What might you do in these situations? What are the pros and cons to
the various options, and what do you see as being the best approach to take? Are there any negative
consequences to your chosen actions? What might you do to minimize and/or
counteract those? Is there any way you could
have prevented these situations from arising in the first place?
1. You have recently begun seeing Mr. & Mrs. Jones for marital
counseling. Between sessions, Mr. Jones calls you and tells you that
he is having an affair with another woman, and in fact has had multiple
sexual relationships throughout their marriage, without Mrs. Jones’ awareness.
He says he is telling you this because he feels "it’s stupid to keep secrets
from your therapist," but he does not want Mrs. Jones to find out.
You’re scheduled to see the two of them later today for their marital counseling
session.
2. You are a therapist specializing in long-term psychoanalysis.
A new client with obsessive-compulsive disorder comes to see you, saying
she wants to get rid of her OCD symptoms. Although you know that
both drugs and intensive behavior therapy have been shown to be effective
in reducing OCD symptoms fairly quickly, you personally believe that long-term
psychoanalysis is more effective in the long run, and that it is important
to get at the underlying root of her problems.
3. You’ve been seeing Ms. Smith in therapy for several weeks,
and in today’s session she suddenly asks you about confidentiality.
You remind her that sessions are confidential, with a few exceptions such
as potential suicidality or homicidality, or cases of child abuse.
She asks you if that meant that if she WERE to tell you about abusing a
child, that meant you would have to turn her in.
4. Although you’ve only worked with Ms. Brown for a few sessions,
you readily developed a diagnosis for her of Borderline Personality Disorder.
Today she began the session asking what Borderline Personality Disorder
is, and how you know that’s what’s wrong with her. When you ask where
she heard that term, she says that she saw the code on her insurance forms,
and looked it up in the library.
5. Mr. and Mrs. White have requested a learning disabilities evaluation for their son. He is not doing well in school, and seems to have many difficulties with his schoolwork and homework. If he receives a learning disability diagnosis, it will be a part of his permanent record, and he will be eligible for special education services and accommodations. Your evaluations shows that although he is performing below his abilities, he does not meet criteria for an LD. Mr. and Mrs. White are not pleased with this outcome, and say that if you do not certify that he has an LD, they will find someone who does.
5a. What if he DID meet criteria for an LD, but that outcome displeased his parents who want to ensure that their son is not stigmatized so early in life?
5b. What if the person being evaluated was a college junior who was about to take the LSATs, and requested the evaluation because although she’s struggled successfully through high school and college despite her difficulties in reading, she wants to give herself every advantage to do well on the LSATs and knows she can use the extra time allotted for people with LDs?