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As a mental health professional (MHP) I face a variety of ethical dilemmas, some of which I am competent enough to handle while others are a little bit out of my level of competence. There are situations where I have to terminate my engagement with a mental patient and refer them to a more qualified professional. This may come with a huge burden of the feeling of abandonment on the side of the patient and guilt on my side. Termination and abandonment are issues that require an ethical distinction so that professionals do not get caught up in the confusion. For instance, there is this client that I had been counseling for several sessions after she had been referred to me because she had difficulties in anger management, interpersonal relationships and was undergoing depression. However during the counseling process, I realize that the client had a high suicide ideation and multiple plans of terminating her own life. Eve though she did not have any history of suicidal attempts, her threats kept on increasing with every session and could not concentrate on anything else other than her suicidal tendencies. When I tried suggesting other copying mechanisms she would have outbursts that were accompanied with tears. On several occasions she stormed out of the session too early, overturning pillows and chairs on her way out. As a professional, it was my duty to warn her that that she needed a more intense level of care than I could provide (American Psychological Association Code of Ethics). Most of the times cognitive behavioral approaches would solve most of my client’s mental issues but with her, it was difficult. So I suggested to her that I should refer her to a psychologist with greater expertise but she refused saying that she believed I was the one who she trusted would help her and she promised to corporate during the sessions. However, after two sessions, she was back to being uncooperative and would refer to plans that are underway to end her own life. I therefore had to terminate my services and referred her to a more qualified clinician even though she neither made the follow up nor spoke to me again. According to AMHCA Code of Ethics (2015),” If mental health counselors determine that services are not beneficial to the client, they avoid entering or terminate immediately the counseling relationship. In such situations, appropriate referrals are made. If clients decline the suggested referral, mental health counselors discontinue the relationship”. The client was not benefitting from my services at the moment hence my decision to terminate my services.
AMHCA Code of Ethics (2015). American Counselors Association.
Ethical Issues in Clinical Psychology. Chapter 5, American Psychological Association Code of Ethics.