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Navigating Ethical Dilemmas in Professional Psychology [Your Name] Clinical Psychologist Harmony Wellness Center

Dealing with an Ethical Dilemma Related to a Cultural Conflict  Professional Setting: Harmony Wellness Center  Individuals Involved  Me (Clinical Psychologist)  Sarah Williams, M.S. (Intern Therapist)  Rita Patel (Client)  Ethical Dilemma  Confidential Revelation  Duty to Warn/Protect  Supervision Responsibilities  Challenges and Considerations  Communication barriers due to cultural incongruence.  Power distance orientation impacting trust and collaboration in the therapeutic alliance.  Ethical concerns regarding confidentiality and duty to warn or protect in light of potential harm to Rita's family

Cultural Differences [Your Name] Rina Patel • Individualistic values, emphasizing personal autonomy and independence • Collectivist culture, valuing close-knit family connections and group harmony • Lower preference for hierarchical structures and authority • Higher value on respecting authority figures and clear hierarchical structure • Direct communication style • Prefer indirect communication. Rely on no-verbal cues

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Relevant Biases • Ethnocentrism • Increase cultural exposure through workshops and readings • Confirmation bias • Actively seek diverse perspectives during case discussions

Ethical Concerns • Breach of Confidentiality – Apply Ethical Standard: APA Ethical Principle 4.01 (Maintaining Confidentiality) • Duty to Warn/Protect – Apply Ethical Standard: APA Ethical Principle 4.05 (Disclosures) • Supervision Responsibilities – Apply Ethical Standard: APA Ethical Principle 10.02 (Therapy and Ethical Education)

Deontological Ethics Virtue Ethics • Focus on Duties and Rules • Emphasis on Moral Character • Rule-Oriented Framework • Focus on Personal Integrity • Emphasis on Universal Principles • Holistic View of Ethical Behavior Comparison of Deontological & Virtue Ethics Theories

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Ethical Decision Making with the Fisher's Eight-Step Decision-making Model • Step 1: Develop and sustain a professional commitment to doing what is right. – Establish a commitment to ethical decision-making and adherence to professional standards. – Acknowledge cultural variations in defining what is considered ethically right, considering diverse perspectives on morality. – Sarah and I must navigate their differing cultural backgrounds in determining what constitutes the right ethical course of action. • Step 2: Acquire Sufficient Familiarity with APA's "Ethical Principles" – Familiarize with ethical principles to anticipate and identify ethical situations. – Recognize cultural nuances in ethical principles, understanding that interpretations may vary across diverse cultural backgrounds. – Sarah and I, with distinct cultural backgrounds, need to navigate the interpretation of ethical principles in the context of their multicultural perspectives.

Ethical Decision Making with the Fisher's Eight-Step Decision-making Model • Step 3: Gather Additional Facts Relevant to the Ethical Situation – Collect additional information from guidelines, laws, and policies. – Consider how cultural factors may influence the ethical situation and information gathering, recognizing diverse cultural perspectives on confidentiality and disclosure. – Sarah and I must be attuned to potential cultural variations in Patel’s views on confidentiality and disclosure. • Step 4: Understand the Perspectives of Different Stakeholders – Consider the impact on all parties involved and consult with colleagues. – Recognize diverse cultural perspectives among stakeholders, ensuring a culturally sensitive approach to understanding their views. – Sarah and I must navigate cultural variations in understanding Patel’s perspectives, ensuring a holistic consideration of cultural factors. • Step 5: Apply Steps 1-4 to Generate Ethical Alternatives – Apply ethical theories and principles to generate alternatives. – Consider how cultural factors may influence the generation of alternatives, recognizing diverse cultural approaches to ethical decision- making. – Sarah and I need to integrate their multicultural perspectives to generate alternatives that align with ethical principles and respect cultural nuances.

Ethical Decision Making with the Fisher's Eight-Step Decision-making Model • Step 6: Select and Implement an Ethical Course of Action – Choose an ethical response. – Recognize that cultural variations may impact the chosen course of action, ensuring a culturally competent and sensitive approach. – We must collaborate to select an ethical course of action that respects cultural differences and aligns with ethical principles. • Step 7: Monitor and Evaluate the Effectiveness of the Course of Action – Assess the effectiveness of the chosen action. – Consider how cultural factors may influence the effectiveness of the chosen action, recognizing diverse cultural responses to interventions. – We need to monitor the impact of their chosen course of action, being mindful of cultural variations in Patel’s response and well- being. • Step 8: Modify and Continue to Evaluate the Ethical Plan – Adjust the ethical plan if necessary. – Recognize that cultural variations may necessitate modifications to the ethical plan, ensuring ongoing cultural competence (Fisher, Fried & Masty, 2007). – Sarah and I must be open to modifying their ethical plan based on ongoing cultural considerations and evolving ethical dynamics.

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Best Practice for Working With Communication Style • Best practice : Incorporating Cultural Formulation in Assessment (APA, 2013) – Aligns with the cultural identity of Communication Style – Encourages a comprehensive understanding of Rina's cultural background, values, and beliefs

Best Practice for Working With Power Distance • Best practice : Culturally Competent Supervision (Ladany et al., 1997) – Aligned with the cultural identity of Power Distance – This best practice focuses on the dynamics of authority and hierarchy within the therapeutic relationship.

Best Practice for Working With Individualism/Collectivism • Best practice : Intercultural Sensitivity Training (Chen & Starosta, 2000) – This best practice is particularly relevant to the cultural identity of Individualism/Collectivism. – Intercultural sensitivity training emphasizes understanding and adapting to diverse cultural perspectives, aligning with the collectivist values present in Rina Patel's cultural background. – It promotes empathy and cooperation, crucial for bridging cultural gaps in individualistic-collectivistic dynamics.

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Proposed Resolution • Summarized Resolution – As the clinician, I should be informed of the potential harm to Patel’s family – Collaborate with Sarah and the client on the appropriate course of action – Provide guidance to Sarah on navigating confidentiality dilemmas in supervision • Justify your resolution – Grounded in a careful consideration of ethical principles, professional obligations, and the welfare of all involved parties

References • American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct. https://www.apa.org/ethics/code • Center for Substance Abuse Treatment (US). Improving Cultural Competence. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 59.) 1, Introduction to Cultural Competence. https://www.ncbi.nlm.nih.gov/books/NBK248431/ • Chen, G. M., & Starosta, W. J. (2000). The development and validation of the intercultural sensitivity scale. Human Communication, 3(1), 1–15. • Ladany, N., Inman, A. G., Constantine, M. G., & Hofheinz, E. W. (1997). Supervision of multicultural supervisees. The Counseling Psychologist, 25(4), 594–604. https://doi.org/10.1177/0011000097254008 • Lewis-Fernández, R., Aggarwal, N. K., Bäärnhielm, S., Rohlof, H., Kirmayer, L. J., Weiss, M. G., Jadhav, S., Hinton, L., Alarcón, R. D., Bhugra, D., Groen, S., van Dijk, R., Qureshi, A., Collazos, F., Rousseau, C., Caballero, L., Ramos, M., & Lu, F. (2014). Culture and psychiatric evaluation: operationalizing cultural formulation for DSM-5. Psychiatry, 77(2), 130–154. https://doi.org/10.1521/psyc.2014.77.2.130

References • Benlahcene, A., Zainuddin, R. B., Syakiran, N., & Ismail, A. B. (2018). A narrative review of ethics theories: Teleological & deontological Ethics. Journal of Humanities and Social Science (IOSR-JHSS), 23(1), 31-32. • Fisher, C. B. (2023). Decoding the ethics code: A practical guide for psychologists (5th ed.). Sage. • Fisher, C. B., Fried, A. L., & Masty, J. K. (2007). Critical thinking and ethics in psychology. Critical thinking in psychology, 271-288. • Lewis-Fernández, R., Aggarwal, N. K., Bäärnhielm, S., Rohlof, H., Kirmayer, L. J., Weiss, M. G., Jadhav, S., Hinton, L., Alarcón, R. D., Bhugra, D., Groen, S., van Dijk, R., Qureshi, A., Collazos, F., Rousseau, C., Caballero, L., Ramos, M., & Lu, F. (2014). Culture and psychiatric evaluation: operationalizing cultural formulation for DSM-5. Psychiatry, 77(2), 130–154. https://doi.org/10.1521/psyc.2014.77.2.130 • Trianosky, G. (1990). What is virtue ethics all about?. American Philosophical Quarterly, 27(4), 335- 344.

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