by Eric Fischer

Question by ebizartistry: For substance abuse counselors…Question about your profession.?
What are some of the ethical issues in your profession of dealing and working with involuntary clients? Complete explanations are most desired as I am doing some research on issues in your profession. Thanks!

Best answer:

Answer by michele
One major problem with involuntary/court-ordered clients involves the issue of informed consent. If a client is compelled to attend treatment, “informed consent” becomes a moot point. Theoretically (and ethically) this shouldn’t happen. When treatment is not voluntary, informed consent becomes an incredibly sticky area.

Another issue with court-ordered clients involves the definition of WHO , precisely, is the client. Oftentimes, it is not the person receiving services who is actually paying for it. In the eyes of some therapists, that makes the payor (i.e., the state, the prison system, department of children’s services, etc) the “client”, and puts the therapist squarely in a CONSULTANT role.

Confidentiality (or lack thereof) represents yet another ethical dilemma with court-ordered clients. If is often the case that reports must be made to the state (or the agency compelling the person to be in treatment) regarding treatment progress, etc. In voluntary situations, this information could only be revealed IF the client signs a release form. In the case of involuntary clients, some therapists believe that such reports constitute a (required) confidentiality breach.

Finally, the bottom line, is that many non-voluntary clients do not want to be in therapy. Many will refuse to actively participate in therapy. Therefore, in many cases, precious little therapeutic progress will be made. This nets yet another ethical quandary, in that psychologists are ethically bound to discontinue treatment with clients who are clearly not making progress in therapy.

Best of luck in your research,
~M~

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