Conflicts Between Ethics and Law in Counseling and Psychotherapy

Counseling the HIV-Infected Client

The emerging empirical and clinical literature on the psychosocial issues of human immunodeficiency virus (HIV) has only begun to guide clinicians in their work with seropositive clients. This article presents a model that provides a conceptual framework for assessing the client's resources as he or she attempts to address the psychosocial issues that may occur as a result of this disease. The model has four components: special characteristics, social supports, situation, and client characteristics. It is hypothesized that these client resources predict or moderate the clients response to HIV infection. Responses to HIV infection are discussed followed by counseling strategies and interventions to address each response or reaction. Case management issues are presented including ethical dilemmas, rethinking clinical goals, the changing boundaries of the therapeutic relationship, transference, and countertransference.

Ethical Issues in the Conduct of Supervision

The American Psychological Association code of ethics is used to understand the ethical issues present in the conduct of supervision. Because supervision is characterized by goals of behavior change, has many qualities similar to therapy, and by definition requires multiple roles of its participants, it should be considered a psychological intervention particularly vulnerable to ethical misconduct. The ethical issues of responsibility, client and supervisee welfare, confidentiality, competency, moral and legal standards, public statements, and professional relationships are discussed in relation to supervision.

Treating adolescents. Legal and ethical considerations

Treating adolescents in the health care system raises significant legal and ethical issues related to consent for treatment, confidentiality of communications and records, and payment for care. The law provides many opportunities for adolescents to consent to their own care and offers significant protections of confidentiality. Publicly funded programs provide access to free care for some adolescents, but financial considerations continue to limit access for many poor and low-income adolescents. In addition to legal concerns, serious ethical dilemmas arise, particularly with respect to treatment of special populations of adolescents. Resolution of the legal and ethical questions requires cooperation of professionals from many disciplines.

Ethical dilemmas faced by family therapists

This study explores the reactions of 202 randomly selected clinical members of the American Association for Marriage and Family Therapy (AAMFT) to a variety of ethical dilemma situations which examine what family therapists are doing in their work when confronted with these difficult situations. Eight of the issues studied have been discussed in the literature and eight are included in the AAMFT'sEthical Principles for Family Therapists(1984). In addition to showing how clinical members responded to dilemmic vignettes that reflect these dilemmas, results indicated that family therapists are facing these dilemmas, have a high rate of consensus of what they would and would not do in each situation and almost all the situations were seen as being ethically significant by the majority of respondents.