Clinical Diagnostic Issues

In the context of marriage and family therapy (MFT), ethical dilemmas constitute decision-making problems that characterize two possible moral imperatives. Particularly, neither of the moral imperatives is unambiguously preferable or acceptable (Nichols, 2012). In the MFT context, an example of a potential ethical dilemma includes secrets in which a couple of therapist exhibits outside contact with one of the partners. In such a case, it becomes the therapist's role to discern the manner in which secrets would be managed. The dilemma is how the therapist should proceed if one partner discloses specific data but insists that it is not revealed to the other partner. In such a case, Standard 4.02 of the APA ethical codes highlights that the therapist needs to discuss confidentiality limits at the onset of the therapeutic intervention (American Counseling Association, 2014). For this dilemma, options include keeping secrets confidential to retain trust, making a blanket statement highlighting that no secrets will be kept, and only keeping certain information secretive.

Another ethical dilemma concerns the decision on whether to accept or decline a gift from a client. Notably, therapists are expected to maintain certain professional boundaries with client groups. As such, it is imperative to determine the motivation behind the provision of the gift. Whether the gift is offered as an appreciation of the therapy or intended to make the therapist like the client is worth examining. Culture is also important to note because, as highlighted by Nichols (2012), rejecting a gift could be offensive in some cultures. Another ethical dilemma concerns religious and cultural conflict in which the values of the therapist threaten to interfere with the service provision. In such a case, it is worth acknowledging that the therapist needs to refer the client to an alternative therapist (American Counseling Association, 2014).