Mental Health Counselors Research Paper

AIDS-RELATED ETHICAL AND LEGAL ISSUES FOR MENTAL HEALTH PROFESSIONALS
HIV/AIDS (Human immunodeficiency virus/Acquired Immune Deficiency Syndrome) raises challenging ethical and legal dilemmas for mental health professionals. Relevant issues pertaining to these dilemmas are examined in this article. Specifically, the authors review the following: professional responsibility, competence, and confidentiality. Special attention is paid to several court cases that have implications for mental health counselors working with clients who are HIV-positive.
HIV (human immunodeficiency virus), the precursor of AIDS (Acquired Immune Deficiency Syndrome), is spreading at an epidemic rate throughout the world. As a result, health care workers are being
A number of mental health professional organizations, including the American Counseling Association (ACA), have not yet clearly defined their standards related to HIV and the limits of confidentiality. Harding, Gray, and Neal (1993) recommended that ACA sponsor state legislation that would provide clear guidelines and would limit liability for all counselors who are working with HIV-infected clients. The APA (1991) has articulated its position related to legal liability regarding confidentiality and HIV infection. APA has recommended that legislatures not impose a legal duty on psychologists to protect third parties. If legislation imposing such a duty were to be considered, however, APA offers several recommendations. First, the psychologist must have knowledge of an identifiable, at-risk, unsuspecting third party. Second, the HIV-infected client must have been urged to notify the at-risk party, but has refused to do so; or, the client has been deemed by the psychologist to be unreliable in willingness to inform a threatened person. APA also recommends that service providers be immune from liability regarding their good-faith decisions to disclose or to refrain from disclosing HIV information to third
The first criterion under Tarasoff is met because the client and therapist have a special relationship. The two other conditions are not as clear, however. First, when considering whether there is imminent danger, it is important to know for sure that the client is HIV positive. In assessing the level of dangerousness, the mental health counselor must know whether the client is using risk reduction techniques during sex or engaging in any high risk behavior that could transmit the virus. This calls for an in-depth discussion of a client 's drug use and sexual practices, because clearly not all such behaviors result in HIV transmission. The qualifier "imminent" introduces further uncertainty given the high level of variability in HIV transmission and consequent lethality of the exposure. Although any one individual becoming infected is personally and socially significant, it has been noted that in any given exposure through heterosexual genital intercourse, there is about a .001 probability of transmission (Furrow et al., 1991b). That probability could cast doubt on the imminent nature of the situation. The third condition set out in Tarasoff involves the knowledge of an identifiable victim. The duty to protect would extend to identifiable victims, but not to all potential victims of infection by the client. In other words, it would probably extend to spouses or partners of an exclusive relationship, but would