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Post the first draft of your Ethical Decision-Making Paper to the discussion forum for peer review on the first day of Topic 5. Label your paper with your first name.
To complete the Peer Review assignment, access the Peer Review Instructions.
Complete the peer reviews by the end of Topic 5.
Post your reviews as a reply to the original thread.
APA style is not required, but solid academic writing is expected.
Use the peer review feedback
you receive on your own paper to revise/edit your essay.
The final draft of the Ethical Decision-Making Paper is due to the instructor by the end of Topic 7.
Peer 1
Religion and psychology have often been on opposite sides of the spectrum. There becomes an ethical dilemma when abuse arises in the religious community within a marriage or family, or any clergy type relationship and at what point will a person report that or reach out for help to make a change. Some have deep religious beliefs that marriage should not be broken and may encounter abuse in a relationship but because of religious beliefs do not report the treatment. At what points to ethics come in and the cognitive behavioral standards set in over emotional beliefs of love and treatment? Beginning to practice teaching how to differentiate between ethical standards and emotional standards may be the key point needed to close the gap of this decision (Elliott, 2012).
Some may consider religion in itself as harmful for a clients welfare. Relgious impairment is a term used to describe some aspects of this when a clients use of logic and reasoning are no longer at forefront in matters of safety versus a deep religious belief (Yarhouse, 2003). Some may also see that the lack of belief as harmful when there have been studies of positive aspects of meditation and prayer practices. Ethical decision making is what helps in each clients case. Taking the clients autonomy and ability to choose what they think is beneficial in reducing harm to the client. A client should be able to make this choice and convey it with the therapist without any type of blame or leading from the counselor. This step of ethical decision making is the first one to take and widely popular in then proceeding to help the client. Depending on different religions and levels of conviction and position in the church there are different standards set for what remains confidential and what does not. Some clergy members are deemed to silence even in the face of abuse, while others are free to get help for a member of the church if a problem arises (Rudolfsson & Milstein, 2019). This is not the same 3
with the ethical standards of a therapist who is to report abuse when it is learned of and presents harm to the client. Some churches now have counselors they refer members to in order to help remedy this gap in standards.
A therapists must use the ethical decision making to act on the beneficence of a person to and are obligated to report mistreatment and for the benefit of others. A psychologist must take into consideration the moral worries of a client but also keep the knowledge of not imposing harm on others in key consideration (Kroll, et al., 2006). While moral beliefs are forefront for certain demographic areas the need for a strong ethical following is what keeps client’s welfare at the forefront of practice. No matter what beliefs there may be a therapist must keep ethical decision making a necessity and use it daily in aid to each client weather religiously inclined or not. 4
References
Elliott, M. (2012). The emotional core of love: The centrality of emotion in christian psychology and ethics. Journal of Psychology and Christianity, 31(2), 105-117. https://lopes.idm.oclc.org/login
Kroll, J., Carey, K., Johnson, M., Thuras, P., & Erickson, P. (2006). Psychiatrists’ attitudes and practices regarding the moral worries of their patients: A postcard survey. Mental Health, Religion & Culture, 9(2), 109–117. https://doi-org.lopes.idm.oclc.org/10.1080/13694670500071612
Rudolfsson, L., & Milstein, G. (2019). Clergy and mental health clinician collaboration in Sweden: Pilot Survey of COPE. Mental Health, Religion & Culture, 22(8), 805–818. https://doi-org.lopes.idm.oclc.org/10.1080/13674676.2019.1666095
Yarhouse, M. (2003). Ethical issues in considering “religious impairment” in diagnosis. Mental Health, Religion & Culture, 6(2), 131. https://doi-org.lopes.idm.oclc.org/10.1080/1367467021000038219
Peer 2
Ethical Decision Making
The ethical dilemma that I have chosen to evaluate is the situation of gift giving and receiving. There are many aspects to consider when it comes to either receiving or giving a gift and whether they violate ethical boundaries. In some cases, cultural norms may need to be considered as well as milestone gifts, and gifts from children can all be gray areas in which a provider may find themselves struggling to make the ethical decision. Gift-giving and receiving within the parameters of a therapeutic relationship can present precarious situations that can be difficult to navigate, it’s important to utilize an ethical decision-making model to work through decisions that lead to boundary crossing.
Gift Receiving
Receiving a gift from a patient may sound like boundary crossing to some, however, others believe this may be an integral part of the therapeutic process as it can be part of establishing a connection with the therapist, as in child-centered play therapy. “For instance, for the child to feel safe enough to freely communicate his or her needs, the child may feel it necessary to present a gift to the therapist. The child’s expression of self may be inhibited if the therapist chooses to refuse the gift” (Blanco & Sheely-Moore. 2012). Gift giving can also represent cultural norms.
“Counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and showing gratitude. When determining whether or not to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, a client’s motivation for giving the gift, and the counselor’s motivation for wanting or declining the gift” (Standard A.lO.e. as cited in Blanco & Sheely-Moore. 2012).Whatever the circumstances, therapists must be aware of the many facets involved in receiving a gift from a patient.
Gift Giving
It has been suggested that there may be many cases in which a patient may benefit from receiving a gift from their therapist, such as a token to express mile markers or achievements within the therapy process. Other circumstances in which gift giving may take place is the providing tools and resources that the patient may need to complete tasks assigned by the therapist. This could include journals, writing utensils, or books (Shelton, K. 2020).
I believe a key factor in evaluating whether a therapist is giving gifts inappropriately would be to ask questions such as; are these gifts or a variant appropriate to the patient, available to all clients? What is the therapists motive? How will this impact the dynamic of the relationship? Does the patient have the option to decline the gift, if so will this affect the relationship?
Ethical Decision-Making Model The ethical decision-making model I used to evaluate this situation is the ‘Practitioner’s Guide to Ethical Decision Making. This is a seven-step method that I retrieved from the counseling.org website. These steps include; identifying the problem, applying the ACA code of ethics, determining the nature and dimensions of the dilemma, generating potential courses of action, considering the potential consequences of all options and determining a course of action, evaluate the selected course of action, and implement the course of action (Forester-Miller & Davis, 2017).
“How do professionals apply the decision-making model in such situations? Quite simply, they comply by having done their ethics homework and by prior integrating the ethical values of the profession. In addition to a firmly grounded commitment to ethical ideals, counselors and therapists must have sufficient knowledge to arrive at a decision based on more than intuition. They advance the process by being well studied in the ethics codes and guidelines and by having prior practice in applying the standards to real” (or realistic) situations(Welfel, 2016. pg. 30)., Conclusion
There is no argument that to circumvent the unrealistic expectations or hurt feelings, providers should establish boundaries within their informed consent documentation before treating patients. “Boundaries provide structure for the process, safety for the client, and the required emotional distance for effective therapeutic work” (Gabbard, 1994; Sommers-Flanagan et al., 1998 as cited in Welfel. 2016).
In addition to using an ethical framework model, it is important to take into consideration within any dilemma or decision; autonomy, justice, beneficence, nonmaleficence, and, fidelity. Giving or accepting a gift should never impede someone’s quality of care, their access to care, their choice of care, or in any other capacity. If it can do so, the gift should not be given or received. When in doubt, consult a colleague or supervisor to ensure that boundary crossing doesn’t turn into boundary violations. Reference
American counseling association. (2017). Practitioner’s guide to ethical decision making. https://www.counseling.org/docs/default-source/ethics/practioner-39-s-guide-to-ethical-
decision-making.pdf
Blanco, P. J., & Sheely-Moore, A. I. (2012). Gift Giving and Receiving in Child-Centered Play Therapy: An Ethical Response. Journal of Humanistic Counseling, 51(1), 66–77.
Shelton, K. (2020). Good therapy. Is it ever okay to give or accept a gift in therapy? https://www.goodtherapy.org/for-professionals/personal-development/therapeutic-alliance/article/is-it-ever-okay-to-give-or-accept-gift-in-therapy
Welfel, E. R. (2016). Ethics in Counseling and Psychotherapy: Standards, Research, and Emerging Issues (6th Ed.). IBSN-978-1-305-08972-3

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