Issues in a Family Counseling Case

This research paper discusses the legal and ethical issues involved in providing family, marital and child counseling therapy to a family consisting of the wife, Cynthia, and her 15-year-old daughter, Mary, the husband and stepfather of Mary, George, and his seven-year-old son, Kenny, the interventions or actions the therapist can take to minimize the risks associated with providing such therapy and some of the individual reactions the therapist may encounter. It is assumed that the therapist is a family, marital or child counselor (FMCC) licensed by the State of California to provide such services, including the use of psychotherapy, and that California law applies.

1. Legal and Ethical Issues. These issues fall into two broad categories: (a) representational issues; and (b) confidentiality and privilege issues.

(a) Representational issues. The therapist must first decide whether he or she wishes to undertake representation and provide therapy and to whom. There is no requirement under California law that the therapist undertake the responsibility of treating this family or any of its members. On the facts presented, it may be difficult to treat the members separately without dealing with the inter-related nature of the problems of this family, which appear to include marital relations problems, parenting problems and the symptoms of psychological difficulties of two children. The problems of the children may be in whole or in part the result of the marital conflicts a

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t the disclosure by FMCCs of patient confidences is also an ethical obligation under Part 2.1 CAMPF Standards. The restriction on disclosure of confidential patient material applies to any unauthorized disclosures to third parties. The physician-patient privilege applies only to disclosures in court proceedings. Under California Evidence Code sec. 1010(e), the psychotherapist-patient privilege applies to FMCCs. According to Lageman, Dolina & Koerman, "marital therapists contend that their 'clients' are the entire therapeutic relationship and that such relationship is the entity to which the confidence is owed, not the individual within the relationship." Part 2.1 CAMPF Standards says that "marriage and family therapists have unique confidentiality problems because the 'patient' in a therapeutic relationship may be more than one person. The overriding principle is that marriage and family therapists respect the confidence of their patients." Under Business & Professions Code, sec. 4982(m), the FMCC must not "fail to maintain confidentiality, except as otherwise required or permitted by law, of all information that has been received from a client in confidence during the course of treatment." According to King, the underlying

Category: Psychology - I