Abstract

This paper examines the ethical issues surrounding the decisions taken by Ludwig an individual therapist in maintaining a working relationship with Ella a patient in need of the services of a family therapist. In studying specific principles from the code of ethics put in place by the AAMFT, it comes out clearly that Ludwig is in breach of a number of principles. First, he should ensure that he is not trying to treat an issue that is outside the scope of his training. In addition, he must allow Ella to make decisions on her treatment having laid out the facts of the situation to her. He should be working to refer her to someone who is better qualified to handle her case. These principles stipulate that he should refer the patient to therapist qualified in issues to do with family therapy.

Maintaining Ethical Standards

The code of ethics spelt out for those in the helping profession, for example for therapists and psychologists is clear on the duties and responsibilities that these people have towards their patients. Ella is a patient seeking help and relief from issues that have plaguing her, just as most who reach out for therapy do. After numerous consultations with Ludwig, he discovers that he is not qualified to tackle the nature of the issues that Ella is facing. For this reason, he, ideally, should be prompt in directing Ella to someone who can offer her the kind of help that would eventually be most effective to her. However, Ella’s case is sensitive and he fears that doing this would send out the wrong message to her and be detrimental to her and instead decides to keep working with her. This essay analyses the dilemma in which Ludwig is and what steps he should follow to achieve the best results for his patient.

Ethics demands that therapists protect the best interests of their clients. According to principle 1.9 in the code of ethics as spelt out by the American Association for Marriage and Family Therapy (2012), a therapist should only maintain the relationship with a client for as long as it continues to benefit the latter. In addition, principle 1.10 (AAMFT, 2012) inculcates that in the event that a therapist is, for whatever reason, unable to provide the best service, they should refer the client to obtaining more capable therapeutic services. This principle is especially backed up by principle 3.11 (AAMFT, 2012) that discourages therapists from treating problems that lie outside the scope of their competences. In adherence to this, it would have been best for Ella if Ludwig referred her to a therapist that is more qualified for family therapy. This is because continuing to work with her is no longer beneficial to her. Ludwig’s decision to continue working with her is therefore bound to subject her to more harm in the end. He is not qualified to see her through problems of this nature. Therefore, whether Ella’s family is present in the therapy sessions from this point forward or not, this course would be minimally beneficial to Ella.

By making the decision to continue treating Ella on his own Ludwig automatically assumed that she would not agree a referral. This infringes on her rights to make informed consent, which according to principle 1.2 (AAMFT, 2012) she should do. It is up to Ludwig to inform her of his findings that her problems fundamentally lie in her family issues and then proceed to inform her of his limitations as an individual therapist. This would lead her to understanding why she is better off working with a therapist trained in family therapy. To ensure that he abates her abandonment problem, he could suggest that they continue to work on her individual problems together should she deem it necessary.

In a case whereby Ludwig had training in family therapy, he could maintain the working relationship he has with Ella. There is however, a chance that Ella might refuse to have family sessions. In this case, it is important that Ludwig try to work with her on the issues that he can tackle given the constraints. This is because principle 1.11 (AAMFT, 2012) does not make provisions for him to abandon her just because she will not adhere to his instructions. In the course of the treatment, she might see the need to have her family around. If not, he will have offered the best that he possibly could, given the circumstances.

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