Minggu 3

ISU-ISU ETIKA DALAM PRAKTIS

PSIKOTERAPI/KAUNSELING
Dr. Aizan Sofia Amin
Isnin |10am 1pm | 3A.503
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Mengutamakan Kebajikan Klien

Whose needs are being met in this relationship. My clients or my own?
To put our needs in perspective without exploiting clients
Awareness of our blind spots, learn to recognize them
If we have personal conflicts and there is a chance that we will project
them onto clients, its better to seek our own therapy before assisting
clients
E.g. the need to change others in the direction of our own values; the need
to persuade
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Membuat Keputusan Beretika

Ethics purposes:

Educate therapists and the general public about the responsibilities of the
profession
Provide a basis for accountability in away that clients are protected from
unethical practices
Improving ones professional practice

Therapists must follow ethics codes in their practical work

However, existing ethic codes usually offer general guidelines and

rather limited
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Proses Membuat Keputusan

Corey & Corey (2003)
Identify the problem or dilemma the more you have clear understanding of the issue,
the more easier it becomes (ethical, moral, legal, clinical etc)
Identify the potential issues the rights, responsibilities, welfare of others involved
Look at the relevant ethics codes for general guidance

Consider the applicable laws and regulations

Seek consultation from more than one source
Brainstorm various possible courses of action
Enumerate the consequences of various decisions and their implications
Decide what appears to be the best possible solution
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Informed Consent
Is a legal and ethical term defined as the consent by a client
to a proposed medical or psychotherapeutic
procedures/participation in a research/clinical study.
The client must first achieve a clear understanding of the
relevant facts, risks and benefits, and available alternatives
involved.
The concept of informed consent originated with the
recognition that individuals have rights: to freedom,
autonomy and human dignity. Clients (whether in inpatient
or outpatient treatment) possess these rights and cannot be
denied their rights due to mental health status or condition.
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Informed Consent
Some aspects include:
General goal of therapy process

The responsibilities of the counselor toward the client

The responsibilities of clients
Limitation of and exceptions to confidentiality
Legal and ethical parameters that could define the relationship
Qualification and background of the practitioner
Fees
The services, length of the therapeutic process
Benefits and risks involved
The possibility that the clients case will be discussed with the therapists
colleagues/supervisors
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Informed Consent Challenges

Too little VS too much information can be very overwhelming
It takes both intuition and skill to strike a balance
I cant
decide!

SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Kerahsiaan (Confidentiality)
Is the requirement that therapists and most other
mental health professionals protect their clients
privacy by not revealing the contents of therapy

Professionals have the responsibility to define the

degree of confidentiality that can be promised
Therapists have an ethical responsibility to
discuss the nature and purpose of confidentiality
early in the counseling process
To keep or to breach confidentiality?
What circumstances that can warrant therapists
to breach confidentiality?
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Contoh Kes:

The duty to warn and protect third parties from harm

Tarasoff v. Board of Regents of the University of California, 1976

In the fall of 1969, Prosenjit Poddar, a citizen of India and naval

architecture student at the University of California's Berkeley campus, shot
and stabbed to death Tatiana Tarasoff, a young woman who had spurned
his affections. Poddar had sought psychotherapy from Dr. Moore,
psychologist at the university's student health facility, and Dr. Moore had
concluded that Poddar posed a significant danger. This conclusion stemmed
from an assessment of Poddar's pathological attachment to Tarasoff and
evidence that he intended to purchase a gun. After consultation with
appropriate colleagues at the student health facility, Dr. Moore notified
police both orally and in writing that he feared Poddar posed a danger
to Tarasoff. He requested that the police take Poddar to a facility
hospitalization and an evaluation under California's civil commitment
statutes. The police allegedly interrogated Poddar and found him rational.
They concluded that he did not really pose a danger and secured a
promise that he would stay away from Ms. Tarasoff. After his release by
the police, Poddar understandably never returned for further
psychotherapy, and two months later stabbed Tarasoff to death.
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Kerahsiaan: Had dan Kekecualian

Contoh: Kod Etika Kaunseling (Lembaga Kaunselor Malaysia)
Bahaya dan keperluan undang-undang
Penyakit berjangkit dan mengancam nyawa
Pendedahan atas perintah mahkamah
Pendedahan minimum
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Kerahsiaan: Had dan kekecualian

Maklumat yang boleh dikongsi dengan orang lain:
Subordinat
Pasukan rawatan
Setting rahsia
Pembiaya pihak ketiga
Penyaluran maklumat rahsia
Klien meninggal dunia
*Rujuk lanjut kod etika Kaunselor untuk maklumat terperinci
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Kerahsiaan
Also involved protecting confidential data, consent to record
a therapy process, access to client, record keeping, transfer
of clients record etc

SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Etika Dalam Multibudaya

The traditional theories, assumptions made about mental health,
optimum human development, the nature of psychopathology, the
nature of effective treatment may have little relevance for some
clients
The individuals are best understood by taking into consideration
salient cultural and environmental variables
Create therapeutic strategies that are congruent with the range of
values and behaviors that are characteristic of a pluralistic society
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Etika Dalam Multibudaya

Traditional theories are not value free/value neutral
Some of ideas, values, assumptions, techniques or practices may be
irrelevant to people of color or other ethnicities.

Practitioners must listen to clients and determine why they are

seeking help and how best to deliver the help that is appropriate for
them
Focusing on both individual and environmental factors to bring about
change
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Isu Dalam Proses Penilaian

Diagnosis in therapy is widely practiced

The purpose is to identify disruptions in clients present behavior and lifestyle
Can identify problems and thus to plan intervention or treatment programs
Widely used diagnostic assessments is DSM-IV-TR (Diagnostic and Statistical
Manual of Mental Disorder, Text Revision)
The importance of being aware of unintentional bias and the presence of
distinctive ethnic and cultural patterns that could influence the diagnostic process
Some clients maybe subjected to erroneous diagnoses
Some characteristics and personality maybe labeled neurotic or deviant because
they are simply not in the dominant culture
E.g. repressed, inhibited, passive, unmotivated > undesirable in western
standards
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Dual & Multi Hubungan

Occur when counselors assume two or more roles simultaneously or
sequentially with clients.
Non sexual dual relationships
e.g. teacher and therapist or supervisor and therapist

Bartering for goods or therapeutic services

Borrowing money from clients
Providing therapy to a friend/an employee/relatives
Engaging in a social relationship with a client
Accepting an expensive gift from a client
Going into a business venture with a client
Becoming emotionally or sexually involved with a current client is
unethical, unprofessional, and illegal
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Dual & Multi Hubungan

Reasons:
Can impair the therapists objectivity, competence and effectiveness
in performing his or her functions as a therapist
Risks exploitation or harm to the person with whom the professional
relationship exist
Some dual relationships are clearly exploitative and do serious harm
both to client and to the professional but others may have potential
benefits to clients then potential risks
Not much consensus regarding the appropriate way to manage dual
and multiple relationships
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Dual & Multi Hubungan

1. Protection of the therapeutic process
2. Protection of clients from exploitation
3. Protection of therapist from liability
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)

Dual & Multi Hubungan

Ways of minimizing risk:
Set healthy boundaries early in the therapeutic relationship (informed
consent, discuss with client, document your discussion)
Consult with fellow professionals as a away to maintain objectivity
and identify unanticipated difficulties
Always to work under supervision
Self monitoring
SKPW3023-PSIKOTERAPI UNTUK KERJA SOSIAL (M3)