Ethical, Legal, and Professional Issues in the Practice of Marriage and Family Therapy
By S. Allen Wilcoxon, Theodore P. Remley, Jr., Samuel T. Gladding, Charles H. Huber
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
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.
After completing this course you’ll be able to:
- Discuss the internal and external factors as depicted.
- Describe values as stated by Rokeach.
- Compare the two value-based decisions and discretionary actions.
- Define culture, subculture, and intraculture.
- State the terms of sexual orientation as described by MacGillivay (2000).
- Compare core and contextual factors from the Model of Multiple Dimensions of Identity from Figure 1-6.
- Define novelty, dissonance and integration.
- Discuss value clarification and value-sensitive care.
- Describe the concept of recognizing limitations.
- Discuss valuing values, valuing uniqueness, and valuing reality.
- List the derivatives of duty according to Dell (1983).
- State the four implications of value-sensitive care according to Table 1-1.
- Discuss the duties of the therapist.
- Define epistemology, psychological worldview, and systemic worldview.
- Discuss the object relations theory.
- Describe institutional values.
- Discuss three forms of power.
- List examples of “recoupling.”
- Discuss autonomy, beneficence, justice, fidelity, and nonmaleficence.
- Compare the Kidder Model, the Kitchner Model and the Koocher and Keith-Spiegel Model.
- Define competence and due care.
- Define confidentiality, privileged communication and privacy.
- Discuss informal consent.
- State the three types of secrets (Karpel).
- Discuss goal setting according to M.P. Nichols (2008).
- Compare inequities and imbalances.
- Compare deterioration and relapse.
- Discuss the two aspects of enabling.
- Describe the paradoxical procedure.
- State the data from the CDC (2009) regarding intimate partner violence.
- List the four interrelated clinical positions to ensure ethical practice according to Willbach.
- Compare the DSM approach with marriage and family therapy when locating a presenting problem.
- Discuss “insurance diagnosis.”
- Describe third-party payment arrangements.
- State the reasons dual relationships are problematic.
- Compare the synchronous and asynchronous format in technology.
- Describe technology-based therapy.
- Discuss the Tarasoff criteria in an AIDS-related therapeutic situation.
- State the five major steps in handling complaints of unethical behavior by AAMFT members from Figure 9-1.
- List the eight principles of the AAMFT Code of Ethics and briefly describe each.
- Define common law, constitutional law, statutory law and administrative law.
- List the five components which are helpful in interpreting court decisions.
- Discuss the three factors in the duty to protect from the Tarasoff decision.
- Define child abuse.
- Discuss the roles of the therapist as a diagnostician, resource expert, and treatment provider.
- List the five stages of the mediation process.
- Define direct examination, cross examination and redirect examination.
- List the four key elements that must be present to prove malpractice.
- List several reasons for an increase in cohabitating couples.
- Discuss the process of adoption.
- Compare annulment and divorce.
- Describe the four forms of child custody.
- State how marriage and family therapists should seek legal advice.
- Define a minor.
- Describe the Family Educational Rights and Privacy Act (FERPA).
- Describe the four types of waivers as stated by Knapp and Vandercreek (1985).
- Define personal affiliation and licensure.
- Describe the various membership categories within AAMFT.
- List several temptations and their risks made by graduating students and novices.
- State the five major premises that support licensure efforts according to Fretz and Mills (1980) and the critics response.
- Discuss the importance of continuing education.
- Discuss practice issues and precedents.
- Discuss the research of May and Church (1999).
- Describe the aspects of the simplified checklist from principle 8 for Marriage and Family Therapists.
- State how to discontinue a practice.
Chapter I VALUES AS CONTEXT FOR THERAPY Why Begin with Values? Culture, Worldview, and Identity
Social Class or Socioeconomic Status
Other Cultural Dimensions
Psychosocial Identity, Meaning Making, and Context
Stability, Dissonance, and Integration
Value-Sensitive Care: Preliminary Therapist Concerns
Value Clarification as a Prelude to Value-Sensitive Care
Respecting Cultural Differences in Value-Sensitive Care
Other Concerns in Value-Sensitive Care
Implications of Value-Sensitive Care
Implications of Context
Implications for Therapist Roles and Duties
Implications for the Process of Therapy
Implications for the Goals of Therapy
Chapter II PROFESSIONAL ACCULTURATION AND THE ECOLOGY OF THERAPY
Systemic Epistemology as a Professional Worldview
The Feminist Critique of Systemic Epistemology
The Self in the System
Values and Power: The Foundations of Influence
Layers of Values
Forms of Power
Personal and Professional Acculturation in the Ecology of Therapy
PART II Ethical Issues in Marriage and Family Therapy
Chapter 3 PROMOTING ETHICAL PRACTICE: PRINCIPLES, TRADITIONS, AND CONSIDERATIONS
Foundational Principles and Professional Codes
Mandatory Actions from Ethical Codes
Discretionary Actions from Ethical Codes
Ethical Decision Making
The Kitchner Model
The Koocher and Keith-Spiegel Model
Complementary Elements: Competence and Due Care
The Duty to Protect
Professional Disclosure Statements
Chapter 4 UNIQUE ETHICAL CONSIDERATIONS IN MARRIAGE AND FAMILY THERAPY: PRINCIPLE DISTINCTIONS
Foundational Ethical Principles in Marriage and Family Therapy: New Complexities
Multiple Client Considerations
Confidentiality in Marriage and Family Therapy
Privileged Communications in Marriage and Family Therapy
Informed Consent Concerns in Marriage and Family Therapy
Defining the Problem and Establishing Goals Inequity and Imbalance in Marriage and Family Therapy
Chapter 5 UNIQUE ETHICAL CONSIDERATIONS IN MARRIAGE AND FAMILY THERAPY: PRACTICE DISTINCTIONS
The Therapist as Agent for Change
Complications in Convening Multiple Clients
Paradoxical Procedures in Multiple Client Care
Other Uniquenesses in Marriage and Family Therapy
Chapter 6 INTIMATE PARTNER VIOLENCE AND THE ECOLOGY OF THERAPY
Intimate Partner Violence: An Overview
Cultural, Value-Power, and Systemic Considerations
Principles, Traditions, and Uniquenesses
Decision-Making Models and Options for Resolution
Treatment Alternatives: Choices and Stipulations
Chapter 7 CONTEMPORARY ETHICAL ISSUES: CONTEXTUAL MATTERS
Meta-Issues of Context: Opportunities, Vulnerabilities, and Exceptions
The Diagnostic and Statistical Manual of Mental Disorders and Its Use in
Marriage and Family Therapy
Incompatibility of Orientations
The Stigma of Diagnosis
Misrepresentation of Diagnosis
Competence to Diagnose
Managed Mental Health Care
Intrusion into the Therapeutic Relationship
Exceptions to the Rules
Short-Term Treatment and Therapist Competence
Input by Service Providers
Acting Ethically as a Service Provider
Institutional Values and Legal Duty in Conflict with Professional Values
Chapter 8 CONTEMPORARY ETHICAL ISSUES: PRACTICE MATTERS
Multiple Relationships with Clients or Others
Ethical Codes and Multiple Relationships
Compatibility of Expectations
Divergence of Obligations
Power and Prestige Differential
Other Forms of Multiple Relationships
Taking Appropriate Action
Technology in Information Management
Technology as a Practice Resource
Technology as Therapeutic Modality
Ethical Issues in the use of Technology: Concerns for the Ecology of Therapy
HIV/AIDS, Confidentiality, Client Welfare, and Public Protection
A Fiduciary Relationship
Other Factors and Considerations
Taking Appropriate Action
Research and Publication: Informing Ethical Practices
Chapter 9 ETHICAL ACCOUNTABILITY: A CASEBOOK
Adjudication of Ethical Complaints
The AAMFT Code of Ethics
Principle 1: Responsibility to Clients
Principle 2: Confidentiality
Principle 3: Professional Competence and Integrity
Principle 4: Responsibility to Students and Supervisees
Principle 5: Responsibility to Research Participants
Principle 6: Responsibility to the Profession
Principle 7: Financial Arrangements
Principle 8: Advertising
Part III Legal Issues in Marriage and Family Therapy
Chapter 10 THE MARRIAGE AND FAMILY THERAPIST: ROLES AND RESPONSIBILITES WITHIN THE LEGAL SYSTEM
Administrative (Regulatory) Law
Case Law (Court Decisions)
Criminal Versus Civil Law
The Marriage and Family Therapist as a Source of Information
Confidentiality, Privileged Communication, and Records
The Duty to Protect
Child Abuse and Neglect
The Marriage and Family Therapist as a Referral Resource
The Treatment Specialist
The Marriage and Family Therapist as Expert Witness
The Rules of Evidence
Professional Liability Under the Law
Unintentional Torts: Malpractice
Professional Liability Insurance
Chapter 11 FAMILY LAW
Marriage and Cohabitation
Legitimacy and Paternity
Parental Rights and Responsibilities
Annulment and Divorce
Division of Property
Child Custody and Support After Divorce
Legal Actions Between Parents and Children
Chapter 12 LEGAL CONSIDERATIONS
Case 1: Ethics and the Law
Case 2: Divorce Mediation
Case 3: Liability in Crisis Counseling
Case 4: Informed Consent?
Case 5: Criminal Liability
Case 6: Parental Rights and FERPA
Case 7: The Premarital Agreement
Case 8: Privileged Communications
Case 9: Legal Responsibility of Clinical Supervisors
Case 10: Insurance Fraud?
Part IV Professional Issues in Marriage and Family Therapy
Chapter 13 PROFESSIONAL ISSUES: IDENTITY, AFFILIATION, TRAINING, AND TRANSITIONS AS A MARRIAGE AND FAMILY THERAPIST
Professional Identity: Who Am I?
Profession or Specialization? Field or Form? Basic Premises of Professional Identity
Marriage and Family Therapy as a Separate and Distinct Profession
Marriage and Family Therapy as a Professional Specialization
Is Balance Possible?
Professional Affiliation and Training: Who Are We?
American Association for Marriage and Family Therapy
American Family Therapy Academy
The Society for Family Psychology (Division 43 of the American Psychological Association)
International Association of Marriage and Family Counselors
Transitions: What are My Next Steps?
Chapter 14 PROFESSIONAL ISSUES: SUPERVISION, LICENSURE, AND PROFESSIONAL DEVELOPMENT AS A MARRIAGE AND FAMILY THERAPIST
Supervision: What Do I Do?
Marriage and Family Licensure: What Can I Do?
The Scope of Licensure Privilege
The Licensure Process
Professional Development: What’s Next for Me?
Research: Examining and Refining Professional Development
Continuing Education: Sustaining and Renewing Professional Development
Intraprofessional Relationships and Service: Expanding and Enriching Professional Development
Chapter 15 CONTEMPORARY PROFESSIONAL ISSUES: QUESTIONS AND RESPONSES
QUESTION 1: Evolving Epistemology in Actual Practice
QUESTION 2: Values Transactions
QUESTION 3: Professional Advertising
QUESTION 4: Practice Interruptions
QUESTION 5: Fees and Business Expenses
QUESTION 6: Independent Practice in a Rural Area
QUESTION 7: Being a “Public” Marriage and Family Therapist
QUESTION 8: Optimally Serving Oneself and One’s Clients
Closing Thoughts and a View to the Horizon
Appendix A AAMFT Sample Privacy Document
Appendix B AAMFT Sample Office Practices Document