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Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice

A Casebook from the Files of Experts

Edited by W. Brad Johnson and Gerald P. Koocher

This book offers succinct analyses of compelling and ethically complex issues occuring in a range of difficult work settings
Chapter authors provide engaging personal reflections on their own unique ethical dilemmas
The process of ethical reasoning used to arrive at a final decision in each case is mapped out for the reader

Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice

A Casebook from the Files of Experts

Edited by W. Brad Johnson and Gerald P. Koocher

Description

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client? How can clinicians refuse costly gifts from clients without damaging the therapeutic relationship? Should a therapist disclose a client's suicidal intent to the authorities?

In Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice, these and other real-life scenarios constitute a comprehensive and definitive ethics casebook for mental health professionals. Inspired by the many difficult situations they themselves have faced, an eminent group of accomplished mental health clinicians provide first-hand accounts of ethical problems that defy boilerplate solutions. Each chapter begins with a compelling and ethically complex case followed by an illustrative yet succinct analysis of the key ethical issues present and a personal reflection on the case itself, along with the process of ethical reasoning used to arrive at a final decision. Every case concludes with key recommendations for promoting ethical practice within an often challenging work setting. Highlighting the human aspect of ethics in mental health practice through the use of mesmerizing narratives while also provoking the reader to reflect upon what is the "right" thing to do, Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice offers trainees and seasoned professionals alike invaluable informative models for dealing with ethical dilemmas, as well as the inspiration to confront seemingly insurmountable clinical problems.

Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice

A Casebook from the Files of Experts

Edited by W. Brad Johnson and Gerald P. Koocher

Introduction, W. Brad Johnson & Gerald P. Koocher

In the Psychotherapist's Office
1. But It's a Really Nice Gift!: Ethical Challenges in Responding to Offers of Gifts from Clients, Jeffrey E. Barnett
2. Everyone I Know Knows Everyone I Know: Boundary Overlap in the Life of One Lesbian Psychotherapist, Laura S. Brown
3. Hitler Should Have Finished the Job: Counter Transference, Anti-Semitism, Abandonment, and Termination, Michael A. Grodin
4. Suicidal Blackmail: Ethical and Risk Management Issues in Contemporary Clinical Care, David Jobes
5. An Affair to Remember: Protecting Vulnerable Clients and Confidentiality When Spouses Cheat, Mary Ann McCabe
6. Trapped by Trauma: When Clients Cannot or Will Not Protect Themselves From Harm, John Peteet
7. To Warn or Not to Warn: That is the Question, David L. Shapiro
8. What Would She Think?: Disclosure of Therapy Details After Death, Dan Shapiro
9. It's My Right!: Working with a Terminally (or Chronically) Ill, Persistently Suicidal Client, James L. Werth, Jr.

In the Forensic World
10. High Stakes Indeed: Forensic Psychology in Death Penalty Litigation, Richart L. DeMier
11. Is that what I said?: Ethical Challenges When Parents Divorce during Treatment, Robin M. Deutsch
12. Now you see it, now you don't: When Releases of Information are Rescinded, John C. Gonsiorek
13. The Siren Song of Silence: Ensuring a Basis for Professional Judgments, Robert Kinscherff
14. Thera-mail for a Quarter Century: Managing Complex Boundaries with a Former Client, Frederic G. Reamer
15. Jonas and His Protective, Delusional, or Alienating Mother: Advocacy, Forensics, and Boundaries with Battered Women, Lenore E. Walker

In Medical Center Corridors
16. Determining a Patient's Capacity to Refuse Dialysis and Die: When Professional Competence and Credentials Do Not Overlap, James DuBois
17. When Boundaries Intersect in Cyberspace: Facebook, Multiple Relationships, and Confidentiality in a Hospital, Nabil Hassan El-Ghoroury
18. Second Chances: Decision Making in Pediatric Transplantation, Lisa M. Farley
19. On being there: Boundaries in Emotionally Intense Contexts, Gerald P. Koocher

In National Security Settings
20. I've Got This Friend: Multiple Roles, Informed Consent, and Friendship in the Military, W. Brad Johnson
21. Establishing Rapport with an "Enemy Combatant": Cultural Competency in Guantanamo Bay, Carrie H. Kennedy
22. Psychotic, Homicidal and Armed: The Delicate Balance Between Personal Safety and Effectiveness in a Combat Environment, Heidi S. Kraft
23. What Do You Know that Can Help Us? Behavioral Science in National Security Settings, Susan E. Brandon

In Organizations
24. A Disaster in a Suite and Tie: When Organizational Policies Undermine Ethical Obligations, Charles A. Morgan
25. Risking Your Job: On Striving to be An Ethical Leader in Difficult Organizational Circumstances, Rodney L. Lowman
26. When Bad Things Happen to People Who Try Really Hard: Ethical Quandaries in Test Validation, Nancy T. Tippins

In Schools and Colleges
27. When in Doubt, Pull Them Out? Ethical Issues Related to Decisions on Child Removal from the Home, Lyvia Chriki
28. A Near Fall: The Multifaceted Challenges to Work in Sport Psychology and Intercollegiate Athletics, Edward F. Etzel
29. Doing good versus avoiding harm: Resolving Situational Contradictions, Alan Green

Supervising or Assisting Colleagues
30. The Wink: Ethical Aspects of Encountering Clients in Unexpected Places, Stephen H. Behnke
31. Can you help us?: Supervising Graduate Students in a Crisis Situation, Clark D. Campbell
32. Doing it by the Book: Ethical Issues in Teaching a Group Didactically and Experientially. Gerald Corey
33. So, how exactly did you get interested in eating disorders?: Confronting a Colleague's Unhealthy Behaviors, Jennifer L. Derenne
34. Knocked Off Kilter: Supervising in the Wake of Sexual Boundary Violations. Janet T. Thomas

In Religious Concerns and Settings
35. Of Course It's Confidential - Only the Community Knows: Mental Health Services with the Old Order Amish, James A. Cates
36. Working Out One's Salvation in Fear and Trembling: Ethical and Spiritual Dilemmas Around Therapeutic Boundaries, Andrew Michel

In the Public Arena
37. Ethics, The Constitution, Politics, Clinical Judgment and the Case of Terri Schiavo, Brian Baird
38. Isn't this against the Law? Boundary problems in Police Psychology, Gerald Sweet

Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice

A Casebook from the Files of Experts

Edited by W. Brad Johnson and Gerald P. Koocher

Author Information

W. Brad Johnson is Professor of Psychology at the United States Naval Academy and Faculty Associate in the Graduate School of Education at Johns Hopkins University. As a past chair of the American Psychological Association's Ethics Committee and a former Director of Research for George Fox University's Graduate School of Clinical Psychology, Johnson is a leading authority on ethical practice in clinical psychology, having authored many publications including 10 books in the area of mental health and counseling.

Gerald P. Koocher is Associate Provost and Professor of Psychology at Simmons College and a Senior Lecturer at Harvard Medical School. Having served as the President of the American Psychological Association (APA) and as the Chief Psychologist at Children's Hospital Boston, he has authored more than 200 articles and book chapters and authored or edited 15 books, including the paramount text in ethics and mental health, Ethics in Psychology and the Mental Health Professions: Professional Standards and Cases, now in its third edition.

Contributors:

Brian Baird, Ph.D.
University of Wyoming

Jeffrey E. Barnett, Psy.D. ABPP
Department of Psychology
Loyola College in Maryland

Susan E. Brandon
Behavioral Science Program at the Defense Counterintelligence & HUMINT Center (DCHC)
National Institutes of Mental Health, Bethesda, MD

Stephen H. Behnke, J.D., Ph.D.
American Psychological Association
Department of Psychiatry
Harvard Medical School

Laura S. Brown
Department of Psychology
Argosy University
Seattle, WA

James A. Cates, Ph.D.
Amish Youth Vision Project, Inc.
Fort Wayne, IN

Clark D. Campbell, Ph.D.
Rosemead School of Psychology
Biola University
La Mirada, CA

Lyvia Chriki
Mood and Personality Studies
Department of Psychology
Ohio State University

Gerald Corey, Ed.D, ABPP
California State University, Fullerton
Fullerton, CA

Richart L. DeMier, Ph.D.
U.S. Medical Center for Federal Prisoners
Federal Bureau of Prisons

Jennifer L. Derenne
Child and Adolescent Psychiatry, Psychiatry
Massachusetts General Hospital

Robin M. Deutsch
Children and the Law Program
Department of Psychiatry
Massachusetts General Hospital

James DuBois, Ph.D., DSc
Albert Gnaegi Center for Health Care Ethics
Saint Louis University

Edward F. Etzel
Department of Sport and Exercise Psychology
West Virginia University

Lisa M. Farley, Ph.D.
Children's Hospital of Boston
Harvard Medical School

John C. Gonsiorek, Ph.D.
Department of Psychology
University of Minnesota

Alan G. Green, Ph.D.
School Counseling Program Lead
USC Rossier School of Education

Nabil Hassan El-Ghoroury
Department of Pediatrics
MetroHealth Medical Center
Cleveland, OH

David Jobes Ph.D., A.B.P.P.
Department of Psychology
The Catholic University of America

Robert Kinscherff, Ph.D., Esq.
Forensic Concentration, Doctoral Psychology Program
Massachussetts School of Professional Psychology

Heidi S. Kraft
Naval Health Research Center
San Diego, CA

Rodney L. Lowman
Strategic Planning Advisory Committee
American Psychological Association (APA)

Mary Ann McCabe, Ph.D.
Pediatrics
George Washington University School of Medicine

Charles A. Morgan, III
School of Medicine - Psychiatry
Yale University

Andrew Michel, M.D.
Department of Psychiatry
Vanderbilt University School of Medicine

John Peteet, M.D.
Department of Psychiatry
Brigham and Women's Hospital
Boston, MA

Fred Reamer, Ph.D.
School of Social Work
Rhode Island College
Providence, RI

Dan Shapiro, Ph.D.
Humanities Department
Penn State College of Medicine

David L. Shapiro, Ph.D.
Center for Psychological Studies
Nova Southeastern University
Fort Lauderdale, FL

Gerald Sweet, Ph.D.
Los Angeles Police Department

Janet T. Thomas, Ph.D.
Saint Paul, MN

Nancy T. Tippins, Ph.D.
Society for Industrial and Organizational Psychology, Inc.

Lenore E. Walker, Ed.D., A.B.P.P.
American Board of Professional Psychology
Fellow Academy of Clinical Psychology
Executive Director - Domestic Violence Institute
Center for Psychological Studies - Nova Southeastern University

James L. Werth, Jr., Ph.D.
Radford University
Radford, VA

Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice

A Casebook from the Files of Experts

Edited by W. Brad Johnson and Gerald P. Koocher

Reviews and Awards

"What an excellent, important compilation of many prickly, sticky, complex ethical practice dilemmas! The multidisciplinary 'Who's Who' of ethical experts have presented memorable cases of their own, which contribute to a very compelling, highly readable set of ethical predicaments in a wide variety of work settings, followed by each author's personal reflections. This text is brilliant, grounded in both principle ethics and virtue ethics, rooted in real world experiences. I love this book, and couldn't put it down!"--Melba Vasquez, Ph.D., ABPP, President of the American Psychological Association

"Widely-respected ethicists Johnson and Koocher have edited a unique casebook that blows the dust off ethical abstractions and brings them to life. It takes us inside the minds of mental health professionals as they think their way through the conflicting values, demands, and goals of actual ethical dilemmas. The authors show us the diversity of ethical challenges we meet in our work and the diverse ways of approaching them. A valuable contribution to the literature and a wonderful gift to both beginner and seasoned professional."--Kenneth S. Pope, Ph.D., ABPP, co-author of Ethics in Psychotherapy and Counseling: A Practical Guide, Fourth Edition

"As rich in fundamental clinical wisdom as it is in ethics analyses of professional dilemmas, this vital book is jam-packed with courageous, self-revealing and riveting narratives from expert clinicians about their adventures in that ethical twilight zone called actual daily practice. The honesty and candor of the many authors' voices make this a unique contribution to deep understanding of decision making in the real world. Highest recommendation."--Thomas G. Gutheil, MD, Professor of Psychiatry, Harvard Medical School

"Ethical Conundrums, Quandaries, and Predicaments in Mental Health Practice: A Casebook From the Files of Experts is a remarkably comprehensive, often gripping firsthand account of mental health professionals struggling with real ethical challenges. It represents a unique and long-overdue resource for students and practitioners, primarily in its illustrations of the phenomenology, the human experience, of the ethical dilemma from the point of view of the clinician." -- Andrew M. Pomerantz, PsycCRITIQUES

"This is an excellent ethics guide for practicing mental health professionals. The book is unique in its narrative format that not only provides highly nuanced and useful cases, but makes for very interesting reading." -- DOODY'S