PSY 699 Reply to Colleague Jessica’s Post Week 3 Discussion 1 The Ethnics of Mandated Treatment
Assignment Details: Provide specific, research-based arguments to support your reasoning as you create your responses. Did your colleague give full consideration to the ethical implications presented in the scenario? Was the recommendation mindful of specific client factors which could potentially cause an adverse response to mandated treatment? What further challenges might your colleague have considered in his or her recommendation(s)? Did your colleague utilize appropriate research to support his or her recommendations? Do you agree with the recommendations made by your colleague for both of the situations? (SEE JESSICA’S POST BELOW)
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Jessica Johnson Week 3 Discussion 1 Post: The Ethnics of Mandated Treatment
Scenario 1 and 2
The filing of a legal request (in scenario 1) by the psychiatrist requesting mandated treatment for the client poses substantial challenges to the ethical principle of informed consent. According to APA (2017), code 10.01 mandates therapists to obtain consent from their clients at the feasible earliest; a fact that is overlooked in the matter. However, principle C (integrity) can be quoted as a justification for the filing for mandated treatment. Darby and Weinstock (2018) states that informed consent is founded on the principle of autonomy and accords the client with substantial power to control or influence decisions related to their health or treatment process. Richards (2009) adds that mandated treatment poses a major challenge to informed consent.
Drawing from scenario 2, the implementation of mandated treatment for the client with bipolar disorder would also breach the ethical principle of informed consent to treatment. Since the client is not posing any imminent danger or threat to the community, the therapist should consider other approaches to drive voluntary treatment and avert the risk of breaching ethics regarding informed consent.
Despite mandated treatment’s intrusion into the client’s autonomy in scenario 1, the debate between individualism and the common good is evident in the scenario. The premise of the common good holds that the benefit to all members of a community is important than that of an individual (Bayer, 2007).Therefore, the pursuit of mandated treatment for the potentially dangerous to the community is inevitable for the realization of the common good.
There exists substantial evidence for the effectiveness of treatment for potentially dangerous clients under coercion(scenario 1). According to Coviello et al. (2013), mandated treatment has proved to be an effective tool in community-based outpatient treatments for dangerous clients. The approach has been proved to maintain control over involuntary clients; thus, boosting the premises of individualism and the common good. However, treatment is ineffective in such a case without any form of coercion. Hachtel et al. (2019) point out that voluntary clients demonstrate intrinsic motivation for treatment; a phenomenon that is inexistent in this scenario. Therefore, treatment can only be effective if the patient is coerced.
Evidence for the effectiveness of treatment without the use of coercion in this type of situation (scenario 2) has been highlighted in previous research. Hachtel et al. (2019) argue that voluntary clients are intrinsically motivated by their innate psychological needs; thus, increased treatment efficiency. In the case of coercion, the risk for treatment ineffectiveness is high due to the possibility of resistance by the clients.
A primary challenge in evaluating the effectiveness of mandated treatment in scenario 1 is the resistant and uncooperative nature of the clients. Hachtel et al. (2019) attribute increased resistance to mandated clients compared to voluntary clients. They may fail to cooperate in follow-up procedures; thus making it impossible to assess the treatment effectiveness. Client denial may also make it difficult to assess their progress. The challenge of evaluating the effectiveness of mandated treatment in scenario 2 would also emanate from the possible innate resistance of the clients and their lack of willingness to cooperate.
In the context of such cases (scenario 1), mandated treatment may strengthen my objectivity regarding the formulation of clinical decisions. From a professional perspective, the scenario can serve towards the sharpening of my decision-making abilities to identify and highlight the need for mandated treatment and implement the same upon court authorization.
In scenario 2, mandated treatment would strengthen my clinical decision-making by appreciating the need to listen to the client’s opinions before formulating a professional recommendation for treatment. Some clients may be uncomfortable with the decisions formulated in mandated care; thus, opposing the treatment process or crippling the follow-up efforts on treatment effectiveness. Accommodating their perspectives would significantly boost the treatment’s effectiveness.
Client factors that limit the benefits of mandated treatment in scenario 1 include health history, stigma, and discrimination in society. Others that might augment the treatment include social cohesion and family support.
In scenario 2, mandated treatment would be augmented by social and familial support while it would be limited by the manifestation of various aspects such as discrimination, stereotyping, and stigma as well as the lack of appropriate and adequate resources.
The responses entailed the consideration of the ethical principle of beneficence and nonmaleficence which dictates that psychologists are obliged to protect the welfare of the persons they interact with, professionally. For instance, seeking mandated treatment for the potentially harmful client sought to protect harm to the society. The ethical principle of justice and integrity were also applied. It was honest view to foresee the potential of the dangerous client becoming unwell again, thus the need for mandated treatment. Justice is evidenced by the premise of common good versus individualism when administering mandated treatment to the dangerous client.
References
Bayer, R. (2007). The continuing tensions between individual rights and public health. EMBO Reports, 8(12), 1099-1103. https://doi.org/10.1038/sj.embor.7401134 (Links to an external site.)
APA. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org. Retrieved 2 June 2021, from https://www.apa.org/ethics/code.
Coviello, D., Zanis, D., Wesnoski, S., Palman, N., Gur, A., Lynch, K., & McKay, J. (2013). Does mandating offenders to treatment improve completion rates?. Journal Of Substance Abuse Treatment, 44(4), 417-425. https://doi.org/10.1016/j.jsat.2012.10.003
Darby, W., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent and Psychotherapy. FOCUS, 16(4), 395-401. https://doi.org/10.1176/appi.focus.20180020
Hachtel, H., Vogel, T., & Huber, C. (2019). Mandated Treatment and Its Impact on Therapeutic Process and Outcome Factors. Frontiers In Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00219
Richards, E. (2009). Legally Mandated Treatment. Biotech.law.lsu.edu. Retrieved 1 June 2021, from https://biotech.law.lsu.edu/map/LegallyMandatedTreatment.html.
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