A recently licensed therapist, Joy, observes that many of her colleagues suffer from burnout. She decides to prevent this from happening to her. Joy schedules several extended vacations throughout the year and arranges for other therapists to see her clients in case of an emergency. Joy believes that this takes care of her professional responsibilities. However, none of her clients are made aware of this arrangement in the informed consent process that took place at the beginning of therapy. When she takes her vacations, she then informs her clients of her unavailability for several weeks. In reading the case study for unit 3, do you think Joy took care of her professional responsibility or do you think this was a case of client abandonment? Be sure to explain your answer.

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The central issue under consideration here is what constitutes “making reasonable arrangements” for clients to receive continued treatment. This issue is specifically addressed by professional associations. For instance, the Code of Ethics of the American Association for Marriage and Family Therapy (AAMFT), revised in 2015, considers “non-abandonment” in Section 1.11....

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The central issue under consideration here is what constitutes “making reasonable arrangements” for clients to receive continued treatment. This issue is specifically addressed by professional associations. For instance, the Code of Ethics of the American Association for Marriage and Family Therapy (AAMFT), revised in 2015, considers “non-abandonment” in Section 1.11. The Code states therein that “therapists do not abandon or neglect clients in treatment without making reasonable arrangements for the continuation of treatment.” Similarly, the American Mental Health Counselors Association (AMHCA) Code of Ethics (Revised 2015), states in Section I.B.5, regarding abandonment,

Assistance is given in making appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacation.

The situation indicated in Joy’s case, as she made arrangements for possible replacement therapists to see clients while she is on vacation, seems adequate as “reasonable arrangements” and thus would not be considered abandonment. As long as the therapists have the same qualifications as Joy has, so that they are professionally competent to advise the clients, her arrangement is reasonable. Nevertheless, meeting a minimum standard and engaging in meaningful and mutually satisfactory practices may differ. It would probably benefit the client to be made aware of Joy’s vacation arrangements in advance and for Joy to provide the possibility of discussing the client’s reactions to her absence.

There is a question about the informed consent aspect of this case, however, which relates more to confidentiality than abandonment. In the AAMFT Code, Section 2.1 and 2.2 address the necessity of disclosing the limits of confidentiality and for written authorization to release information, respectively. The informed consent form that Joy provided should have discussed the possibility of sharing client records with another therapist, as an aspect of the client’s right to confidentiality ensured in Section 2.1. More specific information about releasing information is provided in Section 2.2, which lays out conditions in which a therapist might disclose client confidences without a written authorization. In making the arrangements for other therapists to see her clients if necessary, Joy would be behaving ethically, provided she did not give those therapists any information about the treatment. An exception to the need for written authorization is noted there, however, which is an emergency situation—and that is the situation that the case description stipulates.

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