DQ#1 EVIDENCE-BASED PRACTICE
Hello class and Professor
In this assignment on evidence-based practice truly explains the way treatment process should be based upon to better serve
the clients in need of help. Evidence-based practice is when a treatment has been researched, studied, tested, and approved to work
before being applicable for the clients to use as a part of their treatment. As a counselor conducting an assessment with a client it is
ethical to communicate with the client to listen and observe the client to be able to gather as much information as possible to be able
to make referrals for the client to recieve approved and concrete treatment that works for the clients who choose to work the treatment
correctly so the treatment will benefit them in their life. According to the APA, (2006) states that eveidence-based practice movement
has become an important feature of health care systems and health care policy. The APA Presidential Task Force on evidence-based
practice describe and talk about evidence-based practice in psychology (EBPP).
“In an integration of science and practice, the Task Force’s report describes psychology’s fundamental committment to sophisticated
EBPP and takes into consideration the full range of evidence psychologists and policymakers must consider. Research, clinical expertise,
and client character are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances
public health by applying empirically supported principles of pschological assessment, case formulation, therapeutic relationship, and
treatment”. (APA,2006). One of the perspectives that will influence the writer is the Behavioral Perspective. According to Whitbourne, (2020)
states that in “behavioral perspective the individual acquires maladaptive behavior through learning. Staying true to its name, this perpsective
focuses on the individual’s noticeable behaviors, the factors that might precipitate it, and the consequences that maintain it over time.
It is thought that the abnormal behavior is caused by negative learning experiences”.
One of the reasons why evidence-based practice while doing assessments is so important because it will not only help the client
with helping them to recieve the appropriate treatment because the counselor will know what treatment will best fit the needs of the client,
also it will help the counselor to make better decisions with the refferrals for the client because the counselor will know which treatment
based on EBP will best benefit the client. According to DeAngelis, (2018) states that guidance for determining your competence is in
section 2 of APA’s Code of Ethics. It calls for clinicians to have sufficient “education, training, supervised experience, consultation, study, or professional experience” in a given domain to practice in it competently. Whenever a counselor does not have the knowledge to work with
a client in certain areas of their treatment needs, the counselor should gently explain to the client that some of their colleagues have more
experience and knowledge to better help them and refer them to another counselor. This can also ensure to keep in mind EBP for the
treatment and help to protect the client and counselor.
APA Presidential Task Force on Evidence-Based Practice, (2006). Evidence-based practice in psychology. www.pubmed.ncbi.nlm.nih.gov
DeAngelis, T. (2018). What should you do if a case is outside your skill set? www.apa.org
Whitbourne, S. K. (2020). Abnormal Psychology: Clinical Perspectives on Psychological Disorders (9thed). McGraw Hill.
Evidence-Based Practice (EBP) is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences (APA, 2008). APA adopted principles of evidence-based practice in 2005 that provide guidelines for clinicians to follow in their provision of psychological treatment (APA, 2008; Whitbourne, 2020). EBP is very important in regards to assessment and treatment planning for a variety of reasons. EBP promotes effective and purposeful practices because it is supported empirically. All of that evidence gathered can be used to better guide the assessment and treatment planning process, and tailoring it more to the individual and their diagnosis needs. EBP starts with the patient and asks what research evidence will assist the psychologist in achieving the best outcome by encompassing a broader range of clinical activities, such as psychological assessment, case formulation, and therapy relationships (APA, 2006). With the evidence available, the therapist can formulate clear and theoretically coherent case conceptualizations, assess patient pathology as well as clinically relevant strengths, understand complex patient presentations, and make accurate diagnostic judgments (APA, 2006). Since treatment planning strongly involves setting goals and action steps to achieve those goals, having and utilizing evidence-based practice can help a therapist take into consideration the unique patient, the nature of the patient’s problems and concerns, the likely prognosis and expected benefits of treatment, available resources, the patient and his or her family’s worldview and sociocultural context, and patient attitudes, values, and context (APA, 2006). The choice of treatment strategies requires knowledge of interventions and the research that supports their effectiveness as well as research relevant to matching interventions to patients (Norcross, 2002).
Evidence-Based Practice can also play an important role in ethically treating clients when the therapist does not have significant training in a topic or disorder that a patient presents with. EBP can be found in a variety of ethical guidelines, including Guideline 14 for Psychological Practice with Older Adults when it states, “Psychologists strive to be familiar with the theory, research, and practice of various methods of intervention with older adults, particularly with current research evidence about their efficacy with this age group” (Whitbourne, 2020). Another example of incorporating evidence into practice can be found in the American Law Institute’s (ALI) guidelines. These specific guidelines allow for the introduction of medical and psychiatric evidence and provide a modern test for the insanity defense (Whitbourne, 2020). If a therapist does not have experience with a specific diagnosis, all of these forms of evidence and research can support ethical treatment. A therapist can also reach out and consult other professionals with experience with that diagnosis to request feedback, clinical suggestions, and discuss concerns.
One theory addressed by Whitbourne in Chapter 4 that may influence this writer from the perspective of client assessment and treatment planning is Trait Theory. Trait Theory proposes that psychopathology develops when the individual has maladaptive personality traits, which are enduring patterns of perceiving, relating to, and thinking about the environment and others (Whitbourne, 2020). Most commonly people use adjectives to describe someone’s personality traits, and trait theories agrees that these adjectives contribute to the psychological makeup of a person. According to the Five Factor Model of trait theories, there are 5 basic dispositions, each consisting of 6 facets, all leading to 30 personality components (Whitbourne, 2020). These 5 basic dispositions can be easily remembered through the acronym “OCEAN”, and includes the personality traits of neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness (Whitbourne, 2020). Through conducting an assessment, a therapist can measure these personality qualities, possibly evaluate if they were genetically inherited, and begin to develop an idea of how these traits contribute to how the individual functions daily. By utilizing this theory, a therapist can evaluate where certain risks lie within an individual. For example, people who score high on personality traits representing riskiness are more likely to get hurt because their personalities lead them into situations that can land them in trouble (Whitbourne, 2020). One key sentence that this writer found very intriguing and extremely applicable to the treatment planning and assessment process is that “although circumstances can change personality, it’s more likely that personality molds circumstances” (Whitbourne, 2020). While trait theory doesn’t have direct clinical applications, it can support a more thorough assessment of a client’s personality traits to measure concerns and diagnosis. A client’s personality trait profile can allow the therapist to share feedback and improve the client’s insight and awareness into their own traits and patterns.
APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271-285. doi:10.1037/0003-066x.61.4.271
American Psychological Association (APA). (2008). Evidence-based practice in psychology. Retrieved March 23, 2021, from https://www.apa.org/practice/resources/evidence.
Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patient needs. New York: Oxford University Press
Whitbourne, S. K. (2020). Abnormal Psychology: Clinical Perspectives on Psychological Disorders (9thed). McGraw Hill. ISBN 9781260500196
DQ#2 ETHICAL CONSIDERATIONS
Ethical and legal ramification are associated with most child abuse caseses. Below is the link to an article that referrs two individuals who were arrested for child abuse as a result of a Facebook post. There were several posts which led to their arrest, the first post depicted a minor child outside without clothes and the other is of an adult male slapping the minor child. The clip below does not disclose the age of the child but does identify that he or she is a minor. The problem of child maltreatment and protection has prompted a variety of responses at social and political concerns. Some of these concerns deal with confidentiality and least restrictive treatment.
Historically, cases of child abuse constitute significant moral problems that are associated with promoting and protecting the wellbeing of the child. For professionals who deal with these cases it’s important to acquire a balance between the needs of the child involved and interests of different people, such as the primary caregivers. These considerations will contribute to the justification on whether to intervene or not intervene. Because children rely on others for help they are considered one of the most vulnerable populations. This vulnerability presents roadblocks in a child protecting themselves from other people.
Legal consideration associated with child abuse are associated with corpral punishement. Although states do not prohibit parents from spanking their children there are laws assciated with statutes that define child abuse. Once an individual is accused of child abuse the judicial system would be the deciding factor on whether that particular individual’s actions constitute abuse, based on the state law. According to the Connecticut Judicial Branch website the following is considered abuse: A child may be found ‘abused’ who (A) has been inflicted with physical injury or injuries other than by accidental means, (B) has injuries that are at variance with the history given of them, or (C) is in a condition that is the result of maltreatment, including, but not limited to, malnutrition, sexual molestation or exploitation, deprivation of necessities, emotional maltreatment or cruel punishment. In addition the Connecticut Judicial Branch website suggest that neglect is considered any or all of the following: A child may be found ‘neglected’ who, for reasons other than being impoverished, (A) has been abandoned, (B) is being denied proper care and attention, physically, educationally, emotionally or morally, or (C) is being permitted to live under conditions, circumstances or associations injurious to the well-being of the child.
This writer believes that there are some ethical considerations associated with this case for those who view the post on social media, especially individuals who identify as mandated reports. Because social media sites are used by mental health professionals and clients it creates ground for ethical challenges and complex decision making. In this writer’s opinion it seems there is an unsaid rule that outsiders should not intervene in the family lives of others, but this writer believes that abuse on social media needs to be addressed. In addition there are also concerns with the co-exististants of social media and confidentiality.
Child protection proceedings. (n.d.). Retrieved March 23, 2021, from https://www.jud.ct.gov/juv_infoguide/IJCP_ChildProtection.html
Because conflicts between personal and professional values can interfere with ethical decision making, a counselor or therapist must think carefully before any decision is made by them. As professionals, counselors, therapists, or doctors must be culturally and professionally aware of the legal and ethical standards that govern the profession when it comes to the wellbeing of their clients/patients as well as their ethical and legal issues toward them (Calley, 2009). Therefore, counselors/therapists would need to question their responsibilities toward the clients/patients as well as toward the profession itself when it comes to make a client/patient happy by breaking all the rules or come forward by being honest and supportive and still come through for the client/patients. In the case of Sarah who has lost so much already, would it be best to hide the truth from her just so she can be happy again or tell her the truth? According to the ethical standards for school counselors, they must recognize their primary obligation for confidentiality is to the students/clients but balance that obligation with an understanding of parents’/guardians’ legal and inherent rights to be the guiding voice in their children’s lives, especially in value-laden issues (Calley, 2009). Understand the need to balance students’ ethical rights to make choices, their capacity to give consent or assent and parental or familial legal rights and responsibilities to protect these students/clients and make decisions on their behalf (A.2.d, 2005). Also, counselors/therapist have the responsibilities to provide interpretation of the nature, purposes, results and potential impact of assessment/evaluation measures in language the parents can understand and monitor the use of assessment results and interpretations and take reasonable steps to prevent others from misusing the information (Calley, 2009). Therefore, in this case, how did Sarah’s brother find out about her condition before she did? Why did the doctor share the results with the brother prior to discuss it with Sarah? In this situation, we can analyze two situational crises that lead to understand why the brother got the news before Sarah and why does he think that the news should not be shared with his sister after he has evaluated the assessment provided by the doctor (Calley, 2009). First, when Sarah lost her husband and spent 6 months at the hospital, we can assume that family members had to be by her side to take care of her until she recovered. During such period, when patients are unable to care for themselves and their family, another family member can be assigned as the legal guardian or legal voice when it comes to make any decision about the person’s life at the time of their turmoil. In this case, we can assume that Sarah’s brother Warren was probably the one that was legally in charge when she had a mental breakdown (2009). Therefore, in her records, his name may be listed as her legal contact and decision-making when it comes to her health and her life. However, in this situation, they stated that Sarah had made significant progress in working through her husband’s death. Therefore, she should be able to make her own decision. Because we are not clear or certain of these allegations, Sarah should be treated just like any other patient. Her privacy must be kept private unless stated otherwise by the patient at the time of her visit. Sometime, the patients have the right to provide the doctors or therapist with a contact person in case they are unable to be reached in case of an emergency.
Calley, N. G. (2009). Promoting a Contextual Perspective in the Application of the ACA Code of Ethics: The Ethics into Action Map. Journal of Counseling & Development VOLUME 9
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