Ethics in Psychotherapy

My point of view as a psychotherapist dealing with both the custodial and noncustodial parents in the issue of a depressed minor who is expressing his or her emotions by cutting would have to be the best interest of my client. As this situation arises I would research law, read professional publications on the issue, and consult with colleagues who have experience in dealing with the sensitive issue at hand.

We need to gather more information to make an informed decision. How old is the client? In the state of Oregon minors age 14 and older can access mental health without parents consent or knowledge. The person providing treatment has to have the parents of the minor involved before the end of treatment unless the parents refuse or if there are clear clinical indications to the contrary, which must be documented in the treatment record. (ORS 109.675) My next questions would be: When did the cutting start? What is the reason for the cutting? Is the cutting an expression of emotion? Or is it solely an outlet for depression? Is the self-harm based in the minor’s relationship with his or her parents? Would including the parents be harmful to the minor? The answers to these questions will determine if involving the parents would be going against the principle to strive to benefit and safeguard my client (Ethics Code, Principle A).

Based on reading a scholarly journal by Barnett, J. E. (2008), I would sit down with both parents and modify my informed consent agreement to balance the parents and the child’s interest and participation in the psychotherapy. My assumption leading me to the conclusion that to uphold positive ethical practice, my focus for the best possible outcome is that some of the treatment needs to be solely with the minor.

As the psychotherapy progresses, my involvement of both parents may likely increase based on what is uncovered in therapy. The implications and consequences of self-harm are not to be treated lightly and often associated with treatable psychiatric disorder. I would still take the expression of emotion in such a harmful way seriously even in the absence of psychiatric disorder.

References

http://www.oregon.gov/obpe/Pages/laws_rules.aspx :
ORS 109.675 Right to diagnosis or treatment for mental or emotional disorder or chemical dependency without parental consent; a psychologist licensed by the State Board of Psychologist Examiners under the provisions of ORS 430.620

Barnett, J. E. (2008). The ethical practice of psychotherapy: Easily within our reach. Journal of Clinical Psychology, 64(5), 569–575

References: http://www.oregon.gov/obpe/Pages/laws_rules.aspx : ORS 109.675 Right to diagnosis or treatment for mental or emotional disorder or chemical dependency without parental consent; a psychologist licensed by the State Board of Psychologist Examiners under the provisions of ORS 430.620 Barnett, J. E. (2008). The ethical practice of psychotherapy: Easily within our reach. Journal of Clinical Psychology, 64(5), 569–575