Clinical Psychology

1

I was a therapist working with a client with schizophrenia who had a history of violent behavior, including physical assault and threats to harm others. During one of our sessions, the client revealed to me that he had been experiencing paranoid delusions and was convinced that a particular person was trying to harm him.

I had to consider the ethical considerations of balancing the client's right to confidentiality with the duty to protect potential victim(s) from harm. Additionally, I had to consider the client's right to autonomy and the need to maintain a therapeutic alliance, which could be damaged by any action that the client perceives as a betrayal of trust.

From a legal standpoint, I had to comply with mandatory reporting laws in my jurisdiction, which typically require me to report any credible threat of harm to law enforcement or other authorities.

In this situation, I decided to explore the client's delusions further to assess the level of risk to potential victims. I also collaborated with the client to develop a safety plan that balanced their needs with the need to protect others.

Since the client was at high risk of harming others, I decided to break confidentiality and report the threat to the appropriate authorities, while informing the client of my actions and reasons for doing so.

The outcome of my actions depended on various factors, such as the severity of the client's delusions, the level of cooperation from the client, and the effectiveness of any interventions I undertook. Based on these factors, I saw that I needed to involve other mental health professionals, such as psychiatrists and social workers, to provide additional support and expertise.

Overall, the ethical challenges of working with clients with severe mental illness, such as schizophrenia, can be complex and require careful consideration of various factors. As a therapist, it is important to remain vigilant, flexible, and responsive to the changing needs and risks of your clients while upholding ethical and legal obligations.

2

If I were working with a client who I assessed to be at moderate risk for suicide, I would take the following steps to ensure her safety:

1. I would conduct a thorough suicide risk assessment to determine the client's level...…the situation and continue to provide support and treatment for the client.

Throughout this process, I would document all communication with the father and any steps taken to address his refusal to participate in treatment, in order to ensure that appropriate measures have been taken to address the situation and to protect the client's well-being.

To bring the father onto the treatment team, I might ask the following of any family member or members: Can you help me understand why the father is hesitant to participate in treatment? Are there any family dynamics or relationships that might be impacting the father's decision to not participate in treatment? Are there any cultural or community factors that might be contributing to the father's reluctance to participate in therapy? Are there any other family members or individuals who might be able to help encourage the father to participate in treatment, or who might be able to provide support and assistance to the client in his absence?

Through working collaboratively with the family, I believe it would be possible to overcome any barriers to his participation and improve the client's overall…