Vignette Eight Case Study

In Vignette Eight, Dr. Faye Miller has received Betty Drapier as referral for therapy. Betty presents with depression and marital problems. In treatment she also expresses concern for her husband, Don, who is in therapy with with Dr. Cooper. Betty believes that Don is no longer receiving help from his therapist, but is actually getting worse. After hearing this Dr. Miller suggests that both Don and Betty come to therapy together so Dr. Miller can evaluate their marriage and see for himself the extent that Don is impaired. During the session Dr. Miller sees that, indeed, Don is impaired on multiple levels. During the therapy Don admits to his drinking problem and asks Dr. Miller for a second opinion on his treatment with Dr. Cooper. It is also important to note that Don admitted to having suicidal ideation during the therapy session with Dr. Miller. Don leaves therapy in a rushed manner after Dr. Miller reiterates the reason that they were in therapy together, pointing out it was not to assess his treatment from Dr. Cooper. The ethical dilemmas presented in this vignette stem from Dr. Miller’s willingness to have a couples therapy session with Don and Betty.

Miller’s actions in the vignette it is evident that there are many potential problems. First, there is the issue of Don’s confidentiality. As Betty is Dr. Miller’s client in this situation, not Don, Dr. Miller must be careful as to how much he allows Betty to disclose about Don. This is especially difficult because he must keep in mind that part of the reason Betty presented to therapy is because of her marital problems. Dr Miller must keep the session balanced in a way that Betty is able to share her concerns in a safe manner but does so without violating ethical standard 10.2a and ethical standard 4 and while keeping in mind principles 1, 2, and