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Discuss about the Issues On Client Rights In Psychotherapy.

Psychotherapy of disturbed individual is one of the delicate treatment processes that medical expertise has come across in recent era. In order to provide best treatment therapy for betterment of patient, many practitioner cross boundaries that sometimes are justified but in most of the scenario individuals feel offended (Sharf,2015). Subsequently, question arises on morality of expertise along with ethical protocol of reputated establishment. A significant number of patients generally take legal action against the expertise and institutions, few simply terminate the therapy session.

Most important client rights that documented in codes of ethics are as follows:

Competence of a therapist defined as finest skills, knowledge and qualification possessed by expertise in order to provide best therapy. This also includes expertise also well aware of emotional state of disturbed individuals while verbally communicating with individuals (Hatcher, 2015). It is also responsibility of therapist to give the detailed information about the disturbed pattern and emotional state of the individual and implementation plan to cure the problem. In case of physically disable individuals, it is responsibility of expertise to communicate with written paper for the sake of the therapy (Waller & Turner, 2016)

Informed consent defined as the important part of therapy where it ensures the conscious decision of patient to involve in the therapy. It is presumed generally that when individual seeking helps from expertise they already involve themselves consciously in the session. However, every time this scenario does not happen (Lamont- Mills, Christensen& Moses, 2018). Therefore, this is rights of client and responsibility from the end of the therapist to take informed consent in the form of declaration form, which clearly emphasize the reason behind therapy, role of patient and expertise in the therapy, and protocols need to follow to complete therapy (Trachsel & Gaab, 2015)

As a part of one of the crucial profession, medical expertises are expected to maintain confidentiality of client such as any embarrassing incident, traumatized experiences and information of treatment setting by any means. However, in certain exceptional cases, practitioners cross their boundary of ethics in order to provide best treatment for betterment of patient (Pepper, 2015). In those exceptional cases, medical expert should inform client about the area of concern for revealing confidential information (Thomas?Anttila, 2015). Otherwise, when therapists are not transparent about their intentions, it is legal right of client to seek legal consultation.

Competent therapist

Like any other therapy psychotherapy, also come with many loopholes and uncertainties that damage the reputation of healthcare center, mind set of individual and ethics of the practice premises. There are several scenarios where malpractices of lawsuits are frequent and individual has to suffer. Four possible malpractices of suits in psychotherapy are as follows:

Inefficiency of expertise:

Inefficiency of medical expertise arises question about the stability of lawsuits of particular practice premises. In many cases, health care centers hire psychotherapist who has moderate knowledge about psychotherapy treatment, lack special skills to handle disturbed individuals and reluctant about the emotional well being of patient( Lewandowski et al., 2016). As a result, in many cases clients are not satisfied with their session and compelled to terminate the session or contract (Wallace, 2015). In severe cases, clients take legal action against the medical expertise and protocol setting of the health care centre.

Lack of advanced technology also make situation difficult for many health care center to meet all the demands of client ethically. In many cases, hospital authority used backdated technology to monitoring the pattern of disturbance and emotional state of the patient. Backdated technology also affected the treatment procedure (Carman& Turek, 2017). Scenarios where assistance of highly advanced technologies required for monitoring the severity, few hospital or health care centers are able to meet the demand of client. In other case, significant number of patient suffered from wrong treatment due to backdated technology and inefficiency in monitoring procedure (Lo, lo & Hasiao, 2016). Eventually, patient becomes dissatisfied.

Most of the reputated health care centers diminish overnight due to unethical access of third party to record party. In many health care centers, due to poor technological security such as lack of password protection in emails and lack of use of medical codes, third party can easily get the access of the information that are very confidential (Sah, Fagerlin & ubel, 2016). Subsequently, in that way health care centers break the rules of client protection. Even, psychotherapists are not truthful to their profession. They sometimes leak the confidential documents of patient without the consent of the patient party (Azaria et al. 2016). Eventually, patients and their family experience trauma from these kinds of experiences.

Over the 30 to 40 years, a large amount of data recorded that suggested that crossing non sexual boundary crossing enriches the possibility of providing best therapy to the needed individual (Barnett & Molzon, 2014).  These kinds of boundary crossing also strengthen the relationship between therapist and patient. However, many practitioners cross their boundaries and inappropriately touch patients, specifically patients who are verbally impaired to express their thoughts (Herlihy & corey, 2015). In that case, it permanently damages the emotional framework of patient and patient might experience depression and lost faith over flexibility of treatment (Dworkin et al., 2018). Subsequently, many families of patient took legal action against the psychotherapist.

Informed consent

In recent area, nation lawsuit journals are addressing issues about confidentiality of psychotherapy. Maintaining confidentiality is also an essential part of psychotherapist job. However, it is crucial to take account of the fact that there are certain exceptions are legally accepted socially regarding maintenance of privacy. Therefore, information about the disrupting privacy of patient should be part of declaration form of informed consent and therapeutic contract. In the following section, exceptions where confidentially breached are discussed.

  1. a) It is legal rights of therapist to breach the confidentiality and release the information in case of emergency. In cases where depression of individual disrupts the normal life style of the individual and posses threat to surroundings, practitioner has to release information for betterment of patients (Chetty, 2017) Psychotherapy also share information with multidisciplinary team for sake of the patient.
  2. b) Lawfully, therapist can breach confidentiality if the client threatened the therapist for his life or take legal action against the therapist. In many cases, clients threatened therapist by black mailing and sometimes therapist might get threat of canceling license or might get phone calls that threats their integrity and dignity (Mosher & barman , 2015). In that case, psychotherapist has rights to release the confidential information about patient without the consent of patient. Psychotherapist has legal rights to case a file with accurate evidences in order to prevent ill practice of therapy session.
  3. c) If a patient is threat to humankind then psychotherapist has rights to release the confidential information about patients. Many individual ill mentality or with motivation to harm humankind seek help of psychotherapy. Moreover, individual with split personality or bipolar may have tendency to harm individuals (Elger, Handtke, & Wangmo, 2015).In that case, psychotherapist has legal rights to release the confidential information about the patients. Besides, sometimes juvenile are affected by the event of divorce of parents. In that case, confidentiality of patient breached by psychotherapist for curing the child.

Thus, it can be concluded that client rights in psychotherapy is important for satisfaction of client in order to get best therapy. However, few cases are there where patient or psychotherapist takes the advantages of the protocols and ethics of health care center. Subsequently, individual experience prolonged mood swings and depression that permanently damages their mental makeup and stable life style. Reputation of well know health care also diminishes over night due to ill practice of lawsuit. National lawsuit journal also pointed out the boundary issues of psychotherapist. To strengthen relationship many therapist inappropriately touches patients. That creates wrong impression about the institution and expertise. Hence, in order to get best therapy, ethics and laws of every health care should be strong. In addition, it will prevent the ill practice of ethics.

References:

Azaria, A., Ekblaw, A., Vieira, T., & Lippman, A. (2016, August). Medrec: Using blockchain for medical data access and permission management. In Open and Big Data (OBD), International Conference on (pp. 25-30). IEEE.

Barnett, J. E., & Molzon, C. H. (2014). Clinical supervision of psychotherapy: Essential ethics issues for supervisors and supervisees. Journal of clinical psychology, 70(11), 1051-1061.

Carman, J., & Turek, J. (2017). Challenges and Response. Archaeologies, 13(2), 355-368.

Chetty, R. (2017). How safe is your digital therapy session? A review of ethical considerations for online counselling(Doctoral dissertation, City University of Seattle).

Corey, G. (2015). Theory and practice of counseling and psychotherapy. Nelson Education.

Dworkin, E. R., Ullman, S. E., Stappenbeck, C., Brill, C. D., & Kaysen, D. (2018). Proximal relationships between social support and PTSD symptom severity: A daily diary study of sexual assault survivors. Depression and anxiety, 35(1), 43-49.

Hatcher, R. L. (2015). Interpersonal competencies: Responsiveness, technique, and training in psychotherapy. American Psychologist, 70(8), 747.

Herlihy, B., & Corey, G. (2014). Boundary issues in counseling: Multiple roles and responsibilities. John Wiley & Sons.

Lamont-Mills, A., Christensen, S., & Moses, L. (2018). Confidentiality and informed consent in counselling and psychotherapy: a systematic review.

Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective. Psychotherapy, 51(4), 467.

Lewandowski, R. E., Bolton, P. A., Feighery, A., Bass, J., Hamba, C., Haroz, E., ... & Verdeli, H. (2016). Local perceptions of the impact of group interpersonal psychotherapy in rural Uganda. Global Mental Health, 3.

Lo, Y. F., Lo, Y. H., & Hsiao, J. (2016). A Case Study of Synchronous Distance Learning Between Shih Chien University and Beijing Foreign Studies University. Journal of Systemics, 14(4), 1-5.

Mosher, P. W., & Berman, J. (2015). Confidentiality and its discontents: Dilemmas of privacy in psychotherapy. Psychoanalytic Interventions.

Pepper, R. S. (2015). Is Group Psychotherapy Inherently Unethical?. group, 39(2), 159-160.

Sah, S., Fagerlin, A., & Ubel, P. (2016). Effect of physician disclosure of specialty bias on patient trust and treatment choice. Proceedings of the National Academy of Sciences, 201604908.

Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.

Thomas?Anttila, K. (2015). Confidentiality and Consent Issues in Psychotherapy Case Reports: The W olf M an, G loria and J eremy. British Journal of Psychotherapy, 31(3), 360-375.

Trachsel, M., & Gaab, J. (2016). Disclosure of incidental constituents of psychotherapy as a moral obligation for psychiatrists and psychotherapists. Journal of medical ethics, medethics-2015.

Wallace, K. S. (2015). Perspectives on the Essential Characteristics of Highly Effective Psychotherapists (Doctoral dissertation, University of Alberta).

Waller, G., & Turner, H. (2016). Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track. Behaviour research and therapy, 77, 129-137.

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