For this assignment, I interviewed Jane Smith (name changed), a licensed marriage and family therapist with over 15 years of experience working in private practice and community mental health settings.
Smith emphasized the primacy of client interests, confidentiality, and not harm. She stated that therapeutic work must be grounded in ethical principles to guide actions like thorough and accurate recordkeeping, clear boundary-setting around relationships, communication mediums, and termination procedures, and ensuring clinicians continuously enhance their competence through professional development and expertise consultation when needed. Ms. Smith highlighted how legal and ethical codes exist precisely to promote client welfare and dignity.
As the opening to the AAMFT Code of Ethics asserts, “marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, sexual orientation, and gender identity or relationship status” (AAMFT, 2015, p.1). Ms. Smith discussed how this non-discrimination imperative helps ensure all clients can access and engage in the therapeutic process without fear of harm, coercion, or exploitation from therapists failing to acknowledge and mitigate their own biases and limitations.
Ms. Smith recounted an early career incident where she was accused of negligence by the parents of a suicidal teenager. Though eventually dismissed, this taught the importance of thoroughly documenting risk assessments, safety plans, and intervention reasoning. She now keeps meticulous notes on high-risk cases per standards like those outlined in Standard VI of the AAMFT Code of Ethics (AAMFT, 2015) and Cameron & Turtle-Song’s (2002) guide to writing practical SOAP notes.
When discussing insurance panels, Ms. Smith noted advantages like serving low-income communities. However, frequently changing administrative requirements complicated treatment planning and termination per Standard III of the Code (AAMFT, 2015). She described clients making rapid progress but insurance mandating extra sessions, creating ethical dilemmas. Leslie (2003) similarly highlights potential conflicts between legal and ethical obligations regarding recordkeeping and client care.
Ms. Smith emphasized keeping accurate, objective, treatment-focused notes. She avoids speculation and only documents information related to the treatment plan and interventions. This aligns with guides like Leslie (2003) and the Code’s assertions that records should exclude “personal information about clients not relevant or necessary…[and] any interpretations or accusatory statements” (AAMFT, 2015, p.8).
On termination, Ms. Smith highlighted the importance of concluding therapy for clinically appropriate and ethical reasons rather than solely the financial motivations of the clinician or practice per Standard V of the AAMFT Code of Ethics (AAMFT, 2015). She emphasized that therapists have an ethical responsibility to establish and discuss termination protocols early in the treatment process and then revisit them periodically to ensure clarity for both therapist and client. If at any point Ms. Smith believes she cannot provide specific needed services due to lack of competence or fit with a client’s issues or therapeutic orientation, she discussed the ethical imperative to immediately provide several referrals to appropriate alternative practitioners after transparently notifying the client. She can only terminate the provision of care by facilitating continuity of quality care that meets the client’s needs. This reflects standards like those outlined in Chapter 8 of the User’s Guide to the AAMFT Code of Ethics, which requires therapists to make reasonable efforts to ensure the continued availability of professional services from either themselves or other qualified professionals that can assist clients progressing through the termination process (AAMFT, 2015). Ms. Smith noted that termination, while often difficult or emotional, is a critical phase of ethical clinical practice. If mishandled, it can undermine the progress clients have made during the counseling relationship.
Though not currently providing teletherapy services herself, Ms. Smith discussed the importance of safeguarding client electronic records via encryption, firewall-protected networks, and communication platforms specifically designed to allow confidential digital exchange in compliance with Standard VI of the Code and guides like Leslie’s (2003) overview of recordkeeping best practices. Ms. Smith highlighted the importance of being up-to-date on the changing risks and regulations throughout the progressing digital spaces and practices across multiple platforms and geographical areas that affect clinical practice.
She also noted that aside from the extensive ethics policies and codes of conduct that continue to be updated on the AAMFT Code of Ethics (2015), practicing clinicians also have to frequently consult state and federal laws, licensing board policies, legal precedent, and professional development resources focusing on the technological impacts to maneuver through them, while you should remember all of the ethical principles defined in Standard I about the practitioner The critical point, according to Ms. Smith, is that the technology has been developed many new formats to breech ethics regarding privacy and confidentiality and also to challenge the professional relational boundaries in many different forms. As a result of the role technology plays in healthcare practice, the focus is on more careful attention to the protection of data, cyber security expertise, dependable policies, special training, and informed consent should be sought when necessary to ensure that the practice evolves with client interests in mind.
In conclusion, this interview was very informative in extracting practical applications of ethical and legal policies in clinical settings across different disciplines. Under Ms. Smith’s guidance, a practitioner should be able to see that not only professional codes of ethics, state laws, federal regulations, and licensing board standards can be comprehensively used in the approach to recordkeeping but also to maintaining the professional boundaries, ensuring continuity of care during the termination process, proper use and safeguarding emerging technologies such as telehealth platforms impacting modern practice, and managing complex situations that often happen when Ms. Smith highlighted the significance of continuing professional growth and consultation for better management of such complex matters. The integrity and steadfastness of her advice and guidance are not only paramount but are the very basis for ethically justifiable clinical practices and not an optional addition. These are the guiding principles that I will use not only as I begin but also as I build my career on a foundation of the strictest legal and ethical standards. I will always put my clients first and help advance the profession.
References
Behnke, S., & Jones, S. Ethics: Competence. https://www.texcpe.com/pdf/ny/ONYEC3.pdf
Johnson, A. M. (2023). Ethical Practices Among Christian Counseling Practitioners: A Comparison of the Influences of Theological Training on Counseling Practice (Doctoral dissertation, Southeastern Baptist Theological Seminary). https://www.proquest.com/openview/757e453cbea6f665dc34a6c8583906a7/1?pq-origsite=gscholar&cbl=18750&diss=y
Pozgar, G. D. (2023). Legal and ethical issues for health professionals. Jones & Bartlett Learning. https://books.google.co.ke/books?hl=en&lr=&id=zBSwEAAAQBAJ&oi=fnd&pg=PP1&dq=Definition+of+Legal+and+Ethical+Practice&ots=uKZ8gTBPvT&sig=4T8kgiibmFhLZJpGRfuko7WZVQ0&redir_esc=y#v=onepage&q=Definition%20of%20Legal%20and%20Ethical%20Practice&f=false
Zhu, Y., Wang, Z., Zhou, Y., Onoda, K., Maruyama, H., Hu, C., & Liu, Z. (2020). Summary of respiratory rehabilitation and physical therapy guidelines for patients with COVID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy. Journal of physical therapy science, 32(8), 545-549. https://www.jstage.jst.go.jp/article/jpts/32/8/32_2020-089/_article/-char/ja/
Vu, J. (2022). An Overview and critical analysis on teletherapy. Western Undergraduate Psychology Journal, 10(1). https://ojs.lib.uwo.ca/index.php/wupj/article/view/15248
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