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I'm so excited for this generation to come of age.
It is a generation that I feel
is particularly informed around identity.
It's a generation that is asking hard questions.
The responsibility of keeping up to date
with codes of ethics fall
on the responsibility of the therapist.
It is important for you to know what is going on in the field.
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When working with a therapist,
clients are often at their most vulnerable,
discussing complex aspects of their lives
and navigating difficult issues.
At times, this can create a challenge for the therapist.
Where can they turn when they run
into these situations?
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Imagine a therapist is facing
a challenging ethical dilemma involving a client named Alex.
During their therapy sessions,
Alex revealed deep-seated feelings of anger
and thoughts of harming his partner.
The therapist is concerned about the potential danger
Alex might pose to his partner and the community at large.
Now, it's important for the therapist to engage
in a more comprehensive inquiry and evaluate
the potential risk involved with Alex.
For instance, it's essential to ascertain
whether Alex has a specific plan to cause harm
to his partner or if he possesses any weapons.
Additionally, if Alex explicitly expresses
the intent to harm his partner,
the therapist has an ethical duty to breach
confidentiality and inform the appropriate authorities.
If Alex's thoughts about harming his partner
are less explicit and more ambiguous,
the therapist should schedule
individual sessions with each partner
to thoroughly assess the risk factors
present in the relationship.
This assessment may include investigating
any history of violence within the couple's dynamic
and addressing any underlying anger management issues
that Alex may be experiencing.
In either scenario, the therapist must engage
in open and candid discussions
with each partner to determine the level of risk
associated with the situation.
Balancing ethical principles can create
a complex situation for the therapist,
one that requires consideration
and consultation with supervisors
or ethical guidelines to make the best choice
for everyone involved.
Ethics is very critical.
Ethics guides us in our day-to-day lives
and in the work that we do.
It helps us to navigate
difficult situations that are there.
Meet Dr. Naveen Jonathan,
a licensed marriage and family therapist and MFT educator.
Part of an MFT's training is learning about
ethics and how to navigate difficult situations.
Many therapists follow ethical guidelines such as those
of the American Association for Marriage and Family Therapy,
AAMFT.
Representing over 70,000 professionals in North America,
AAMFT promotes best practices, ethics,
and the advancement of the profession.
The code of ethics
for the profession of marriage and family therapy is created
by the American Association
for Marriage and Family Therapy,
otherwise known as AAMFT,
are professional expectations and guidelines
for the practice of marriage and family therapy, both here
in the United States as well as across the world.
For the code of ethics, it governs
a lot of different areas.
One of the most important piece is that in that code of ethics
is that there's a huge connection
with public trust by being a member of the AAMFT
and also following the code of ethics.
The AAMFT code of ethics plays a crucial role in guiding
through the complexities of ethical decision-making.
It acts as a compass,
especially when faced with challenging situations.
The code of ethics offers us the ability to refer
back to be able to look at what are our expectations,
how do we handle such issues.
Oftentimes we talk about sometimes
when we have these ethical issues
that they may fall in gray areas and gray spaces.
We can look at the code of ethics
as a place for us to begin
and explore to see what are my responsibilities?
What are the guiding values in this code of ethics
that I should be following?
From there, we may take other actions.
We may consult with others.
We may engage in other research,
but it's a good place for us to start
and to explore and to say,
"Okay, what are those foundational values
and principles that we should be exploring
as we're making ethical decisions?"
We spoke to Dr. Asha Barber Sutton,
one of the contributors to the new AAMFT
systemic ethics textbook about
how publications like this help students
and new professionals entering the field.
The textbook is a really great tool,
particularly for students that are starting off.
It gives a wonderful, comprehensive look
at a myriad of different ethical considerations.
I would say that it's also good for faculty
if you are teaching an ethics course
because it's providing you
with the information that you need
to help students to consider.
It is a challenge not only to understand
the basic code of ethics when it comes
to how we operate as marriage
and family therapists but also to apply.
The textbooks provides a wonderful resource
in terms of doing both.
For MFT professionals,
it's a little more nuanced than you might imagine.
Former AAMFT ethics committee member and chair,
Dr. William Northey, explains.
The AAMFT code of ethics
is our aspirational goals
to deliver effective services.
The underlying theme,
as with all helping professionals,
is to do no harm but also to benefit the client.
I think that in family therapy,
it's somewhat unique in that question
we have to answer is, who is our client?
If you're a doctor or an individual therapist,
your client or patient is very clear.
If you're a marriage and family therapist,
is your client the husband, the wife, the kids?
We think of our client as the family.
Coming up.
I also have a lot of colleagues that have different expertise,
particularly in working
with the high-conflict divorce family.
I have in the last year reached out
to one of my colleagues and said,
"What do I do with this?"
Despite their role as helpers,
therapists are not immune to life's challenges.
Like everyone else, they experience
emotions and stress.
I have a case right now
where the kids, who are 11 and 9,
don't want to meet with their mother.
They're refusing to do that despite a court order
that says that they have to come and dad has to help.
They'll sit in the room with mom,
but they will not talk to her directly.
I felt stuck.
Therapists might even feel stuck
when they can't find a path forward to help their clients
or how they can best help them work towards a resolution.
I don't know in this particular case
what the best thing to do is.
I think that's where you start to look
at morals and ethics and legal responsibilities.
When you're acting independently,
having a core set of colleagues
that you can bounce ideas off of, always protecting
the identity of clients but saying,
"Hey, I got this clinical situation and would love
to get your ideas on how I might navigate
that or resources that I might look
into to help support my approach as a clinician."
There is no time throughout our work
as a marriage and family therapist
where we have to operate on an island.
The value of a strong support system and resources
in marriage and family therapy is clear.
Collaboration is helpful,
even for independent therapists, as colleagues offer
a secure platform for idea exchange,
while upholding client privacy.
I'm lucky. I have a pretty robust resource
community available to me.
My wife is MFT, so I can talk with her about things.
I also engage in a monthly peer supervision
with a colleague from the United Kingdom.
William takes his support game to the next level by having
the support of a therapist spouse
and engaging in transcontinental brainstorms.
Wait, there's more.
I also have a lot of colleagues that have different expertise,
particularly in working
with the high conflict divorce family.
I have, in the last year, reached out
to one of my colleagues and said,
"What do I do with this?"
If I really had a dilemma, I would reach out
to get a consultation
with the American Association
for Marriage and Family Therapy.
They have a lawyer who does
legal and ethical consults around those things.
If all those other resources
still got me to the point where I felt stuck,
I would probably reach out to them.
Let's be honest.
We don't have someone to lean on every time.
Having a core set of ethics helps in understanding
how a person can navigate some of these challenges.
There are many clinical situations that may arise
where therapists may face ethical dilemmas.
I may be seeing a couple for a period of time,
and maybe perhaps the couple ends
their relationship or they're moving
towards the ending their relationship.
If a client at some point decides
that they do not want to attend therapy anymore,
it is the client's decision when to stop treatment.
We would not force them or to force them to attend.
It's things like that I think are really important.
They are wanting to continue on with treatment.
Maybe one partner, for example,
reaches out to me and says that they want to see me.
Ethically, when I look at that, I've developed
a relationship with both partners.
It's like that moment when a couple breaks up.
Maybe you are a friend to both of them
and have to maintain a relationship with each side.
For me now to work with one individually,
that would be problematic because,
for example, if the couple got back together, what do I do?
I've developed a relationship with you individually
and now you've got that other partner
entering into the relationship.
It could be very much where I've now sided
with one person over the other if both partners
enter back into the relationship
and then they come into couple therapy.
That is an example of an issue.
In addition to relationships,
finances can also create ethical dilemmas.
For example, what would happen
if a client has a strain on their finances?
Maybe they had a issue that came up
that affected their finances.
They lost their job, for example.
Or, maybe they lost their insurance
that they were using to pay for treatment.
I know that treatment would be still helpful for them.
How might I handle that?
Would I make an exception for a reduced cost
for treatment for a period of time?
Would I perhaps even explore some pro bono work
for a period of time because they would need it?
Would I refer them, maybe,
perhaps to another therapist or another clinic
that could offer pro bono or low-cost clinical services?
Those are some example
of these ethical dilemmas that could come up.
Now imagine this.
You're facing these ethical dilemmas.
You're stuck between a rock and a hard place.
Where do you turn?
In each of these particular cases
that I've shared with you,
looking back at codes of ethics and knowing
what my responsibilities
are and how can I ethically
and consciously think of all different sides
of the issues before I make a decision.
That's very important in this work to do.
Again, when you have guiding
documents such as codes of ethics,
it's very helpful to be able to go back
and to refer to them and to say,
"Well, how might I handle the situation?"
As a therapist, it's not uncommon
to face ethical dilemmas,
but by staying true to ethical principles,
therapists can ensure that their clients
receive the best possible care.
These principles also help them become
stronger and more resilient in their work.
If you have a passion for wanting to help people
and to walk alongside their journey,
not to necessarily be the director of their journey
but to help facilitate an understanding for them
of what their journey looks like,
this field is a wonderful way to give back,
to give back in a way that is supportive,
to give back in a way that is meaningful
and additive in their experiences,
and to create safety.
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In the world of therapy,
both experienced and new therapists
face ethical challenges.
Staying true to ethical principles
is crucial to providing care.
As time moves on, so does our evolution.
Therapists need to keep up with updated ethical codes
and seek ongoing education to handle complex situations.
Ethics serves as a guiding force to ensure
both the client's and therapist's well-being.
The responsibility of keeping up to date with codes of ethics
fall on the responsibility of the therapist.
It is important for you to know what is going on in the field.
How can therapists, with clients
coming in day in and day out,
stay up to date with the evolving ethics
perspectives and resources?
It's important for you to have membership
in an association, for example, the AAMFT.
AAMFT puts out materials and information
to the membership constantly to tell you there's this change
that is happening, for example, in the codes of ethics.
It is important for you to follow them
so that they can guide you in the work that you need to do.
Secondly, for example, AAMFT puts out the codes of ethics
when they are revised.
Each state in the United States
has its own regulatory board that governs
the practice of various professions,
including marriage and family therapy.
These boards establish and enforce
the requirements for obtaining
and renewing licenses to practice
within their respective states.
The licensure boards set standards for education,
training, ethical conduct,
and continuing education for professionals in the field.
State licensure boards vary across the United States,
as well as in Canada,
and even in some places across the world
where there may be different governing bodies
in the field that may be there.
Here in the state of California where I live,
we have a requirement for renewal of our licensure,
which happens every two years.
It is important for us to attend
a law and ethics training or seminar.
It's a six-hour training.
We receive updates in the field of marriage
and family therapy to the codes of ethics
that are out there.
You never stop learning,
whether it's from your clients or your peers.
It's important for us to be students,
for us to learn and be aware of that.
In my role as a clinical supervisor,
as an educator, it is important for me
to keep up to date with the AAMFT,
with my state licensure boards
so that I have this information so I can educate my students,
I can train them, mentor them as I educate them
in the classroom or clinically supervise them also
in their clinical work as well.
They're paving the way for new norms and forming
connections based on genuine curiosity.
It's a refreshing stamp,
one that holds immense promise for the future.
This is why it's important they get
the right help in their journey of growth.
Once you are licensed to practice independently,
as long as you're competent to work in any particular area,
the legal and ethical requirements
would cover that.
Most people I know will get
other certifications or training,
whether it's in trauma-informed care,
specific types of evidence-based family therapies,
emotionally focused couple therapies.
There's lots of opportunities to learn
more and create a niche in terms of the populations.
If you want to get into this field,
what ethics or values do you need?
I think it's important for the individual to know
about your own personal values and how you come to the field.
Even as I was exploring entering the field,
things such as being a safe person,
being somebody that someone
could attend to and come to rather,
and knowing that you will be a confidential space,
you will be someone that can hear, listen, empathize,
be able to sit with the client in the moment,
I think is very critical.
I encourage oftentimes individuals
who are going into this field
to look at what are those values?
Is this a field for you?
What sort of person do you have to be if you want
to get into this field?
If you have a passion for wanting to help
people and to walk alongside their journey,
not to necessarily be the director of their journey
but to help facilitate
an understanding for them of what their journey
looks like, this field is a wonderful way to give back
in a way that is supportive,
to give back in a way that is meaningful
and additive in their experiences,
and to create safety.
It often allows you to feel
a sense of accomplishment within yourself,
knowing that you have helped people along the way,
and I'll walk alongside them until they feel
confident enough to continue their own walk in life.
We are looking at how we can change
the interaction patterns and the ways that people
are so that they can stay in those relationships
and can be healthy and happy.
Therapists who uphold ethical values
play a crucial role in providing
exceptional care and promoting a world filled with compassion.
Thanks for watching.
I'm your host, Kristen Morant,
and we'll see you on the next episode
as we explore the jobs of tomorrow.