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Ethical. Counselling. Mental Health. Therapy.

Nicole Martinez-Martin, Karola Kreitmair
This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services...
April 23, 2018: JMIR Mental Health
Frederic G Reamer
Behavioral health professionals are making increased use of cybertechnology to deliver services to patients, communicate with patients, gather information about patients, and communicate with colleagues. The advent of cybertechnology - included the Internet, text (SMS), email, video, cloud storage of electronic records, and other forms of electronic communication and documentation - has introduced novel and unprecedented ethical and risk-management challenges. This article provides an overview of emerging issues related to informed consent; delivery of services; privacy, confidentiality, and privileged communication; boundary issues and dual relationships; documentation; and practitioners' relationships with colleagues...
March 2018: Behavioral Sciences & the Law
Thomas D Steensma, S Annelijn Wensing-Kruger, Daniel T Klink
Counseling and treatment of transgender youth can be challenging for mental health practitioners, as increased availability of gender-affirming treatments in recent years raises ethical and clinical questions. Is a gender identity diagnosis helpful? What is the right time to treat, and should the adolescent's age matter in decision making? In this article, we discuss these questions in light of a case in which an adolescent wishes to pursue hormone therapy. Our analysis focuses on the importance of balanced decision making when counseling and treating adolescents with nonconforming gender identities...
August 1, 2017: AMA Journal of Ethics
Bamini Gopinath, Ashley Craig, Annette Kifley, Gerald Liew, Jaye Bloffwitch, Kim Van Vu, Nichole Joachim, Rob Cummins, Julie Heraghty, Timothy Broady, Alison Hayes, Paul Mitchell
INTRODUCTION: Age-related macular degeneration (AMD) is a leading cause of blindness and low vision among older adults. Previous research shows a high prevalence of distress and disruption to the lifestyle of family caregivers of persons with late AMD. This supports existing evidence that caregivers are 'hidden patients' at risk of poor health outcomes. There is ample scope for improving the support available to caregivers, and further research should be undertaken into developing services that are tailored to the requirements of family caregivers of persons with AMD...
August 4, 2017: BMJ Open
Kenneth Cornetta, Candy Gunther Brown
The current description of personalized medicine by the National Institutes of Health is "the science of individualized prevention and therapy." Although physicians are beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology...
March 2013: Academic Medicine: Journal of the Association of American Medical Colleges
Joan Gilmour, Christine Harrison, Leyla Asadi, Michael H Cohen, Sunita Vohra
In this article we examine decision-making about complementary and alternative medicine use when the patient is an adolescent. A case scenario describes patient-parent conflict when a 14-year-old boy who was diagnosed with ulcerative colitis that has continued to progress even with medication refuses recommended surgery despite his physician's and parents' support for that option; he prefers homeopathy instead. We address (1) who has decision-making authority about treatment for young people, (2) how to determine if a young person can consent to or refuse treatment, (3) special considerations when counseling and treating adolescents (whether they can decide about treatment for themselves), and (4) parent-child conflicts about treatment...
November 2011: Pediatrics
A Grant
The scientist-practitioner model, which is based on positivistic methodological assumptions, is influential in the development, training and practice of cognitive behavioural psychotherapists. As the emergence of 'Nurse Cognitive Behavioural Therapist' training in the early 1970s in Britain, many of those trained have been mental health nurses and with the emergence of the Increased Access to Psychological Therapies agenda many more are likely to undergo training. Despite some acceptance of its relevance, the scientist-practitioner model is subject of criticism on the grounds of its achievability and contemporary relevance, and its exclusion of other modalities of counselling and psychotherapy without an, as yet, disseminated evidence base...
May 2009: Journal of Psychiatric and Mental Health Nursing
Joan McGarry, Fiona McNicholas, Hannah Buckley, Brendan D Kelly, Louise Atkin, Niamh Ross
A brief consultation and advice (BCA) approach to dealing with routine referrals was introduced into a child and adolescent mental health service (CAMHS) over an 18-month period. This is a time-limited, client-centred and solution-focused approach to dealing with common non-complex referrals. The model proposes that all families are seen for an initial 'consultation' appointment followed by a maximum of two further appointments. A randomized controlled study compared the clinical effectiveness of BCA treatment with treatment as usual (TAU) over a 6-month period...
July 2008: Clinical Child Psychology and Psychiatry
Christopher W Blackwell
Conversion therapies, also know as reparative therapies, emphasize homosexual orientations as psychopathology in gay, lesbian, bisexual, and transgender (GLBT) clients and claim these individuals can reverse their sexual orientation through psychiatric counseling and treatment. Although professional medical and nursing organizations have branded psychiatric interventions designed to change an individual's sexual orientation as unethical, an international movement fueled largely by religious organizations promote such therapies for GLBT persons...
June 2008: Issues in Mental Health Nursing
Sanjay Basu, Duncan Smith-Rohrberg, Sarah Hanck, Frederick L Altice
Before introducing an HIV testing protocol into correctional facilities, the unique nature of these environments must be taken into account. We analyze three testing strategies that have been used in correctional settings--mandatory, voluntary, and routine "opt out" testing--and conclude that routine testing is most likely beneficial to inmates, the correctional system, and the outside community. The ethics of pre-release testing, and the issues surrounding segregation, confidentiality, and linking prisoners with community-based care, also play a role in determining how best to establish HIV testing strategies in correctional facilities...
April 2005: AIDS & Public Policy Journal
Cynthia M A Geppert, Elizabeth Dettmer, Antonie Jakiche
Psychiatric and addictive disorders are often considered contraindications to hepatitis C virus (HCV) treatment. In this pilot study, the ability of 30 veterans to provide informed consent for combined antiviral HCV therapy was examined with a mental health assessment protocol specifically geared to evaluate capacity in this area. The results showed that subjects lacked essential knowledge regarding the course of the disease and the nature of antiviral treatment despite receiving prior counseling. Informed consent assessments of candidates for HCV treatment may identify deficits that are responsive to intervention, thereby allowing patients with comorbid psychiatric and addictive disorders to receive effective HCV treatment...
September 2005: Psychosomatics
Lucia Mitello
A large debate that has brought some depths changes is in action. It is on the relationship between patients and health professionals, physicians, nurses, psychologists etc. The path went through the medical paternalism to the phase of the autonomy, thin to reach the ethics of taking care. In these years, bioethics has tried to answer to urgent questions that primarily interest the private sphere of the people. Currently, by contributions of European and American philosophies, an ethics of the responsibility is delineating This, differentiates the ethics of the rights and the rules (autonomy, self-determination)...
October 2004: Professioni Infermieristiche
Ezra E H Griffith, John L Young
As religious organizations contribute increasingly to community mental health, counseling by clergy acquires greater significance. As a result, clergy confront from time to time ethics challenges resulting from the need to balance a commitment to clients and an obligation to follow the requirements of religious doctrine. The recent New York case of Lightman v. Flaum highlights an example of this dilemma. A woman who asked two rabbis (Flaum and Weinberger) for help in her marriage complained that they had violated the confidentiality she expected of them...
2004: Journal of the American Academy of Psychiatry and the Law
Judith G Proudfoot
The rise of consumerism, escalating levels of technological change and increasing demand for better dissemination of psychological treatments signal a transformation in the treatment of mental health problems. Soon health care consumers will have a choice as to whether they wish to consult a clinician in his/her rooms in order to receive a diagnosis, treatment and support, or instead to receive these services electronically, or a combination of both. Some of the online services currently available include structured therapy programs, psychological treatment by email, real-time online counselling, professionally assisted chat rooms, self-help groups, health information and educational modules...
May 2004: Neuroscience and Biobehavioral Reviews
M Manhal-Baugus
E-therapy is a term that has been coined to describe the process of interacting with a therapist online in ongoing conversations over time when the client and counselor are in separate or remote locations and utilize electronic means to communicate with each other. It is a relatively new modality of assisting individuals resolve life and relationship issues. E-therapy utilizes the power and convenience of the internet to allow simultaneous (synchronous) and time-delayed (asynchronous) communication between an individual and a professional...
October 2001: Cyberpsychology & Behavior
Daniel Edward Shapiro, Charles Eric Schulman
Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed. To address potential hazards to clients and the profession, a new ethical standard for e-mail therapists is offered...
1996: Ethics & Behavior
G M Epstein, L J Weitz, B S Wallston, S I Abramowitz
Health-care-related professionals rated the appropriateness and preferred timing of various community intervention strategies for assisting the bereaved individual. Results indicated: (a) agreement about the general need for such assistance programs, but no concensus as to which were most appropriate; (b) endorsement of the "resumption of activity" ethic; (c) belief that the most desirable period in which to intervene is within six months from the death; and (d) the lesser perceived suitability of therapeutic modalities that involve social contact with nonfamily members immediately following the death...
January 1976: Journal of Community Psychology
J Halevy
The approach described in this paper is predicated on the fundamental belief that in order to become competent and ethical practitioners, students must understand themselves and how they see others. They must be given tools and skills that facilitate examination of their own assumptions and beliefs about themselves, others, and how the world works. It is also essential that students examine how these assumptions and beliefs will influence the way they choose to conduct therapy. Once they are aware of their biases, they must learn to choose to consciously influence themselves in a way that permits their clients the largest room for change within the clients' own contexts of belief, understanding, experience, and possibility...
April 1998: Journal of Marital and Family Therapy
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