Therapeutic Boundaries

This assignment focuses on vignette analysis and direct application of course concepts to the persons, and situations presented in the vignette. All assignments MUST be typed, double-spaced, in APA style, and must be written at graduate level English. Your responses must be written in an original personal and/or professional synthesis of the text and research.
You must integrate the material presented in the assigned text.

You are also required to integrate additional evidence-based research, taken from professional journals, to support and enhance the textbook information. A minimum of 4, current, research articles are required

You must identify and cite the Code of Ethics that are relevant to each of the vignettes. The Ethics Codes are located in under Resources. If the links do not work, please copy and paste them into your browser.

You must illustrate multicultural competence. All discussions must take into account issues of culture and human diversity that may pertain to the situations presented below. Information on Culture and Diversity are covered in the course text, but you are encouraged to utilize other cultural resources to enhance your analysis for this assignment. For example, if the client in the vignette is a Native American who asks to participate in a healing ritual, you would research Native American ceremonies and the ethical issues relating to this.

Please keep your responses focused on what is presented in the vignette. Creativity is encouraged but do not add information or change the vignette.

Your response to each vignette should be approx 2 ½-pages per vignette.

Your entire assignment will be approx 10 pages total plus a title and reference page.

For each of the four vignettes presented below:
What are the ethical issues in the case? Identify the issue in the ethics code.

Did the professional act in a manner consistent with current standards and principles? If not, what other courses of action would be more ethical? Support your decision by identifying the standards and principles relevant to this case.

Are there any indications of bias, stereotyping or marginalization present?

If relevant did the professional advocate for the client?

How can colleagues and supervisors help the professional to act ethically in this situation? Please be specific.

Vignette 1
Marlene is a certified school counselor and licensed clinical counselor specializing in a faith-based approach to healing. She has spent twenty years working with adolescents in a variety of school and clinical settings and has developed extensive competency in spiritual counseling of adolescents with developmental, educational, and mental health issues. She is known in her high school as the counselor “kids can trust”. In the last year there have been numerous reports in the media about teenage girls who have hidden their pregnancies from their families, delivered babies alone, and had babies who died soon after birth, either because of the girl’s actions or independent of them. In fact, one of the more notorious of these cases occurred in the town next to Marlene’s school. As a result, the school principal has mandated that all personnel who know of or suspect a student pregnancy should immediately notify parents and the school principal. Marlene is disturbed by this edict and fears it will jeopardize her open-door policy with students. Therefore, she decides to ignore it.

Vignette 2
Linda is a psychologist who works in the counseling center of a prestigious college with a large number of international students. She says that she could never really learn enough about the varied cultures from which many of her clients come, so she relies on the clients to teach her about their cultural background. When, for example, she had a client from Indonesia, she asked that young man directly about the ways in which he thought his culture affected his thoughts, feelings, and behavior. Linda says that because her clients are all gifted students, they have good insight into their culture and she relies heavily on their interpretation of the role of culture in their lives. She is content that she needs no other knowledge base.

Vignette 3
Petra is a 27-year-old woman who is a recent immigrant from Bosnia. She lost three brothers during the war there. She lives in the U.S. with her parents and she works as a meter-reader. Over the last 6 months Petra has become increasingly depressed. Her work performance has suffered and the employee assistance program at work has referred her to Jonathan for therapy. Jonathan is an experienced mental health professional who also conducts research on the effectiveness of psychotherapy for depression. He has never worked with a recent immigrant, and he has little knowledge of the war in Bosnia. Jonathan decides to refer Petra to another clinician who is from Eastern Europe, but whose knowledge and experience in treating depression is not as extensive as his.

Vignette 4
Marvin, is 28-year-old war veteran. He was diagnosed with posttraumatic stress disorder (PTSD) after he returned from military combat. In addition to PTSD, Marvin suffers from occasional bouts of serious depression. Marvin enters graduate school in counseling, hoping to provide therapy to other young veterans who have been traumatized. Although his academic performance in graduate school is satisfactory, he has been unable to provide competent therapy to his clients in internship. He cannot separate his own experiences and emotions from those of his clients and as a result, he sometimes misdiagnoses their problems and misinterprets their thoughts and feelings. Repeated efforts to help Marvin develop better skills and insight are unsuccessful. Consequently, he fails internship and is dismissed from the program. Marvin is frustrated and calls the actions of his supervisors unethical even though he does not disagree substantially with the faculty’s assessment of his clinical skills. He asserts that his compassion for clients and empathy for their pain should compensate for his deficiencies in other areas. Eventually, Marvin finds an unaccredited degree program from which he successfully graduates after which he opens a private practice. In this practice, he offers professional services to survivors of childhood sexual abuse.

Assignment Outcomes
Consider the impact of personal values, stereotypes and biases.

Discuss culture and diversity as ethical issues.