Therapeutic Psychology 2019 past exam paper with model answers.
All answers are extracted from the prescribed textbook for PYC4809
Corey, G.T. (2017). Theory and Practice of Counseling and Psychotherapy (2nd ed). Cengage, with page references included.
Comprehensive and easy to follow, excellent notes!
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All answers are extracted from the prescribed textbook for PYC4809
Corey, G.T. (2017). Theory and Practice of Counseling and Psychotherapy (2nd ed).
Cengage, with page references included.
,Answer: (Textbook Page 37 - 38)
The right to informed consent and dimensions of confidentiality are regarded as ethical
issues in counselling practice which must be considered when dealing with clients who
require therapy. We will explore issues here;
The right to informed consent:
Regardless of your theoretical framework, informed consent is an ethical and legal
requirement that is an integral part of the therapeutic process. It also establishes a basic
foundation for creating a working alliance and a collaborative partnership between the
client and therapist.
Informed consent involves the rights of the clients to be informed about their therapy
and to make autonomous decisions relating to it. Providing clients with the information
they need to make informed choices generally encourages clients to cooperate in their
counselling plan. By educating your clients about their rights and responsibilities, you
are both empowering them and building a trusting relationship with them. Informed
consent is something far broader than simply making sure clients sign the appropriate
forms. It is a positive approach that helps clients become true collaborators in their
therapy.
Some aspects of the informed consent process include the general goals of counselling,
the responsibilities of the counsellor towards the client, the responsibilities of clients,
limitations of confidentiality and exceptions to confidentiality, legal and ethical issues
that could define the relationship, the qualifications and background of the practitioner,
the fees involved, the services the client can expect and the approximate length of the
therapeutic process. Further areas might include the benefits of counselling, the risks
involved, and the possibility that the client’s case will be discussed with the therapist’s
colleagues or supervisors.
,Educating the client begins with the first counselling session, and this process will
continue for the rest of the counselling process. The challenge is to strike a balance
between giving clients too much information and giving them too little. For example, it
is too late to tell a minor that you intend to consult with their parents after they have
disclosed that they are considering an abortion. Young clients have a right to know
about the limitations of confidentiality before they make such a highly personal
disclosure. Clients can be overwhelmed, however if counsellors go into too much detail
initially about the interventions they are likely to make. It takes both intuition and skill
for practitioners to strike a balance.
Informed consent in counselling can be provided in written form, orally, or some
combination of both. If it is done orally, therapists must make an entry in the client’s
clinical record documenting the nature and extent of informed consent. It is always
preferred that one obtains consent in written form when counselling in contexts of
conflict, family disputes and in the forensic area. The high levels of emotional
investment among antagonistic parties often lends itself to litigious engagement and
ultimately an adversarial attitude in the counselling context. Informed written consent
(and assent, in the case of children) is essential to safeguard all the relevant parties.
Dimensions of Confidentiality
Confidentiality and privileged communication are related but somewhat different
concepts. Both of these concepts relate to a client’s right to privacy. Confidentiality is
an ethical concept. It is a fundamental ethical standard underlying all curative,
promotive and preventive counselling interventions.
Confidentiality is central to developing a trusting and productive client-therapist
relationship. No genuine therapy can occur unless clients trust in the privacy of their
discussions with their therapists, so professionals have the responsibility to define the
degree of confidentiality that can be promised. Counsellors have an ethical and legal
responsibility to discuss the nature and purpose of confidentiality with their clients early
in the counselling process. In addition, clients have a right to know that their therapist
may discuss certain details of the relationship with a supervisor or a colleague. The
limits of confidentiality as they apply to professional and scientific relationships clearly
stipulate a consensual agreement between client and therapist as to that which is in the
, client’s best interest. Only in exceptional circumstances as stipulated by the law, or
where the clients is in danger of self harm or protect others from harm, can
confidentiality be broken. Obtaining consent from the client to disclose confidential
information for organisational or medical purposes is essential for any therapist.
The major exceptions to confidentiality:
There are specific situations in which it becomes necessary to break confidentiality and
disclose confidential information. There are times when confidential information must
be divulged and there are many instances in which keeping or breaking confidentiality
becomes a cloudy issue. In determining when to breach confidentiality, therapists must
consider the requirements of the law, their professional code of ethics and population
they serve. Whenever counsellors are not clear about their obligations regarding
confidentiality, it is crucial to seek consultation and to document these discussions.
There is a legal requirement to break confidentiality and a duty to report cases involving
child abuse, abuse of the elderly, abuse of dependent adults and danger to self or others.
All mental health practitioners and interns need to be aware of these situations and to
know the limitations of confidentiality.
To summarize, these are circumstances in which information must be legally reported
by counsellors:
Child abuse, elderly abuse, abuse of dependant adults
Danger to self and others
When the therapist believes a client under the age of 16 years is the victim of
incest, rape, or other sexual abuse.
When the therapist determines that the client needs hospitalisation (perhaps
suicidal thoughts or psychotic episode)
When information is made an issue in court action.
In general, the counsellor’s primary obligation is to protect client disclosures as a vital
part of the therapeutic relationship. Informing clients about the limits of confidentiality
does not necessarily inhibit successful counselling.
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