hurt because they were too scared to come out of hiding for two hours and haven’t
wanted to leave her side since. What is your ethical and/or legal responsibility in this case?
- Make a mandated child abuse report.
- Legally maintain confidentiality, and ethically provide for safety.
- Create a safety plan with the wife.
- Help the couple with their anger.
A client you have been treating, who is also a therapist, says that she was contacted by a program coordinator of a local PTA to give a talk on the emotional effects of earthquakes on children. She does not feel qualified to give the talk. Knowing that this is an area of expertise that you have, she inquires if you would be interested in doing this. What would be your response to this situation?
- You indicate to your client that she can give your number to the program coordinator.
- You thank her for thinking of you, but you refuse the offer to avoid a dual relationship.
- You tell her that you are interested and ask her to set up a meeting between you and the program coordinator.
- You wait until you terminate therapy and then remind your former client of her previous offer.
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