Communication Case Study

Page 1 Communication Case Study XXXXXX Swinburne University Online COM10003: Learning and Communication ELA: XXXXXXX XXXXXX Page 2 Identification of the ethical issue or problem, stakeholders, and explanation of the effects. James did not follow his professional code of ethics with all stakeholders involved and has breach the three general ethical principles of the code, which are “Respect for the rights and dignity of people and peoples, Propriety and Integrity” (APS, 2007) by creating a conflict of interest and how he terminated Sam’s therapy. Stakeholders are defined as, “any group or individual that can affect or is affected by the achievement of a corporation’s purpose” (Freeman, 2004). The stakeholders are, James, Meg, Sam, Jessica and James’s professional colleagues. James provided informal advice to Jessica via Meg. James has not adhered to his professional boundaries outside of work and discussed issues Meg’s client, Jessica was having with her former husband who is James’s patient Sam. This has created an ethical conflict of issue for James by giving informal advice to an associate of his patient and potentially using his knowledge of Sam’s situation to guide him in his advice to Jessica via Meg. Meg may now have a conflict of interest due to her association with James and Jessica, who both are linked to Sam. Further discussions between James and Meg about their work will be difficult in the future with fear of exposing each other’s clients. Jessica is not aware of James’s association with her estranged husband, but if she was to know, it would cause her to feel violated as Meg has discussed her with James and she could lose trust in Meg. The advice James has given could be interpreted as having “a non-professional relationship with an associated party” (APS, 2007. p. 9). Sam has been affected because James has given informal advice to his former wife and if Sam was aware, he would be concerned if his confidentiality has been breached. Sam’s patient care and welfare has not been considered by James with the abrupt termination of his therapy and not respecting Sam by following his professional code of ethics in how this conflict and termination should be handled. By James breaching his professional code of ethics, he has brought the profession into disrepute and this has wider implications for James’s colleagues. James’s lack of patient welfare and termination of the therapy erodes the efficacy of the patient-therapist relationship and puts further strain on a colleague rebuilding the patient’s trust if Sam was to reengage with another therapist. Page 3 Identification of the spoken and unspoken messages, and the strength and weaknesses within the correspondence. The spoken message in James’s correspondence with Sam is to terminate any future therapy sessions and to make Sam aware that he owes money for unpaid therapy sessions. The unspoken message is that James has disregard for the patient welfare of Sam, his professional obligations of how to terminate a patient’s therapy, deal with continuity of therapy and Sam’s financial position. Sam could interpret the unspoken message as the therapy has been terminated due to non-payment of therapy sessions. James’s register is a mixture of formal and consultative. A formal register is typically used in business or in business transactions and consultative register is a two-way communication used in conversation (Baldovino, 2020). The way the correspondence has been written terminating the therapy is using a formal tone and direct to the point of the business transaction and raises an outstanding amount to be paid but in a consultative way. James opens the opportunity for discussion between Sam and his receptionist regarding his financial position and ability to pay the outstanding amount. The strength of the correspondence brings an outstanding amount to Sam’s attention and that James is providing an opportunity for Sam to seek an extension of time to pay. The weakness is that James abruptly terminates the psychological services and not in accordance with his professional code of ethics. James has not considered his clients psychological wellbeing, considered or offered any ongoing therapy, offered any alternate therapy provider and James has not disclosed the reason for the termination or offered Sam the opportunity to discuss it. By raising the financial matter, Sam could be left feeling negative and let down by James with the use of connotative words like “no longer able” and “behind” when used in a financial term. Connotative words are not related to the meaning but what they could imply or make someone feel (Alexander, 2018). Identification of two skills from the ‘Future Work Skills’ document and explanation of how these skills are useful in meeting professional standards and resolving the ethical issue. The two skills identified in the document by Davies, Fidler & Gorbis (2011) is Social Intelligence described as, “ability to connect to others in a deep and direct way, to sense and stimulate reactions and desired interactions” (p. 8) and Novel and Adaptive Thinking described Page 4 as, “proficiency at thinking and coming up with solutions and responses beyond that which is rote or rule-based” (p. 9). James did not follow the Australian Psychological Code of Ethics (APS Code of Ethics) in terminating Sam’s therapy. Code B.1, ‘Termination of psychological therapy’ requires the psychologist to consider the clients welfare, the termination reason to be disclosed to the client and to also provide assistance to the client to find another therapist (APS, 2007, p.23). James did not make a professional assessment of the issue and abruptly terminated Sam’s therapy without consideration of others involved. If James had utilised the Social Intelligence skill, he could have sought advice from other colleagues, which would have helped him to consider Sam’s wellbeing, the emotional effect the termination would have had on Sam and to consider more positive words to use in the correspondence. The ‘Novel and Adaptive Thinking skill’ could have helped James follow the APS Code of Ethics with regards to his conflict of interest. Code B.12, “Conflicting demands” requires the psychologist to seek advice from a more senior peer, inform the stakeholders of the issue and what the conflict is and to seek a positive outcome within the guidelines of the professional code (APS, 2007, p.24). If James had utilised this skill, he could have taken a step back and assessed the conflict issue, realised that this was not an everyday situation and sought advice from his peers. Additionally, he could have addressed why it occurred and changed the way he approached the discussions with Meg by putting in place profession boundaries and made time to discuss with Sam the conflict he had so he could work with Sam on whether he wanted the therapy to continue. Instead James reacted out of ethical distress for an immediate solution. According to Kälvemark et al (2004), “stress related to ethical dilemmas is usually referred to as moral distress”. A well-established definition of moral distress is that it “occurs when one knows the right thing to do, but institutional or other constraints make it difficult to pursue the desired course of action” (p. 2). James knew from the APA Code of Ethics what to do, but in his mind, it was easier to terminate Sam’s therapy and not resolve his conflict. Propose solutions and identification of the strengths and limitations of the solutions. The conflict of interest issue could have been handled by James seeking advice from peers and his professional body, speaking with Meg and disclose the conflict and what professional boundaries moving forward should be in place before they have future discussion, which include a compliance check of Meg’s client’s names. According to Varkey (2021), “individual physicians must exercise discipline in not discussing patient specifics with their Page 5 family members or in social gatherings” (p. 20). Seeking Meg to cease providing the informal advice to Jessica and for Meg to keep her relationship strictly professional and not personal with Jessica. James needs to explain to Sam the conflict he has and Meg’s involvement. This needs to be done in a way that ensures that Sam has confidence that his trust and confidentiality has not been breached, his therapy sessions have not been discussed and information passed onto his expartner Jessica. By James being open with Meg and Sam, he has been honest, and he is also allowing those stakeholders affected to make an informed choice how they move forward with the conflict and a resolution to the issue. James is also adhering to APA Code of Ethics by discussing the conflict with his patient and ensuring boundaries are in place outside of the workplace. This will show that James is being professional, he is focussed on patient’s welfare and acting in the best interest of the profession and his peers. The limitations are that the stakeholders are upset at his unprofessionalism in not having boundaries, Sam complains about James and feels violated, Meg loses a client, James has brought the profession into disrepute and James and Meg have conflict within their marriage about it. Terminating Sam’s therapy should have been done in consultation with Sam, to prioritise his wellbeing, patient care and ongoing therapy. Additionally, ensuring Sam was fully aware of the conflict reasons. This would have been achieved if James had followed the APA Code of Ethics by seeking assistance from his peers, meeting with Sam and explaining the conflict whilst making sure Sam was fully aware his confidentiality had not been breached. Additionally, at the same time allowing Sam to make an informed decision with James as to his ongoing therapy. The limitation of this is that Sam loses confidence and trust in James, and this has a negative effect on the continuity of Sam’s therapy. James will need to make detailed patient notes as the issues, the course of action he took to resolve the situation and document what he has put in place to ensure this will not occur again. The limitation is that he has had to either report and seek advice from his professional body and or a peer.