ASSESSMENT 2 - CASE ANALYSIS
 

Scenario 1: A psychologist has an inappropriate relationship with a client

The video demonstrates a serious ethical violation in the area of psychology which is presented with a fictional psychologist, Mr. Roberts, who enters into a relationship with his patient, Mr. Smith, thereby breaching the ethical boundaries. Such a behavior is in clear violation of the APA Ethics Code, which explicitly forbids such relationships to protect the client’s integrity and prevent exploitation. Mr. Roberts' ethical deviation creates an uneven power relationship that may lead to emotional damage to the client and make the therapy less effective (Cooper, 2016).

Furthermore, the psychologist's effort to minimize the severity of the infraction and apportioning some responsibility to the client displays a lack of professional accountability and ethical insight. The effects of such an ethical breach are not limited to the short-term damage inflicted on the client, but they also undermine the public trust in psychological services and negatively influence the professional integrity of the psychological profession (Levine & Courtois, 2021).

The situation points out the vital role of keeping boundaries that are clear and protect the client from harm and the therapeutic relationship remains safe and supportive. To this end, it underlines the necessity of regular ethics training and self-awareness for professionals to avoid such breaches. In the last instance, this ethical breach draws attention to the topmost role of professional ethical standards, not only to safeguard individuals facing psychological services but also to maintain the integrity and trustworthiness of the psychological profession.

In dealing with the ethical breach as shown in the case description, I would selectively use the components of the ACTION model to guarantee an ethical and responsible resolution. To address this, I would first concentrate on the Awareness stage so that I could become aware of my feelings and the client’s behavior, which are based on my professional ethics. This could be accomplished by acknowledging the potential for harm and conflict with professional standards.

Next, the classify stage would be important in recognizing the situation as an ethical dilemma, which would emphasize the necessity for a careful navigation to preserve the client’s autonomy as well as the integrity of the therapy relationship. To me, the core would be reflection, consulting with a supervisor or a colleague who is experienced in that area and researching on ethical ways to refuse the client’s advances without crossing professional lines (Blustein et al., 2019).

The main difficulty that may arise in the implementation of the ACTION model is the subjective nature of the Awareness stage where personal biases and emotions could influence the judgment and complicate the process of detecting and resolving the ethical dilemma properly (Passmore, 2011). This emphasizes the fact that reflection and expert consultation can help to resolve ethical issues without causing harm to clients and without breaking the standards of psychological practice.

Scenario 3: A social worker does not meet their Duty of Care

In the case study that is presented, the social worker’s management of Sebastian’s case is a breach of ethics in the context of an inappropriate reaction towards family violence and self-harm disclosures, which is a violation of the Australian Association of Social Workers (AASW) Code of Ethics (2020). According to the code, which encourages the protection of vulnerable groups, this breach is defined as failing to report and safeguard the client. This critical component has the potential to worsen the client's trauma and block them from receiving the interventions they need.

Besides that, the social worker's decision to prioritize short-term educational goals over immediate concerns of safety reflects a lack of alignment with the fundamental ethical principles of social justice, the dignity and worth of the person, and the significance of human relationships (Allan, 2021). This method ignores the overall well-being of the client, underestimating the importance of domestic violence and self-harming on Sebastian's psychological and emotional state, and it also does not consider the AASW Code of Ethics, which requires urgent and sensitive approach when such critical issues arise. This case illustrates the need for social workers to use the ethical guidelines in a way that their clients' safety, dignity, and well-being are the top priorities.

In this case, I would have made safety and mandatory reporting a priority, which is different from the initial approach that ignored these two crucial elements. The ACTION model would have been used with the emphasis on the Awareness and Classify stages, in which the ethical breach would be identified and understood—specifically the failure to report the client and the negligence of the client's immediate safety.

Implementing the ACTION model involves first and foremost, the process of Classifying and Initiating, where the ethical dilemma would be identified as a duty breach, and a plan to remedy this would be formulated. This plan would first entail immediate actions like reporting the disclosed family violence and self-harm, and then gaining more support for Sebastian to make sure these steps are in line with ethical codes and personal values so that the client's interests are better served (Godden, 2017). The ACTION framework implementation may have challenges, particularly in the sense of balancing the urgency of the immediate action with the need for a full ethical analysis.

The Option Evaluation stage may pose a risk of professional obligations and personal values clash that should be handled with great care to ensure both ethical integrity and the client’s trust. All in all, the ACTION model underscores a systematic, ethical approach based on the principle of client safety and general welfare in social work practice. 

Scenario 4: A Criminologist makes a Diagnosis without Evidence

The ethical dilemma here concerns a criminologist who diagnoses a prisoner Gary with borderline personality disorder without properly assessing him. These actions stand in opposition to certain ethical principles that serve as the basis of mental health care.  If the criminologist makes a mistake in diagnosis and treatment, the principle of non-maleficence, which is in Latin “primum non nocere” or “above all, do no harm”, is violated, and instead of improving Gary’s condition, it may become worse (Fazel et al., 2016).

In addition, the principle of beneficence which stipulates that the health workers must act in the best interest of the patients by improving their well-being is violated when the diagnostics are rushed without proper investigation (Hattab, 2021). The ethical concern also lies within the autonomy principle that emphasizes the patient’s right to know and to choose the treatment (Varkey, 2021).

The criminologist's decision to diagnose without a full assessment robs Gary of the right to make well-informed choices about his care, which reduces his dignity and self-determination rights. This method not only endangers Gary's well-being but also the ethicality of psychological practices in correctional institutions, showing the depth of the problem which is not restricted to this particular case and extends to the whole system of mental health care in such places.

In the event that the scenario presented would have been my case, I would have used a more thorough approach to the diagnosis of Gary using the ACTION model for ethical decision-making. Ethical complexities of diagnosing mental health conditions in the correctional environment would be acknowledged, and I would focus on the 'Awareness' and 'Option evaluation' stages of the model. This implies that I first of all make sure that I fully understand my own duties as a clinician and the ethical implications of making a diagnosis without having a complete assessment. The main thing I would be very conscious of is the possibility of Gary being injured from a diagnosis and not just for Gary but within the whole context of correctional mental health care.

At the 'Option evaluation' stage, I would explore all the avenues for assessment that are available, including the option of a multidisciplinary approach and seeking advice from colleagues in order to have a wider perspective on Gary's condition. During this phase, a close assessment of my biases and prejudice will be conducted to make sure that they do not make me reach a wrong diagnosis. The key problem in this approach is the fact that it may be limited by the institutional barriers that restrict the access to the resources which are needed for the full evaluation (Forrester et al., 2018).

Apart from it, there will be resistance from the inside of a correctional system to do a more thorough and time-consuming process of mental health evaluations. In summary, although the ACTION model serves as a useful tool for ethical decision making, it is not without its challenges when applied to the correctional context. The application requires not only a commitment to ethical principles but also a proactive approach to overcoming systemic barriers.
 

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References

Allan, A. (2021). The Australian code of ethics. In Handbook of International Psychology Ethics (pp. 77-93). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9780367814250-6/australian-code-ethics-alfred-allan 
Blustein, D. L., Kenny, M. E., Autin, K., & Duffy, R. (2019). The psychology of working in practice: A theory of change for a new era. The Career Development Quarterly, 67(3), 236-254. https://doi.org/10.1002/cdq.12193 
Cooper, S. H. (2016). Blurring boundaries or why do we refer to sexual misconduct with patients as “boundary violation”. Psychoanalytic Dialogues, 26(2), 206-214. https://doi.org/10.1080/10481885.2016.1144983 
Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: prevalence, adverse outcomes, and interventions. The Lancet Psychiatry, 3(9), 871-881. https://doi.org/10.1016/S2215-0366(16)30142-0 
Forrester, A., Till, A., Simpson, A., & Shaw, J. (2018). Mental illness and the provision of mental health services in prisons. British Medical Bulletin, 127(1), 101-109. https://doi.org/10.1093/bmb/ldy027
Godden, N. J. (2017). The love ethic: A radical theory for social work practice. Australian Social Work, 70(4), 405-416. https://doi.org/10.1080/0312407X.2017.1301506 
Hattab, A. S. (2021). Healthcare Ethics: From Medical Paternalism to Patient Autonomy. In Handbook of Healthcare in the Arab World (pp. 1603-1619). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-36811-1_77 
Levine, S. B., & Courtois, C. A. (2021). Boundaries and ethics of professional conduct. https://psycnet.apa.org/doi/10.1037/0000247-003 
Passmore, J. (Ed.). (2011). Supervision in coaching: Supervision, ethics and continuous professional development. Kogan Page Publishers.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119