Читать книгу Ethics in Psychotherapy and Counseling - Kenneth S. Pope - Страница 80

You share a suite of offices with several other therapists. The name of each therapist is on the door to that therapist’s office. One morning you find that the door to one of the offices has been broken in and the office vandalized. The name on the door was Jewish. Swastikas along with epithets have been spray-painted on the walls, desk, floor, and bookshelves. You have no evidence but believe the vandal may have been one of your patients—someone who has expressed strong anti-Semitic views during therapy sessions, embraces the view that the Holocaust is fiction, and has described fantasies of vandalizing synagogues. But if you were to ask him during the next therapy session whether he had anything to do with vandalizing your colleague’s office, he would deny it.

 How do you feel?

 What would you like to do?

 What do you think you would actually do?

 Would you mention your suspicion that your client may have vandalized your colleague’s office to the colleague, the police, or anyone else? If so, how do you address issues of client privacy and confidentiality?

 Would you mention your suspicion to your client? If so, how?

 How, if at all, would you address your client’s anti-Semitism in therapy?

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You are a Latino psychotherapist who speaks Spanish only moderately well. Your policy is to try to refer all those who speak only Spanish to fluent Spanish speakers, but you will see Spanish speakers who also speak English if they wish. A South American client who speaks fluent English and Spanish sees you because you are the only Latino available on her HMO list. At the first session, she insists that you should be ashamed for not speaking better Spanish and that you therefore have no culture.

 How do you feel?

 What are your thoughts and feelings about this client?

 How would you respond to this client?

 Under what conditions would you continue to see or decline to see this client?

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You have been leading a therapy group at a large mental health facility. As one of the sessions begins, a group member interrupts you and says, “I want to ask you about something. Have you noticed how none of the doctors here are People of Color but almost all the cleaning crew are? Why do you work in a system like that? Don’t you think that has any effects on us patients?”

 How do you feel?

 What are the possible replies you consider?

 What do you think you would say?

 What effects, if any, might such a system have on clients?

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You work in a large office building. As your therapy client, a person of the Sikh faith, is getting ready to leave your office, the police show up at the door, handcuff him, and say they are taking him to the station for questioning. When they leave, the accountant across the hall comes over and says that someone saw your client in the lobby, thought he was acting suspiciously, and called the police to report someone who seemed up to no good.

 How do you feel?

 What do you consider doing?

 What would you like to do?

 What do you think you would do?

 How, if at all, might this affect the therapy?

 How, if at all, would you chart this?

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A married couple comes to you for counseling. Both believe that men are the natural leaders in a marriage and that a woman’s rightful place is to be obedient to her husband. However, they often have what they describe as “slips,” when he seems to look to her for guidance or when she finds it hard to accept his decisions. They are seeking marital counseling to help them eliminate these “slips.”

 How do you feel?

 What are your thoughts and feelings about the wife?

 What are your thoughts and feelings about the husband?

 What are your thoughts and feelings about the marital relationship that they value and have chosen for themselves?

 How do you think you would respond?

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You work as a counselor in a high school where the majority students are African American and Latinx. You see clients in a small space right next to the principal’s office. Most of your clients have been referred to you for “acting out” behaviors—they are often described by their White teachers as “lazy, unmotivated, and trouble-makers.” In therapy your clients often talk about how the school is “not for them.” They often discuss feeling not smart and that the teachers don’t like them. During one of your sessions with a client who is crying while sharing a traumatic event, a teacher barges into your office and blurts out, “gosh, why do these kids have to be so loud, can you keep them quiet for once?”

 How do you feel?

 How would you respond to the teacher in that moment?

 What would you do when the teacher leaves?

 What would you say to your client?

 What would you do when your client leaves?

 What are your thoughts about what happened?

 What are your reactions to what happened?

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You work with a geriatric population that is composed predominately of first-generation immigrants from Asia and Latin America. One of your Mexican clients, an 80 year-old woman comes to your session looking very serious. She begins her session by sharing that she wants to talk to you about what happened last night. She described having a conversation with her dead mother who came to give her a message. The message was that the mother was “not resting in peace” because your client was separated from her abusive husband. Your client states that her mother wants her to forgive her husband from whom she has been separated for over a decade. You have been working with this client for two years now to help her cope with the traumatic experience of living with a husband who abused her for decades.

 How do you feel?

 What are your thoughts? How are you making sense of the case?

 What would you say to your client?

 How would you chart this?

 What would you do?

You are a therapist at an agency with a policy that says that if a client misses two appointments without calling, the therapy automatically terminates. A client who is a single mother, uses public transportation, has no telephone, and is often distressed by a babysitter who does not show up, misses her appointment for the second time. Your supervisor insists that you terminate by letter, given the long waiting list of potential clients.

 What feelings do you experience?

 What are your assumptions about the client’s not showing up? In what way, if any, might her diagnosis be relevant?

 What do you think and feel about the relevance of the policy for clients such as this one?

 What are your options in responding to your supervisor? To the agency policy? To the client?

 Which options do you believe you would choose in deciding how to respond to your supervisor, the policy, and the client?