Written Exercise 3: Therapy In Correctional Settings ✓ Solved

Written Exercise 3 Therapy in Correctional Settings: Can I Leave?

Dr. Bernadette Jackson is a correctional psychologist and treats patients at the state correctional facility using group and individual therapy. Dr. Jackson is treating Andy K., an inmate with an Axis I diagnosis of depression and an Axis II diagnosis of Antisocial Personality Disorder. Andy was sentenced to ten years in prison for strong-arm robbery. He has served six and one-half years and goes before the parole board in six months for the possibility of early conditional-release. Andy requested individual psychotherapy sessions approximately three months ago with a presenting complaint of symptoms related to depression. Andy attributes his depression to news that his estranged mother has been diagnosed with stage-four cancer and has been told by her doctors that she has approximately one year left to live. In therapy, Andy expresses his desire to make amends with his mother and indicates his desire to care for her during her final days.

During a therapy session, Andy mentions that he has private information from inmate Zackman regarding a previous sexual offense. Inmate Zackman was sentenced to three years on a drug-related charge. However, Andy reports that Zackman bragged about a child abduction which has never been solved. The warden has requested that Dr. Jackson prepare a report on Andy’s progress in therapy and offer a prediction regarding his risk to re-offend for Andy’s upcoming parole hearing.

Written Exercise 3 Questions:

  1. Should Dr. Jackson reveal Andy’s information in therapy regarding inmate Zackman, considering the source of the information? Andy’s parole hearing will be completed before the information can be confirmed.
  2. What are the ethical implications of releasing information obtained in therapy? Also, should Dr. Jackson provide a report on Andy’s progress in therapy and provide a risk assessment for the parole hearing?
  3. What are the ethical implications and ramifications for future therapy with Andy, as well as with other inmates, if his request for early release is denied, particularly if Dr. Jackson provides a negative report or risk assessment?
  4. How should Dr. Jackson proceed?

Paper For Above Instructions

In correctional settings, the role of a psychologist is crucial, not only for the mental health of inmates but also for the safety and security of the institution. Dr. Bernadette Jackson finds herself in a complex situation while treating Andy K., an inmate facing possible parole. Andy, diagnosed with depression and Antisocial Personality Disorder, presents several therapeutic challenges, especially regarding confidentiality and the ethical duty to warn.

Firstly, the question arises whether Dr. Jackson should disclose Andy's information about inmate Zackman, who allegedly bragged about a child abduction. This situation raises significant ethical considerations regarding confidentiality versus the potential risk to the public. According to the principles of psychological ethics, confidentiality is paramount. However, there are exceptions, particularly when there is imminent risk of harm to others (American Psychological Association, 2017). The dilemma for Dr. Jackson is compounded by the fact that the parole board process may proceed before the validity of Andy's claims can be verified. If she does not report the information, does she place an innocent child at risk? Conversely, if she discloses the information, it could severely impact Andy's chances for early release and possibly his therapeutic progress.

Secondly, the ethical implications of releasing information obtained in therapy are profound. The American Psychological Association's Ethical Principles of Psychologists and Code of Conduct underscores the importance of maintaining confidentiality, emphasizing its criticality for fostering a trusting therapeutic relationship (American Psychological Association, 2017). If Dr. Jackson discloses Andy’s statements about Zackman, it could not only lead to professional repercussions for her but could also damage the therapeutic alliance between her and Andy. Furthermore, should the allegations against Zackman remain unsubstantiated, this could detrimentally affect Andy's mental state and his rehabilitative journey.

Providing a report on Andy’s progress and a risk assessment is another contentious issue. While the parole board may rely heavily on Dr. Jackson’s insights to inform their decision, the potential for a bias—or misjudgment based on the information shared by Andy—remains high. If Dr. Jackson presents a negative report influenced by the allegations against Zackman, this could hinder Andy’s chances of early release. Additionally, future therapeutic engagement with Andy could become strained if he perceives Dr. Jackson as an adversary, particularly if his request for parole is denied (Harris, 2020).

The ramifications of denying Andy’s parole, coupled with a potentially negative assessment from Dr. Jackson, can be particularly detrimental. If he perceives that the system has failed him, it may exacerbate his depressive symptoms and could even lead to a regression in his mental health. This scenario underscores why psychological practitioners must tread carefully and consider the long-term effects of their professional assessments—both ethically and therapeutically (Miller & Rollnick, 2013). On the other hand, failure to address credible threats can lead to harm not only to individuals involved but also to society at large.

In light of these complexities, how should Dr. Jackson proceed? A prudent approach would be to engage in a candid conversation with Andy about the ethical implications of his disclosures. She can explain the gravity of the situation, including the potential risks to both Zackman and the broader community. Dr. Jackson might consider seeking supervision or consultation with colleagues or expert bodies on such matters, given the implications of her decisions. Establishing rapport and ensuring that Andy feels safe to discuss his feelings and thoughts without immediate threats of disclosure can play an essential role in maintaining an effective therapeutic relationship (D'Onofrio, 2021).

Moreover, if the decision is made to report the information, Dr. Jackson should do so in a manner that emphasizes her commitment to ethical standards and public safety, documenting her rationale for disclosure clearly. The aim should be to balance ethical obligations with the therapeutic process while safeguarding her professional integrity and the welfare of all involved. In the case that Dr. Jackson chooses not to disclose the information immediately, she must continue to work with Andy to process his emotional trauma related to his mother's diagnosis and his estrangement, which is crucial for his ongoing treatment (Williams, 2021).

Ultimately, the decision Dr. Jackson makes will require a thoughtful consideration of ethical guidelines, patient welfare, and public safety. The path is fraught with challenges, but by applying ethical reasoning and adhering to the principles of confidentiality and informed consent, Dr. Jackson can navigate these complex waters effectively.

References

  • American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct.
  • D'Onofrio, A. (2021). Navigating ethical dilemmas in correctional psychology. Journal of Correctional Health Care, 27(3), 219-229.
  • Harris, A. (2020). The psychological impact of incarceration: A review. American Journal of Public Health, 110(1), 64-70.
  • Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.
  • Williams, C. (2021). Mental health care in prison: A provider’s perspective. Journal of Community Psychology, 49(5), 1523-1538.
  • Brooks, E., & Levenson, J. (2020). Risk assessment in parole decisions: Balancing public safety and rehabilitation. Victims & Offenders, 15(6), 762-778.
  • Lehman, A. (2019). Ethics in correctional psychology: Expanding moral territory. Clinical Psychology Review, 73, 101777.
  • Okuda, M., et al. (2020). Understanding the implications of reporting child-abduction claims: A clinical dilemma. Child Abuse & Neglect, 109, 104643.
  • Phillips, C. (2022). Psychological resilience and the impact of parental illness on inmate behavior. The Clinical Psychologist, 26(2), 101-115.
  • Kennedy, D. B., & Franke, G. (2023). Ethical considerations for therapy in correctional settings: A dialogue. Corrections Compendium, 48(1), 12-18.

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