Ethical Considerations in Therapeutic Relationships: A Case Study

 

Title: Ethical Considerations in Therapeutic Relationships: A Case Study

Introduction:
In this case study, we will explore the ethical challenges that arise when a therapist initiates physical contact with a client in response to a distressing event. We will examine the relevant ethical codes and principles, and discuss the best course of action for the therapist, considering both the immediate response and subsequent sessions, while attending to relational ethics.

Ethical Issue:
The ethical issue in this case is the therapist’s decision to initiate physical contact with the client without prior consent or established boundaries.

Ethical Code(s) and Principle(s):
In psychology, I will draw upon the ethical code and principles outlined by the American Psychological Association (APA).

Principle of Respect for People’s Rights and Dignity: Therapists must respect and protect the rights, autonomy, and dignity of their clients. Any behavior that infringes upon these rights, such as initiating physical contact without consent, is a violation of this principle.

Principle of Integrity: Therapists must maintain honesty, fairness, and respect for their clients. Acting in ways that blur professional boundaries or impose personal beliefs upon clients compromises the integrity of the therapeutic relationship.

Principle of Beneficence and Non-maleficence: The therapist’s primary responsibility is to promote the welfare of their clients while avoiding harm. Actions that cause distress or discomfort, such as imposing physical contact, violate this principle.

Best Course of Action on Hearing the News:
If I were Dr. Sole, upon hearing the news of Jason’s father’s sudden death, I would consider the following factors to determine my best course of action:

Reflect on Ethical Codes and Principles: I would remind myself of the ethical codes and principles that guide my profession, particularly the principles of respect for people’s rights and dignity, integrity, and beneficence and non-maleficence. This reflection would help me ensure that my actions align with these principles.

Assess the Established Boundaries: I would consider the existing therapeutic relationship with Jason. If our therapeutic alliance had not involved physical touching before, I would recognize that initiating physical contact without prior consent may breach established boundaries.

Respect for Autonomy: I would acknowledge that clients have the right to determine their preferred forms of comfort and support during times of distress. Recognizing Jason’s potential discomfort with physical touch, I would prioritize respecting his autonomy and personal boundaries.

Best Course of Action in the Session:
If I had given Jason a hug and felt his body go rigid, I would immediately recognize this physical response as a sign of discomfort or distress. In such a situation, I would:

Pause and Acknowledge: I would pause the session and acknowledge Jason’s reaction, expressing my understanding that my gesture might have caused discomfort or violated his personal boundaries.

Apologize and Validate: I would sincerely apologize for any distress caused by my actions and validate Jason’s feelings. It is crucial to assure him that his response is valid and that his emotional well-being is of utmost importance.

Discuss Boundaries: I would initiate an open conversation about boundaries, emphasizing that physical contact should always be consensual and respectful. This discussion would contribute to establishing clearer boundaries within the therapeutic relationship.

Rebuilding Trust: Following the incident, I would focus on rebuilding trust by being transparent about my intentions and ensuring that future interactions are aligned with Jason’s comfort levels. This may involve revisiting our therapeutic contract and discussing any concerns or preferences he may have moving forward.

Attending to Relational Ethics:
To attend to relational ethics in this scenario, it is essential to prioritize open communication, respect personal boundaries, and maintain transparency throughout the therapeutic process. By acknowledging any breaches of trust, validating client experiences, and actively working towards rebuilding trust, therapists can uphold relational ethics within professional relationships.

Conclusion:
In this case study, we have explored an ethical dilemma faced by a therapist when initiating physical contact with a client without prior consent. By adhering to ethical codes and principles, considering factors such as client autonomy and established boundaries, therapists can make informed decisions in response to distressing events. Prioritizing open communication, validating client experiences, and actively rebuilding trust contribute to maintaining ethical standards and attending to relational ethics in therapeutic relationships.