Mini Workshop 17 - My Patient Is Lying to Me, What Do I Do? Addressing This and Other Ethical Quandaries Using an Ethical Decision-making Framework

Ethical dilemmas arise frequently in the practice of clinical psychology and related fields. Ethical codes (e.g., APA Ethical Principles of Psychologists and Code of Conduct; APA, 2017) provide both aspirational goals and enforceable standards related to ethical mental health service delivery. However, these codes are often written with purposefully vague and broad language and do not always provide sufficient guidance in how to make decisions that align with the ethical standards. When the ethical path is not clear, an ethical decision-making (EDM) framework can guide the process and improve ethical decision-making (Johnson et al., 2022). While several EDMs are rated highly for their acceptability and potential to improve decision-making (Johnson et al., 2022), the Transcultural Integrative Model (Garcia et al., 2003) emerged as a leading framework because of its adaptation of a highly effective and acceptable model (the Integrative Model; Garcia et al., 1998) and its explicit consideration of cultural and contextual factors in the decision-making process (Garcia et al., 2003).
This workshop will review and apply the Transcultural Integrative Model (Garcia et al., 2003) to clinical vignettes derived from real scenarios, describing common ethical concerns that arise in psychotherapy practice.
(1) You learn that your emerging adult patient is lying to you about important factors relevant to their treatment,
(2) Your teenage patient feels passionately that they have autism based on videos they have seen online . Autism is not in your case conceptualization for this patient nor is it your area of expertise,
(3) You are working with an 8-year-old who is in foster care; the guardian is having trouble managing their behavior and is employing consequences that feel harsh but are not considered abuse. The guardian’s practices align with their culture of origin, but not that of the child’s.
Facilitators will illustrate the model guided decision-making in the vignette-based scenarios. Presenters will additionally solicit scenarios from the audience and facilitate discussion about navigating ethical challenges in a rapidly changing technological and sociopolitical climate.

Recommended Reading 1: American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code/

Recommended Reading 2: Garcia, J. G., Cartwright, B., Winston, S. M., & Borzuchowska, B. (2003). A Transcultural Integrative Model for Ethical Decision Making in Counseling. Journal of Counseling & Development, 81(3), 268–277. https://doi.org/10.1002/j.1556-6678.2003.tb00253.x

Recommended Reading 3: Johnson, M. K., Weeks, S. N., Peacock, G. G., & Domenech Rodríguez, M. M. (2022). Ethical decision-making models: A taxonomy of models and review of issues. Ethics & Behavior, 32(3), 195–209. https://doi.org/10.1080/10508422.2021.1913593