Given
the commonality of blended families, how do you decide who should be included
in family therapy?
·
Social Class position
·
Sexual orientation in the family and
amongst its members
·
Religion inside the family; taking in to
mind there might be different views
·
Identifiable race and ethnic identity ( I
see my self as bi-racial some see me as Black or Hispanic and addressing me as
such is not ok). Just ask when in doubt, people respect honesty before blatant
guessing and assuming. This character will aid in finding out who should be
involved from the blended family.
·
Individual assessment in family therapy.
According to Goldenberg, Stanton, and Goldenberg 2016,
“The evolving view of cultural diversity recognizes that members of racial and
ethnic groups retain their cultural identities while sharing common elements
with the dominant American culture (Axelson, 1999 as cited in text on p.
64). Simply inquiring is the best way to
go in my opinion. Families that are in second and third marriages; a therapist
may make the decision not to include old exes that are not in the current
family dynamics and may cause more
issues than help.
What
ethical considerations need to be made when determining who to involve in
therapy?
The therapist's primary responsibilities are to
protect the rights and to promote the welfare of his or her clients. The first
is to consider the client that is seeking help for the family, ask the client
to bring in who they want to be a part of the therapy. Have all sign an
agreement on the goals that are needed,
and what and how much they want to share in family therapy. Allow the chance to
walk away to all members if they feel uncomfortable. Out-right denying a family
member access can be considered rude and pose ethical issues such as the client
feels slighted, e.g., what family member not asked to attend by counselor. The
loss of trust between the family and counselor could occur from decisions not
made by the client.
Confidentiality is a big ethical concern because
people divulge secrets in one setting and not in others. Communication between
the family and counselor is important at this stage so all boundaries are clear
and concise. So basically,
1. Determine
a policy that is compatible with his or her method of conducting therapy.
2. Relay
this to the family.
3. Be
clear about the method, using language the entire family can understand.
Informed consent and the right to refuse therapy is an
issue and any family member has this right if not mandated by a legal order.
What
are some ways in which confidentiality and third-party reimbursement challenges
may be navigated?
The insurance companies are a big one. The client must
agree to what information that is shared and unless this is a legal manner or
refers to abuse of family members, e.g., children, or suicide, or murder, we
must have permission to relay certain data. Only data that pertains to keeping
the third party up to par with treatment is warranted. For example, if an
insurance company wants to know information about sessions the information
asked for must be placed in writing and presented to the client for signature
and approval or disapproval.
Title X is an issue and HIPPA makes provisions for
this that all counselors should be aware of. According to English, et al, 2017,
“The HIPAA Privacy Rule also contains important confidentiality protections of
particular relevance for Title X providers,” (p.1.)
Another third-party issue is if the client has a
family member paying for their sessions and wants to know information. If the
patient is a minor this can present issues. If it is an adult consent is
needed.
References:
English, A., Summers, R., Lewis, J., Coleman, C., (2016).
Confidentiality, Third-Party Billing, & the Health Insurance Claims
Process: Implications for Title X. Retrieved from https://www.confidentialandcovered.com/file/ConfidentialandCovered_WhitePaper.pdf
Goldenberg, I.,
Stanton, M., & Goldenberg, H. (2016). Family therapy: An overview (9th
ed.). Boston, MA: Cengage. ISBN-13: 9781305092969 http://www.gcumedia.com/digital-
resources/cengage/2016/family-therapy_an-overview_ebook_9e.php