What would you do in these situations? Are there any negative
consequences to your chosen actions? Other actions you might take
instead, and pros and cons for these? Is there any way you could
have prevented these situations from arising in the first place?
1. You have been working with a 16-year-old client for several weeks, and have been successful both in building a good relationship with her and in improving the depression for which she initially came to see you. In today's session, however, she is clearly distressed. She tells you that she is very concerned about a friend of hers whom she feels is seriously suicidal, but she does not want to give you details because she promised her friend she wouldn't tell anyone. She asks you what she can do to help her friend.
1a. Same as above, but your client is 12 years old instead of
16.
2. You are treating a five-year-old child for pervasive fears, including significant separation anxiety. You receive a message from the child's father that they will not be coming back to treatment as the mother has just been confined to bedrest for a difficult pregnancy, and the household is too chaotic to continue bringing your client to therapy.
2a. Same as above, but the father never wanted the child to come
to therapy in the first place, and has never participated in the therapy
with the child and mother.
3. You are treating a 15-year-old client for behavioral problems at school. Your client's parents agreed at the beginning of treatment to allow their daughter to have a confidential relationship with you so that she could trust you. Now they have begun calling regularly to check on her progress, saying she has been getting into much more trouble than usual, and they are very concerned she is using drugs.
3a. Same as above, but instead of drugs, they are concerned she may be pregnant.
3b. Same as 3a, but in fact you are aware your client is pregnant, and that she has been gathering much information on all of her options.
3c. Same as 3, but in addition, the parents have told you that
if you do not provide the information they are requesting, they will no
longer pay for your services.
4. You have been treating a 70-year-old man for depression. Although this depression has at times been quite severe, including several periods of psychosis, he has been stable now for over a year, with no more than mild depressive episodes. He comes to today's session quite upset, saying that his son is trying to gain power of attorney and has mentioned his psychotic depressive episodes as a form of support for his claim.
4a. Same as above, but your client asks you to testify on his
behalf.