Ann Tran-Lien , JD
Staff Attorney
The Therapist
May/June 2014

We invite you to take a moment to consider the relevant laws and ethical standards applicable to the following vignettes and provide CAMFT with a written response to the questions posed below. The best response(s), judged by the legal team, will be published in the upcoming issue of The Therapist Magazine. Members who answer all eight (8) of the questions presented will receive two (2) self-study continuing education units.

Vignette No. 1
Jane, LMFT had her first couple’s counseling session with Sam and Tina this morning. During the meeting, the couple told Jane that they needed her help in addressing various marital problems, especially their problems with communicating. Although Sam was fairly quiet during the counseling session, he explained that he was simply very tired from his demanding job. Tina pointed out that one of the problems in their relationship was that Sam often complained of feeling tired after working long hours, and it seemed to her that his love for his job may have become more important to him than their relationship. Tina was particularly angry and hurt about the lack of attention that she felt from Sam over the last few weeks. Sam and Tina thought that they had a lot in common, and neither had any intention of seeking a divorce. Although Tina was definitely more expressive during the session than Sam, Sam said that he loved Tina, and he believed that their marriage was worth saving.

A few hours after their counseling session, Jane received a call from Sam. Sam blurted out to Jane that he has been having an affair and does not know if he wants to end the affair, but does not want to end his marriage. He also told Jane that he does not want Tina to know. Sam said that he did not want to hurt Tina and he was certain that she would be devastated if she knew about his affair. He was relieved to have the opportunity to attend marital counseling so he could be certain that the marriage was going to make them both happy. After their first session, Sam said that he realized that he couldn’t live without Tina and he felt guilty about the fact that he may have led another person on.

For each of the following questions, please discuss the reason(s) for your answer and identify any legal or ethical standards which you believe may apply.

1. If Jane decides to disclose the information she learned from Sam to Tina, would the disclosure be a breach of Sam's confidentiality? Please explain.
2. If Sam signed a “No Secrets Agreement” after he told Jane about his affair, could Jane proceed to inform Tina of his disclosures?
3. If neither Sam nor Jane planned to disclose Sam’s affair to Tina, should Jane continue to provide couple’s counseling to them, or, should she refer them to another therapist? If Jane elects to refer them to another therapist, how should she explain her decision to Tina?
4. If Sam no longer wishes to continue couple’s counseling with Jane, but Tina does, should Jane provide individual therapy to Tina? Please explain.

Vignette No. 2
For the past month, Tom, LMFT has been providing weekly individual psychotherapy sessions to Carrie, age 12. At the start of treatment, Carrie’s mother, (Amy) informed Tom that she and Carrie’s father share joint legal custody. According to Amy, she is Carrie’s primary physical custodian, but Carrie stays at her father’s house on Wednesdays and alternate weekends.

Amy decided to bring Carrie to a therapist because of her concern that Carrie has never recovered from her parent’s divorce. In addition, Amy believes that her daughter is bothered by the fact that her father has a habit of ignoring her during visits. Amy also believes that Carrie is nervous around her father, due to his quick temper, but probably doesn’t want to say anything about it to avoid making him mad.

During their session today, Carrie began crying and told Tom that during the past weekend with her father, he became extremely angry when she refused to get off her cell phone to eat dinner. Carrie said he yelled profanities at her, snatched the cell phone, and threw it against the wall, breaking it. He then grabbed her by the arm and said, “Look, missy, if you don’t listen to me again, you’ll get it!” Immediately after the session, Tom received a phone call from Carrie’s father. He demanded Tom stop treating Carrie and to provide him with a copy of Carrie’s complete treatment records within five (5) days.

1. Was Tom permitted to provide therapy to Carrie? Please explain.
2. What should Tom do, if anything, about the information Carrie disclosed to him regarding the situation with her father over the weekend?
3. How should Tom proceed in light of father’s demand that Tom terminate treatment with Carrie?
4. How should Tom respond to the father’s request for a copy of Carrie’s treatment record?