Critiquing Ethical Violations in Marriage and Family Therapy

Week 6: Assignment 6: Critique Disciplinary Meeting Minuets. Ray Ryneer School of Social and Behavioral Sciences, National University MFT-5102 v6- Legal. Ethical. And Professional Development in Marriage and Family Therapy Dr. Turns March 24, 2024

This week’s assignment is based on research from the Marriage and Family Regulatory Boards Annual Delegate Meeting held on 09/22/20. It is composed of licensure disciplinary data and posted summaries of sanctions and violations focused on 36 states from 2008 to 2018. Demographics and findings for sanctioned Marriage and Family Therapists within two different states (Texas and Alabama) are reported below. What Codes are Violated the Most? Three main types of complaints filed against MFT’s in the research report include unprofessional conduct, incompetence, and breaches of confidentiality (AMFTRB, 2020). I reside in New Mexico (a state excluded from the AMFTRB report), however, I’m employed in the state of Texas as a psychiatric technician, and I intend on moving to Alabama sometime after graduation. The report indicates 7 violations in Alabama and 30 violations in the great state of Texas. Common violations/prohibited activities according to the report include non-sexual dual relationships, failure to meet CEU requirements, sexual misconduct, unlicensed practicing, misrepresentation, specific criminal convictions, impairment, and unprofessional conduct. Key Areas of Ethical Risk and Report Trends. Data depicts less ethical violations are correlated with clinical experience and years of practice while “two of the most commonly occurring categories, CE infractions and misrepresentation to the public, seem to deal with the counselors’ ability to maintain their professional license. The value of veracity is a core component of the ACA Code of Ethics (ACA, 2014), which has to do with one’s ability to deal truthfully in the professional community. Violations of these two categories demonstrate the need for counselors to receive initial and ongoing training on the importance of dealing truthfully with the public and licensing board” (Wilkinson et al., 2019., p.103). Interestingly, a difference of 23 ethical violations were reported

between the states of Alabama and Texas with a total of 405 marriage and family therapists Nationwide. Sixty-four % female, eighty-four % Caucasian, and ninety % married or partnered. Nine percent of marriage and family therapists responded that they had received complaints against their license, and sixty-one % of these violations were filed by clients. Roughly thirteen % of those violations were reported by other healthcare professionals, and another two % were filed by employers. Approximately twenty-seven % of these violations were against marriage and family therapists. Wilkerson et al., (2019) discuss successful trends to ameliorating these common violations by complying with maintaining licensure, obtaining continued education credits, and diligently practicing ethical billing, documentation, informed consent, and creating a “single clearinghouse or repository that can store and maintain ethical infractions across states” (p. 103). Regulatory Decisions. Rollins & Grames (2020) added to the report that the severity of sanctions depends on severity and frequency of the violation. Board decisions for serious offences may include license revocation or probation and being restricted from supervising, while lesser infractions include providing statements of compliance and paying fines and court costs. It is worthy to note that roughly 34% of documented complaints were dismissed without investigation, 38% were dismissed following investigation, 2.3 % dismissed with a warning, and 6.8% had consent agreements. The remaining 4.5% were moved for hearing, while 9% of outcomes were pending or unknown, and almost 5% were not disclosed. Alabama has a standard of prohibited activities but no unique prohibited activities for marriage and family therapist to follow, while Texas prohibits the promotion or encouragement of illegal use of alcohol or drugs by a client (Wood & Bergen 2020).

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Rational For Board Decisions. The disciplinary board’s groundwork in decision-making towards violations is based on the type of infraction and recurrences. The boards’ primary goal is to ensure that professional and ethical standards of conduct are being met and investigate consumer complaints. Compliance of clinical requirements, education, and training are the clinician’s responsibility, and training, documentation, and supervision are all used to combat even the smallest of violations. It also aids in discrepancies from state-to-state laws, rules, and regulations. As a Therapist How Would I Avoid These Types of Violations? Quality care is dependent on following both the AAMFT Code of Ethics and the Team- Health Code of Conduct to exercise good judgment and ethical decision-making. I can consult with other professionals in the field for specialization or knowledge, and stay informed on current scientific literature, information, and research. I can commit to operating in the profession with high integrity and avoid putting myself in compromising or unethical situations. I can also be cognizant of pitfalls and use awareness as a strategy to prevent ethical violations and professional abuse of power. Team-Health’s Code of Conduct is also a useful tool to address many issues that are of situational, legal, and ethical relevance to the profession. Clinicians should also always consult with their supervisors for guidance and direction. Part II. Identify a Violation and Apply an Ethical Decision-Making Model. Kitchener’s ethical decision-making model consists of the moral principles of autonomy, beneficence, nonmaleficence, justice, and fidelity. The formula is comprised of a four-step process that 1) determines if a situation requires an ethical decision, 2) formulate an ethical

course of action, 3) integrate personal and professional values, and 4) implementing a plan of action. Kitchener’s model is used in the scenario below and a graphic is included. Case Scenario. Mary, my client of 6 months, has decided to discontinue therapeutic services with me as her therapist ( autonomy ) due to an inappropriate response. Mary mistakenly misinterpreted my genuine concerns for her as her therapist by responding to a probing question with a romantic kiss. Mary now wants to stop her therapeutic treatment because of embarrassment and because I now know she is physically attracted to me. 1) ethical decisions are warranted. Violation AAMFT Code of Ethics 1.3 Multiple Relationships-Risks of impairment or exploitation due to conditions. 2) formulate an ethical course of action- do not abandon Mary ( beneficence ) or leave her feeling embarrassed, ashamed, guilty, or alone. Sensitively and maturely speak with Mary about her misinterpreted response and support her in seeking a new therapist. Refer-out. 3) Integrate personal and professional values. ( Nonmaleficence ) How would I want my feelings and actions to be considered if I made the same mistake? How would I want to be treated while remaining accountable? How do I move forward in treatment with this new vulnerability? These are questions I need to ask myself as her therapist before terminating services and referring Mary to a different clinician. 4). Implement a plan of action (Justice and fidelity). Execute fairness. Document all relevant information about the incident and refer Mary to another provider. Protect Mary, Myself, and her treatment plan accordingly. Stay professional, protect ethical boundaries, and initiate a smooth transition for Mary to her new clinician.

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Reference American Association for Marriage and Family Therapist. Code of Ethics. (2015). American Association for Marriage and Family Therapy. User's guide to the 2015 AAMFT code of ethics. American Association for Marriage and Family Therapy. Counseling Education. (2015-2021). Ethical decision making models American Counseling Association. Examination in Marriage and Family Therapy: Overview and Strategies (2016). Association for Advanced Training in the Behavioral Sciences. Ventura, CA: Vol (I & II). Wilkerson, T., Smith, D., & Wimberly, R. (2019). Trends in ethical complaints leading to professional counseling licensing boards disciplinary actions. Journal of Counseling & Development, 97 (1), 98-104 .

WK6 Critique Disciplinary Meeting Minuets

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