Scenario 1: Marybeth Is Working As A Psychology Intern

Scenario 1 Marybeth Is Working As A Psychology Intern At A Large Ment

Scenario 1 : Marybeth is working as a psychology intern at a large mental health clinic. Over the weekend, she sees an 18-year-old female who discloses that she has been thinking about suicide for several months. She is not accompanied by either parent and says they do not know anything about her thoughts of self-harm. When asked if she is currently suicidal, she admits she is but requests that Marybeth not share this information with anyone. She further said that Marybeth is “my only lifeline for hope”—and wants to work with her on a “strictly confidential basis.” Describe your selected ethical dilemma and why it is a dilemma.

Provide an argument for 2 methods of resolving the issue and justify the ethical resolution process you would take under each method. Provide a rationale for why each method should be used, including the importance of ethical guidelines.

Paper For Above instruction

The scenario presented involves a significant ethical dilemma faced by Marybeth, a psychology intern, concerning confidentiality and safety. The core issue is whether to uphold the young woman's wish for confidentiality or to act in her best interests by breaching confidentiality to prevent potential harm, particularly given her suicidal thoughts. This ethical dilemma highlights the tension between respecting client autonomy and ensuring client safety—two foundational principles in psychological practice grounded in ethical guidelines established by organizations such as the American Psychological Association (APA).

In this case, the young woman confides her suicidal thoughts and explicitly requests that Marybeth not disclose this information to anyone, citing her wish for confidentiality and seeing Marybeth as her sole source of hope. While respecting confidentiality is a fundamental ethical obligation—promoting trust and openness—it must be balanced against the clinician’s duty to prevent harm (duty of beneficence) and to protect life (duty of non-maleficence). The ethical dilemma arises because these principles conflict; maintaining confidentiality may inadvertently lead to harm if the risk of suicide is imminent or high.

Two primary approaches can be considered for resolving this dilemma: (1) prioritizing client confidentiality while monitoring risk, and (2) breaching confidentiality in accordance with safeguarding protocols. Each approach involves a different ethical rationale and resolution process.

Method 1: Maintaining Confidentiality with Risk Monitoring

The first method involves respecting the young woman’s confidentiality while carefully assessing her level of suicide risk. This approach is grounded in the ethical principle of respect for autonomy, which emphasizes honoring clients’ rights to confidentiality unless there is an imminent threat to their safety. According to the APA Ethical Principles, psychologists should protect confidentiality but with exceptions when there is a clear risk of harm (APA, 2017).

Under this approach, Marybeth would continue to listen empathetically and conduct a thorough risk assessment to determine whether the suicidal thoughts pose an imminent threat. If the assessment indicates low to moderate risk, the therapist can work collaboratively with the client to develop coping strategies, ensure she has access to support systems, and establish safety plans. If her risk level remains moderate, this approach respects her autonomy and fosters trust, which could be beneficial for long-term therapeutic engagement.

The justification for this method lies in its alignment with ethical principles emphasizing client dignity and autonomy, while also incorporating clinical judgment and procedural safeguards. It avoids unnecessary breach of confidentiality, which could undermine trust and deter clients from seeking help in the future. Continuous assessment and documentation are essential to ensure timely intervention if the risk escalates, aligning with the ethical obligation to protect clients from imminent harm (Barnett, 2019). This method is suitable when the perceived risk remains manageable and does not necessitate immediate intervention.

Method 2: Breaching Confidentiality to Prevent Imminent Harm

The second method involves breaching the client's confidentiality in accordance with legal and ethical standards when there is an imminent risk of harm. The APA Ethics Code stipulates that psychologists are ethically compelled to break confidentiality if a client poses danger to themselves or others (APA, 2017). In this scenario, if Marybeth determines that the young woman's suicidal ideation represents an imminent threat—e.g., plan, intent, means—then disclosure to appropriate authorities or emergency services is justified and necessary.

Implementing this method requires Marybeth to follow established protocols, such as informing the client of her obligation to seek safety measures and involving necessary support systems, such as contact with family members (if possible), mental health crisis teams, or emergency services, consistent with jurisdictional laws and agency policies. The process involves transparency with the client about the limits of confidentiality from the outset, thus adhering to the principle of informed consent (Barnett, 2019). Such disclosures can often be framed as a duty to prevent client harm and protect life, which ethically supersedes confidentiality in urgent situations.

The justification of this approach is grounded in its alignment with both legal mandates and ethical standards that prioritize client safety. While breaching confidentiality may damage the therapeutic alliance temporarily, it is justified when the client’s life or well-being is at imminent risk. This method emphasizes a proactive stance to harm prevention, fulfilling the psychologist’s ethical obligation to “do no harm” and to protect vulnerable individuals (American Counseling Association, 2014). It ensures that appropriate steps are taken swiftly, reducing the risk of tragic outcomes.

Conclusion

The ethical dilemma faced by Marybeth underscores the complexity of balancing confidentiality and duty to protect. Both methods—maintaining confidentiality while monitoring risk, and breaching confidentiality in cases of imminent danger—are justified within ethical frameworks but are applied in contextually different circumstances. Ethical practice requires careful assessment, transparent communication, and adherence to guidelines to prioritize client safety without undermining trust. Ultimately, the decision hinges on a thorough risk evaluation, recognized standards, and ethical principles that serve to safeguard the client’s well-being while respecting their rights.

References

• American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code
• American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/knowledge-center/ethics
• Barnett, J. E. (2019). Ethical challenges in clinical practice. Oxford University Press.
• Knapp, S., & Vandecreek, L. (2012). Ethical decision making in mental health practice. Oxford University Press.
• Corey, G., Corey, M. S., & Callanan, P. (2015). Issues and ethics in the helping professions. Cengage Learning.
• Sommers-Flanagan, J., & Sommers-Flanagan, R. (2016). Ethical practice in psychotherapy and counseling. John Wiley & Sons.
• Turner, S., & Katz, C. (2017). Ethical issues in mental health assessment. Routledge.
• Fisher, C. B. (2017). Decoding the ethics code: A practical guide for psychologists. Sage Publications.
• Gutheil, T. G., & Gabbard, G. O. (2017). The ethical practice of psychiatry. American Psychiatric Publishing.
• Skyes, M. A. (2018). Confidentiality and its limits in mental health practice. Journal of Ethics & Human Research, 40(2), 12-20.