Ethical, Legal, and Professional Issues in the Practice of Marriage and Family Therapy

By
By S. Allen Wilcoxon, Theodore P. Remley, Jr., Samuel T. Gladding, Charles H. Huber

Course Description

VALUES AS CONTEXT FOR THERAPY

This best-selling text examines the cultural, ethical, legal, and professional issues of marriage and family therapy using values as a beginning point for practice decisions. Organized in a four-part format, the book includes current cultural issues; examines ethical codes, problems, and domains; offers perspective on the latest legislation, and discusses issues of professional identity. Three chapters devoted to case studies add context and illustrate the complexities inherent in marriage and family therapy. One of these “casebook” chapters addresses ethical issues (Chapter 7), one deals with legal issues (Chapter 10), and one looks at professional issues (Chapter 12).

In this fourth edition learn more about:

  • The personal, professional, and institutional layers of values affecting marriage and family therapists
  • Culturally responsive marriage and family therapy
  • The impact and use of technology in marriage and family therapy
  • The Health Insurance Portability and Accountability Act (HIPAA) and its influence on marriage and family therapy practice

About Authors

S. ALLEN WILCOXON is professor and coordinator of the Program in Counselor Education at the University of Alabama. He is a Licensed Professional Counselor in the states of Alabama and Washington, a Clinical Member and Approved Supervisor with the American Association for Marriage and Family Therapy, and a Nationally Certified Counselor. Dr. Wilcoxon holds a B.A. in Religion and Philosophy from Ouachita Baptist University, an M.A. in Psychology from Stephen F. Austin State University, and an Ed. D. in Counselor Education from East Texas State University (now Texas A&M University-Commerce). His postdoctoral work was at Texas A & M University. He is the author of numerous publications related to marriage and family therapy, clinical supervision, and ethics in mental health care. He is former chair of the Alabama Board of Examiners in Counseling. He is married to Dr. Pat Harrison, Professor of School Psychology at the University of Alabama. Their sons, Buz and Andy, are currently completing their graduate and undergraduate careers, respectively. He enjoys fishing, traveling, and baseball played at any level.

THEODORE P. REMLEY, JR., is a professor of counseling and holds a Batten Endowed Chair at Old Dominion University in Norfolk, Virginia. He is a member of the bar in Virginia and Florida and is licensed as a Professional Counselor in Louisiana, Mississippi, and Virginia, as well as a Licensed Marriage and Family Therapist in Louisiana. He is also a National Certified Counselor. Dr. Remley holds a B.A. in English, an M. ED., and Ed.S., and a Ph.D. in Counseling from the University of Florida, and a J.D. from Catholic University in Washington, D.C. Dr. Remley is the Coauthor with Barbara Herlihy of Ethical, Legal and Professional Issues in Counseling. In addition, he has edited and written books and monographs, book chapters, and numerous articles in professional journals on the topic of legal issues in mental health. He is a former Executive Director of the American Counseling Association and was founding president of the American Association of State Counseling Boards. He has served on the counselor licensure boards in Louisiana, the District of Columbia, Mississippi, and Virginia. Dr. Remley is a former officer of the Mardi Gras Krewe of Orpheus in New Orleans and directs an annual counselor study abroad program in Italy.

SAMUEL T. GLADDING is a professor in and chair of the Department of Counseling at Wake Forest University. He is a Licensed Professional Counselor in the state of North Carolina, a National Certified Counselor, and a National Certified Mental Health Counselor. Dr. Gladding is a Clinical Member and Approved Supervisor in the American Association for Marriage and Family Therapy. Dr. Gladding received a B.A. and M.Ed. from Wake Forest University, and M.A.R. from Yale University and his Ph.D. from the University of North Carolina at Greensboro. He is the author of numerous publications, including Family Therapy: History, Theory, and practice (4th ed.). He is past president of the American Counseling Association, a former editor of the Journal for Specialists in Group Work, and a past president of the Alabama Association for Marriage and Family Therapy. Dr. Gladding is married to the former Claire Tillson. They are the parents of three children. As a family they enjoy travel, humor, and attending athletic and artistic events.

CHARLES H. HUBER is on the faculty in the Department of Counseling and Educational Psychology, New Mexico State University. A licensed psychologist in the states of Connecticut, Florida, and New Mexico, he also holds diplomas in family psychology and behavioral psychology with the American Board of Professional Psychology. In addition Dr. Huber is a clinical member and approved supervisor for the American Association for Marriage and Family Therapy and an approved supervisor and fellow of the Institute for Rational Emotive Behavioral Therapy. He maintains a private practice with Associates for Marriage and Family Therapy in Las Cruces, New Mexico. Dr. Huber received his B.A. from Upsala College, M.Ed. and Ed.S. from Florida Atlantic University, and Ph.D. from the University of South Carolina. He has authored or co-authored 10 books, served as editor of several professional journals, and written numerous articles and book chapters. He is active in a number of professional organizations, most recently serving as president of the New Mexico Association for Marriage and Family Therapy. Dr. Huber has been married for over two decades to his partner, Betsy. They and their two children raise and train Labrador retrievers as their family hobby.


Learning Objectives

After completing this course you’ll be able to:

  1. Distinguish between ethics and morality.
  2. Distinguish between virtue ethics and principle ethics.
  3. Discuss the evolution, role, and importance of professional codes of ethics.
  4. List 5 principles of biomedical ethics.
  5. List 9 exceptions to the right of privileged communication.
  6. Describe the dilemma of confidentiality in marriage and family therapy and enunciate three separate positions taken by therapists working with couples and families.
  7. Describe the ethical considerations relating to informed consent and outline three types of information clients should have in order to make informed choices.
  8. Articulate the problem faced by therapists in confronting long-standing social, cultural, and religious assumptions.
  9. Describe the ethical task faced by marriage and family therapists during the initial “presentation” contact and outline the importance of the convening session.
  10. Formulate two types of strategies for involving reluctant members of a relationship system to participate in at least the initial evaluation session to investigate what therapy may entail.
  11. Employ two types of interventions using paradoxical procedures.
  12. Outline 6 guidelines for therapists to prevent agency triangulation.
  13. List 5 contemporary ethical issues facing a marriage and family therapist.
  14. Describe the duty to protect third parties based on the Taras off Decision and its potential applicability to cases of HIV infection.
  15. Name and define the three criteria resulting from the Taras off Decision.
  16. Define a dual relationship and expose the dangers of such relationships involving conflict of interest.
  17. Identify three grounds that make dual relationships harmful.
  18. Identify 4 ethical concerns in the use of the DSM by marriage and family therapists.
  19. List 4 considerations to be employed by a marriage and family therapist when domestic violence is present.
  20. Name the 4 common models of managed health care.
  21. Describe the ethical implications for marriage and family therapists when participating in managed health care organizations in terms of: (1) risk-taking, (2) intrusion into the therapeutic relationship, (3) exceptions to the rules, (4) referral resources
  22. Describe the five major steps in the Decision Tree process AAMFT follows in handling complaints of unethical behavior by AAMFT members, Approved Supervisors, applicants for membership or the Approved Supervisor designation or recently resigned members or
  23. Describe the 8 areas of responsibility to clients described in Principle 1 of the AAMFT Code of Ethics.
  24. Describe the 3 areas of responsibility for confidentiality described in Principle 2 of the AAMFT Code of Ethics.
  25. Describe the 8 areas of responsibility for professional competence and integrity described in Principle 3 of the AAMFT Code of Ethics.
  26. Describe the 3 areas of responsibility to students, employees, and supervisors described in Principle 4 of the AAMFT Code of Ethics.
  27. Describe the 4 areas of responsibility to research participants described in Principle 5 of the AAMFT Code of Ethics.
  28. Describe the 7 areas of responsibility to the profession described in Principle 6 of the AAMFT Code of Ethics.
  29. Describe the 4 areas of responsibility to clients for financial arrangements described in Principle 7 of the AAMFT Code of Ethics.
  30. Name and define the 4 types of law and describe their scope, purpose and role in performing legal research as a marriage and family therapist.
  31. List and define the 5 component parts Shea (Shea, 1985) identified as helpful in interpreting court decisions.
  32. Describe the differences between Criminal versus Civil Law.
  33. Describe the marriage and family therapist’s obligation to provide information leading to intervention by the state when a duty to protect arises or when child abuse reporting is necessary and explain the therapist’s legal obligations.
  34. Define the 5 roles of marriage and family therapists within the criminal justice system.
  35. Discuss the 20 guidelines proposed by Lebow (Lebow, 1992) for marriage and family therapists to consider in systemically evaluating custody disputes.
  36. List the 5 progressive stages of the mediation process.
  37. Describe the rules of evidence and their role in court.
  38. Describe the role of a marriage and family therapist as an expert witness in the legal system.
  39. Discuss the 5 preparatory steps for successful presentation of testimony that should be followed by marriage and family expert witnesses.
  40. Discuss the 3 types of oral examination that may occur during courtroom testimony by a marriage and family therapist expert witness.
  41. Describe how marriage and family therapists as expert witnesses can significantly enhance their effectiveness by transferring their systemic understandings from the therapy context to the courtroom.
  42. Describe the professional liability under the law for marriage and family therapists in terms of contract law including the fiduciary relationship and possible charges of breach of warranty.
  43. Identify and define the 4 key elements that must be shown present to prove professional malpractice on the part of marriage and family therapists.
  44. List 12 possible negative effects of injury on clients resulting from malpractice by marriage and family therapists.
  45. List and describe the 5 major intentional tort actions normally filed by clients against marriage and family therapists for professional malpractice.
  46. Describe the 2 types of professional liability insurance for marriage and family therapists.
  47. Define the 2 major forms of legal marriage.
  48. Describe and define a prenuptial agreement.
  49. Describe the legal complexities and potential consequences arising from a marriage that should be discussed in premarital counseling.
  50. List 7 reasons why contemporary society has seen an increase in cohabitating couples.
  51. Identify 5 frames of reference for considering parent-child relationships under the law.
  52. Define 2 state sources that grant it the right to intrude on a family.
  53. List and describe the 3 ways a marriage can be terminated.
  54. Describe the common denominator offered by Section 308 of the Uniform Marriage and Divorce Act (Bureau of National Affairs, Inc., 1982) for marriage and family therapists to consider concerning alimony awards.
  55. Identify and describe the 2 basic systems of marital property rights that are usually operational in divorce proceedings.
  56. Describe the guidelines offered by Section 402 of the Uniform Marriage and Divorce Act (Bureau of National Affairs, Inc., 1982) for delineating the best interests standard in determining child custody.
  57. List and describe the 4 forms of custody available today.
  58. Summarize the 9 major factors to be considered by judges in deciding on child support awards.
  59. Discuss how the parent-child immunity doctrine is slowly eroding.
  60. Understand the basic legal issues that effect the professional practice of marriage and family therapy and know when to seek the advice of attorneys.
  61. Understand the guiding legal principles and leading laws and cases relevant to: Ethics and the Law, Divorce Mediation, Liability in Crisis Counseling, Informed Consent, Criminal Liability, The Buckley Amendment, The Premarital Agreement, Privileged Commun
  62. Discuss how values can describe either means or ends to actions.
  63. List and describe the 3 steps and 7 subprocesses of values clarification as a means for marriage and family therapists to clarify their professional position.
  64. Compare and contrast the systemic world view with the psychological world view according to the 4 propositions of each position.
  65. Describe the feminist critique of systemic epistemology and identify the two basic positions that have represented a credible attack on systemic epistemology.
  66. Describe the 4 events that have signaled a major challenge to systemic epistemology presented by the perceived overemphasis on the family-as-a-system thereby overlooking the importance of the intrapsychic functioning of the individual.
  67. Discuss the nature of valuing and the negotiation of values as a central issue in the professional practice of marriage and family therapy.
  68. Describe the practice implications of valuing for marriage and family therapists including the implications of affirming marital and family relationships as pluralistic and multidimensional.
  69. Discuss the relationship between epistemological responsibility and social responsibility.
  70. Describe the process of taking responsibility for pathologizing.
  71. Describe how the ethical dimensions centering Contextual Family Therapy represent process-oriented elements that may be employed as valuing components to reconcile any specific issue of mutual concern that may arise in marriage and family therapy.
  72. Articulate the importance of recognizing that valuing begins with acknowledging the mutual obligations and entitlements within all relationships.
  73. Explain the close relationship between acknowledgment and claim and obligation and entitlement in terms of the process of valuing for marriage and family therapy and identify the potential consequences of withholding acknowledgment and capitulating to exc
  74. Discuss the concept of Balance of Fairness and how it can be pursued through the process of valuing in marriage and family therapy.
  75. Articulate the positions of marriage and family therapy as a profession and as a professional specialty.
  76. Describe the process of professional affiliation and the roles both AAMFT and AFTA play in identifying marriage and family therapy as a self-regulating profession.
  77. Describe the process of professional affiliation and the roles both Family Psychology (Division 43 of APA) and IAMFC play in identifying marriage and family therapy as a professional specialty.
  78. Describe the concept of state licensure for marriage and family therapists including the 5 major premises supporting licensure efforts identified by Fretz and Mills (1980).
  79. Explain the concept of licensure coverage as defined in The Model Marriage and Family Therapy Licensure Act (AAMFT, 1992).
  80. Identify the 2 categories of Qualifications employed by most states in determining licensure eligibility for the practice of marriage and family therapy.
  81. Explain the role of research as a means of promoting professional identity among marriage and family therapists and identify the 10 key considerations for strengthening the research-clinical practice connection in marriage and family therapy.
  82. Explain the importance of professional advertising, continuing education and intraprofessional communications as they relate to the professional identity of marriage and family therapists.
  83. Articulate how individual sessions can be incorporated within a systemic framework first, as a part of the diagnostic/planning process and then as part of ongoing treatment.
  84. Identify 5 points from a systemic perspective of marriage and family therapy that can be applied to a school setting in which a marriage and family therapist serves as a consultant.
  85. Discuss how values conflicts can function as a source of dysfunction in marriage and family therapy.
  86. Assuming the premise that actions reflect values, describe the 5 conditions that must be fulfilled if persons are to engage in certain actions (values analysis).
  87. Identify 5 areas of exploration and intervention for the 5 conditions that must be fulfilled if persons are to engage in certain actions.
  88. Articulate the 6 major aspects of Principle 8 Advertising (AAMFT Code of Ethics) as they relate to both general advertising and advertising using AAMFT Designations for marriage and family therapist members.
  89. Describe 5 strategies for planning for emergencies in the practice of marriage and family therapy.
  90. Describe 5 strategies for planning for longer-term absences in the practice of marriage and family therapy.
  91. Articulate the legal and ethical considerations that arise from attending to the business-oriented details of the practice of marriage and family therapy specifically addressing the issue of delinquent accounts and the use of collection agencies.
  92. Articulate 6 professional issues that should be considered relevant to small town practice from the viewpoint of a marriage and family therapist.
  93. List 11 suggestions for assuming the role and being well-prepared as a “public” marriage and family therapist.
  94. List 5 ways for marriage and family therapists to achieve balance between their personal/family and professional life.

Course Contents

Part I CULTURE AND VALUES: A BEGINNING POINT FOR PRACTICE DECISIONS

  1. Values as Context for Therapy
  2. Marriage and Family Therapy: A Framework of Systems and Layers

PART II ETHICAL ISSUES IN MARRIAGE AND FAMILY THERAPY

  1. Promoting Ethical Practice: Foundational Principles and traditions
  2. Unique Ethical Considerations in Marriage and Family Therapy
  3. Intimate Partner Violence: An Illustrative Example
  4. Contemporary Ethical Issues
  5. Ethical Accountability: A Casebook

PART III LEGAL ISSUES IN MARRIAGE AND FAMILY THERAPY

  1. The Marriage and Family Therapist: Roles and Responsibilities Within the Legal System
  2. Family Law
  3. Legal Considerations

PART IV PROFESSIONAL ISSUES IN MARRIAGE AND FAMILY THERAPY

  1. Professional Identity as a Marriage and Family Therapist
  2. Contemporary Professional Issues