Thursday, April 01, 2004

Answers to Dawes: d,a,c,b,c.

This reading struck as being directly related to the EST discussion we had a few weeks ago in the sense that clinicians often justify their treatment methods by relying on their "expertise" or clinical judgment. By using statistical methods such as assessment instruments, clinicians may be able to minimize clinical errors by taking them into consideration when making clinican decisions and justifying their actions.

Thursday, March 18, 2004

answers to Pope: a,b,b,c,b,c,c,d,d,b,b,c.
As a few people had already mentioned it is rather curious that the number of psychologists having sexual relation with their patients declined. In my opinion it is more likely due to underreporting. Furthermore, in answring Dr. Comb's question, I do believe that it may be feasible to have psychologists found guilty of having sexual intercourse with a client be registered as sexual offenders. This, however, brings up many issues that we discussed in class including the nature of the therapeutic relationship, client variables, etc. Either way, this article contains many things that students are not usually taught in school.

Thursday, March 11, 2004

Answer to article: b,d,a,a,c.
Anybody watch Sopranos on HBO this Sunday? It was directly related to what we have been discussing in class in terms of client-therapist sexual relationships.
In the episode, Tony was actively pursuing Dr. Melphy and the more she resisted, the more insistent he became. At the same time, she was having sexual fantasies about him. In the end ethics prevailed when she finally made her position very clear by explaining to Tony that while as a therapist she did pass judgment on his career in "waste management" or his anti-social personality, as a woman she had to reject him on those grounds. I was wondering if anyone watched the episode and their opinion on her conduct.

Thursday, February 26, 2004

Answers to Pope article: d,b,d,a,a or c (the article offers conflicting information), b,a,b,a,c.

I was appalled by the statistics presented in the article regarding the percentages of psychologists that have had sexual relationships with their clients. Statistically speaking if between 5 to 10 percent of psychologists engage in intercourse with their clients, then in a class with 20 people statistically speaking 1 to 2 people are likely to engage in such inappropriate conduct throughout their careers. Sobering!!!
In addition, while the article discusses the implications of training students on the topic, I suppose it was beyond the scope of the article to outline appropriate ways of dealing with sexual transference and countertransference in the session (other than supervision or consultation). Thus, while we are told that sexual intimacies with clients are unethical and illegal while attraction and sexual feelings happen and are normal (or not, the article is not clear), we are not explicitly told how to deal with them.

The guidelines for non-sexual dual relationships and boundaries in psychotherapy make sense in that dual relationships are at time unavoidable and that boundary crossing is at times called for. However, in light of the previous articles we read, I'd be reluctant to pursue any such relationships or cross any such boundaries. Furthermore, while the author reminds psychologists that they are paid to heal and not to protect themselves, I'd like to remind the author that we are studying to be professionals and not professional martyrs.

Thursday, February 19, 2004

Answers to Anfang and Appelbaum: A, D, B, A, C, C.
In response to the Anfang and Appelbaum article, people are always going to find a reason to file suit to the extent that some suits are ridiculous if not scandalous. For instance, a cigar smoker suing his insurance company for the cigars burning in the process of smoking them and the insurance company countersuing with the charge of arson. Poop happens and as clinicians we just have to make sure to do our best, cover our behinds, and make sure not to set a legal precedent.

Thursday, February 12, 2004

Answers to Monahan: D,A,B,C,C,B,B,B,B
The Monahan article, while helpful was rather scary. As was reflected in the survey posted by Dr. Combs, even those who helped write the ethics code have trouble with following it, so how are we expected to function ethically in the field? The only solutions that I can think of are 1) Casey's idea of writing long vague progress notes or 2) always having someone alse to dump the blame on or share it with. A master's degree would have been sufficient for these purposes as far as I'm concerned.
I kind of share Jen's skepticism regarding the decision to become a psychologist. Personally, it is even more of a motivation to lean towards the corporate side of the field. One would certainly hope that higher functioning individuals would not be as likely as for instance the inpatient population to hurt themselves or others thereby lessening my preoccupation with the Tarasoff liability and allowing me to consider other liabilities inherent in this population.

Thursday, February 05, 2004

Hey guys,
1st, the answers to Bregin:c,b,b,d,a,c,b,b,b,d, and Beahrs:b,c,d,a
The Bergin article is somewhat reminiscent of Acceptance and Commitment Therapy in its discussion of values. Values are a major component of ACT in that discrepancies between values and actual behavior are used to promote changes in those behaviors, given that individuals have the willingness to change. As a matter of fact, in a weekend workshop with Steve Hayes, one of the authors of the ACT book, he discussed the role of values at length as well as religion in therapy and how many therapists, especially novices, are afraid of addressing those issues. This as well as Jeff's comment regarding how in class we seem to vacillate between certainty and skepticism as to what we should do when facing an ethical dilemma reminded me of a discussion in supervision and management where we discussed supervisees' developmental levels. Being that we would be considered level 1 trainees, self-doubt and a rather strict adherence to the prescribed course of action is characteristic and not a matter over which anyone should seriously begin doubting their commitment to the profession or their competency. This is all to be expected.
On a personal note, I agree that sudden converts are more disturbed than gradual or non-converts, which may be the reason for the conversion in the first place. Religion is used as a crutch and a substitute for personal responsibility for one's actions as well as a way for individuals to find meaning in a life which they perceive to be void of meaning. It is also my opinion that in the long run this results in increased psychological disturbance once the person becomes disillusioned with religion and the absolute meaning he or she attributed to it.
Regarding the informed consent article... While it was helpful with defining the benefits and limits of informed consent, my vision blurred and my mind wandered after reading something about iatrogenic regression ;-)
The sample informed consent may be too complicated for most patients seen in a community mental health setting. While it may cover the therapist's behind, refer back to iatrogenic regression.
Chapter 4, as suggested by others, clarifies some issues discussed in class while leaving much to be desired when relying on psychologists' better judgment in ethical dilemmas.
See you in class.

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