How Do You Navigate Ethical Dilemmas in Mental Health?
To provide insights on navigating and resolving ethical dilemmas, we asked mental health professionals for their expert advice. From seeking consultation for ethical questions to consulting extensively with colleagues, here are the top seven strategies these professionals shared on handling ethical dilemmas in practice.
- Seek Consultation for Ethical Questions
- Utilize Supervision and Stay Updated
- Blend Guidelines with Personal Judgment
- Consult, Record, and Follow Through
- Consult the Code of Ethics
- Prevent and Address Ethical Dilemmas
- Consult Extensively with Colleagues
Seek Consultation for Ethical Questions
Ethics in therapy can be a little tricky. I always err on the side of seeking consultation or supervision. There is nothing wrong with consulting with a like-minded colleague about an ethical question. Sometimes I even consult with more than one person to get more input. Therapists definitely have differing interpretations of ethical guidelines, so it is always nice to get more than one opinion.
Utilize Supervision and Stay Updated
To help navigate ethical dilemmas, it is extremely helpful to have your own supervision or be part of group supervision even when you are licensed. Having this in place allows you to have another professional or group of professionals give input and support on how to navigate ethical dilemmas, especially the ones that are a bit more nuanced and not so clear. It is also important to stay up-to-date on ethical trainings as so much of the therapeutic landscape is changing with social media.
Blend Guidelines with Personal Judgment
Navigating ethical dilemmas in psychotherapy involves a blend of adherence to established guidelines and personal judgment. According to the American Psychological Association (APA), ethical practice requires respecting client confidentiality, obtaining informed consent, and managing dual relationships (APA, 2020).
In virtual settings, ensuring confidentiality can be challenging, with 83% of therapists citing security concerns (American Telemedicine Association). Implementing secure communication platforms and following HIPAA guidelines is essential.
Additionally, therapists must stay updated with evolving ethical standards. The APA highlights the importance of ongoing education to handle new issues like digital record-keeping and telehealth.
Regular supervision and consultation with peers help in resolving complex cases and maintaining ethical integrity. By combining adherence to professional guidelines with continuous learning and supervision, therapists can effectively manage ethical dilemmas in their practice.
Consult, Record, and Follow Through
Having worked at a community health agency after serving in a nonprofit leadership role with the same population, there were many potential conflicts of interest and ethical dilemmas that arose. The first step was always to consult with colleagues and pursue supervision, recording outcomes from conversations and including them in chart notes when appropriate. Occasionally, the dilemma would warrant contacting the General Counsel of the organization, or a lawyer who specializes in ethics in behavioral health if General Counsel is not available.
At the end of the day, 1) discussing with other professionals, 2) recording the decisions made based on those discussions, and 3) following through with those decisions are key ingredients to successfully navigating ethical dilemmas.
Consult the Code of Ethics
As a social worker, it is important to understand the National Association of Social Work Code of Ethics. This is the guide for professional ethical conduct within social work practice.
When an ethical dilemma comes up in my practice, the first thing I do is consult the Code of Ethics. If the answer can be easily found there, I will follow the guidelines set out in the Code of Ethics. If the ethical dilemma is more complex, I will consult my social work supervisor. It is essential to have a supervisor who is very knowledgeable about private practice and ethics. If the ethical dilemma is not able to be solved by my supervisor, then I would consult a lawyer who is familiar with mental health law.
One of the main tenets of social work is to be an ethical provider. I take ethics very seriously. After consulting the Code of Ethics, my supervisor, and a lawyer, I will then take the next steps to ensure that the most ethical decision is made. I also work with my team of therapists to make sure that they fully understand the Code of Ethics and discuss any potential ethical issues with me as their supervisor.
Prevent and Address Ethical Dilemmas
As a dedicated psychotherapist at Wellness Beyond the Chair, my first step in practice is always to prevent ethical dilemmas. I achieve this by rigorously adhering to the social work code of ethics, maintaining active professional and business liability insurance, and regularly consulting with my clinical supervisor and skilled colleagues.
Despite our best efforts, ethical dilemmas can still arise. In such instances, my immediate response is to seek counsel from a trusted colleague or my clinical supervisor. Together, we prioritize the well-being of our patients and adhere strictly to the social work code of ethics to guide our decisions.
If a dilemma proves particularly challenging, I do not hesitate to consult with my professional liability insurance provider for further guidance and direction. This multi-layered approach ensures that we handle every situation with the utmost integrity and consideration for the health and safety of those we serve. At Wellness Beyond the Chair, we are committed to ethical practice and the highest standards of care, ensuring that every decision supports our clients' journey toward healing and growth.
Consult Extensively with Colleagues
The most important thing you can do when navigating an ethical dilemma is to consult, consult, consult. It is reckless to do this job on your own, and it is important to brainstorm with other therapists. Your colleagues may be able to see things you don't and help you to create a plan of action.