MFT5222-Wk3 Asignment

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Applying the Decision-Making Model 1 Applying the Decision-Making Model Tiffany Beard Capella University MFT5222: Professional Ethics in Marriage and Family Therapy January 28, 2024

Applying the Decision-Making Model 2 Introduction In the field of marriage and family therapy, ethical decision-making is paramount to ensure the well-being and safety of clients. In this vignette, Jim, a marriage and family therapist (MFT) for 10 years, has found himself in an ethical dilemma. Prior to his first session with his new clients, John and Sally, he ensured all necessary forms were completed and thoroughly reviewed. In the first session Jim noticed bruising on John’s neck. Jim is aware of the dominant-submissive nature of their relationship, whereas Sally is a 23-year-old dominant identifying as bisexual and John is a 35-year-old submissive identifying as heterosexual. While Sally identifies as dominant, she does not identify as a sadomasochist. Jim asked to meet with each partner alone individually for 10 minutes, and during this time he inquired about John’s safety. John reassured him has fully consented to physical intimacy action and he feels safe. Later, Jim runs into John at an AI- Anon meeting he attends regularly, but this is John’s first time attending. After the meeting, John asks Jim if they can talk privately about issues, he did not want to share at the session in the couple’s first visit. John disagrees with John and Sally’s lifestyle, and he has never worked with bondage, discipline, dominance, submission, and sadism (BDSM) sexual preferences. Jim is left wondering what his ethical responsibilities are pertaining to treating John and Sally. I will be using the SLEEPP decision-making model and the principles outlined in the AAMFT Code of Ethics to analyze the steps Jim must take to address the ethical complexities of the case. Applying the SLEEPP Decision-Making Model (S)ociocultural Considerations: According to Murphy and Hecker (2016), sociocultural considerations include gender, race, sexual preferences, class, religion, and ability to the problem, issue, or dilemma (pg. 534). Jim acknowledges the societal stigma and misconceptions surrounding BDSM practices. He also recognizes the importance of cultural competence in

Applying the Decision-Making Model 3 understanding and respecting the couple's sexual preferences and identities. He has also acknowledged conflict of interest as it relates to their lifestyle, but it is not clear the cause of disagreement. The substantial age gap between this couple and Sally's non-identification as a sadomasochist might prompt the therapist to wonder if John is coercing Sally into conforming to his sexual desires. An applicable example of this step in practice is Jim acknowledging the societal stigma and misconceptions surrounding BDSM practices. He recognizes that societal attitudes towards alternative sexual practices may influence how John and Sally perceive themselves and their relationship. Jim takes care to approach the couple's sexual preferences with cultural competence and non-judgmental understanding. (L)egal Implications: Depending on state laws, there may be legal implications. Jim will need to know his legal obligations as a mandated reporter in cases of suspected abuse. He will need to remain vigilant throughout the therapeutic process to assess signs of coercion or harm within the couple's relationship and ensure he fulfills his legal obligation to report any concerns, if required in his state. As far as informed consent, he did ensure that all necessary consent forms were completed and reviewed. He must adhere to legal requirements and effectively protecting client confidentiality. (E)thical Imperatives: Jim's primary ethical responsibility is to ensure the well-being and safety of his clients. He must balance respect for autonomy and self-determination with the duty to protect clients from harm. Jim should assess whether John's participation in BDSM activities is truly consensual and free from coercion or abuse. He may need to explore the power dynamics within the relationship to ensure equitable consent. Since it has been indicated that Jim disagrees with this lifestyle and this is his first time working with BDSM sexual preference, he should be mindful of Standards 3.4 (Conflicts of Interest), 3.10 (Scope of Competence), and 1.10

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Applying the Decision-Making Model 4 (Referrals) of the AAMFT Code of Ethics. Lastly, AAMFT Code of Ethics (2015) Standard 1.3, Multiple Relationships, stresses the significance of upholding professional boundaries to preserve the integrity and efficacy of the therapeutic process. This standard warns against engaging in multiple relationships with clients that could compromise the therapist's objectivity, professional judgment, or lead to exploitation (pg. 3). John's request to speak privately with Jim in a public setting presents a potential challenge to maintaining appropriate boundaries. While John's initial intention may have been to provide Jim with additional information, the public setting could blur the lines between personal and professional interactions, potentially leading to the formation of an alliance or coalition between John and Jim outside the therapeutic context. alliances or coalitions can undermine the therapeutic process by eroding the therapist's impartiality and objectivity. Jim may feel compelled to prioritize John's interests or confidentiality over the best interests of the therapeutic relationship or Sally's well-being. Additionally, the power dynamics inherent in the therapist-client relationship may be further exacerbated if Jim agrees to John's request without careful consideration of the potential consequences. Jim should carefully consider the potential risks and benefits of agreeing to John's request. He should assess whether meeting privately with John in a public setting could compromise his ability to maintain professional boundaries and provide impartial and effective therapy to both John and Sally. If Jim determines that meeting privately with John could undermine the integrity of the therapeutic process or pose a risk of exploitation, he should respectfully decline the request and explore alternative ways to address John's concerns within the bounds of ethical practice.

Applying the Decision-Making Model 5 (E)conomic Impact: While not directly applicable in this case, Jim should consider any financial implications related to ongoing therapy sessions and ensures affordability and accessibility for his clients. (P)olitical Ramifications: While there are no political ramifications in the situation, Jim should ensure he is aware of any political debates related to BDSM. This could contribute to his clients’ attitudes and positions related to their sexual preferences. An applicable example of this step in practice is Jim remaining aware of political debates and societal attitudes towards BDSM practices. He advocates for the rights and autonomy of individuals engaged in consensual BDSM relationships while challenging stigma and discrimination. Jim's advocacy aligns with ethical imperatives related to social justice and anti-discrimination. (P)ower: Given the dominant-submissive dynamic within the couple's relationship, Jim must be attuned to power differentials and ensure that both partners have a voice and agency in the therapeutic process. Jim should be cautious not to inadvertently reinforce or perpetuate an unequal power dynamic within the therapeutic relationship. Jim must also consider how his personal identity, professional role, and the systemic context of therapy intersect to shape power dynamics within the therapeutic relationship. An applicable example of this step in practice is Jim carefully examining the power dynamics within the couple's relationship and the therapeutic context. He ensures that both partners have agency and voice in the therapeutic process, avoiding reinforcing unequal power dynamics. By conducting individual sessions with each partner, Jim empowers them to express themselves openly and addresses any dynamics of coercion or control within their relationship.

Applying the Decision-Making Model 6 Conclusion In conclusion, applying the SLEEPP Decision Making Model and principles outlined in the AAMFT Code of Ethics to this vignette involves a comprehensive assessment of sociocultural, legal, ethical, economic, political, and power-related factors to guide Jim in fulfilling his ethical responsibilities as a therapist treating John and Sally. By considering these dimensions, Jim can navigate the complexities of the couple's relationship dynamics and provide effective, culturally sensitive therapy while prioritizing client safety and well-being. Jim has mentioned he is inexperienced with treating couples with BDSM sexual preferences. As the American Association for Marriage and Family Therapy (2015) Code of Ethics outlined in Standard 3.3, Seek Assistance, Jim should consult with a supervisor or colleague experienced in treating couples with diverse sexual preferences, such as BDSM dynamics. Consulting with someone who has expertise in this area can provide valuable insights and guidance in navigating the ethical dilemmas presented in the case. After seeking appropriate professional assistance, Jim should decide if he feels competent to treat the couple to avoid violating the AAMFT Standard 3.10, Scope of Competency (AAMFT, 2015, pg. 5). If determined this case is out of scope for him, AAMFT Standard 1.10 states he should refer his clients to another therapist who is more qualified to take this case (AAMFT, 2015, p 3). If determined Jim feels qualified to provide therapeutic services to John and Sally, he should then examine his own biases and values regarding BDSM and ensure they do not interfere with his ability to provide non-judgmental and effective therapy. If he cannot get past his own issues with the BDSM lifestyle because of a conflict of interest, he should refer to another therapist who can provide therapeutic services beneficial to his clients (AAMFT, 2015, pg. 5). According to Murphy and Hecker (2016), power must be analyzed in the context of therapists' personhood and identity, their professional role,

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Applying the Decision-Making Model 7 and the systemic power dynamics within which they operate (pg. 535). By critically examining and addressing these power differentials, Jim can create a more equitable and empowering environment for his clients to engage in the therapeutic process. This approach is consistent with the ethical imperatives outlined in the AAMFT Code of Ethics, especially those pertaining to encouraging client autonomy, cultural competence, and social equity. Ultimately, ethical decision-making in therapy requires ongoing reflection, dialogue, and commitment to promoting the well-being and dignity of clients. By embracing diversity, cultural humility, and a commitment to social justice, therapists can uphold the highest ethical standards, while effectively supporting clients on their journey towards health and healing.

Applying the Decision-Making Model 8 References American Association for Marriage and Family Therapy. (2015). Code of Ethics https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx Murphy, M. J., & Hecker, L. (Eds.). (2016). Ethics and professional issues in couple and family therapy . Taylor & Francis Group.

MFT5222-Wk3 Asignment

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