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Response Guidelines

Respond to the post of at least two of your peers, discussing your analysis of self-determination that would be helpful in your future interactions with employees. Ask questions that will help you better understand each post and contribute to expanding the discussion. Make substantive suggestions that will provide food for thought.

Student post down below:

Behavior emergencies and crises are often described as interchangeable yet distinguishing the two has relevance for how decisions are made (Callahan, 2009). Behavioral emergency is required an immediate response and intervention to avoid possible harm to the client or someone else. These emergencies are suicidal, violent behaviors, or interpersonal victimization. One of the scariest things’ mental health professionals and or therapist, in general, is working with suicidality. Mental health professionals rank high among the professionals vulnerable to ethical and legal quandaries when making decisions and acting under behavioral emergency conditions (Hanson, Kerkhof & Bush, 2005). In the situation where the employee is faced with such a behavioral crisis, as the supervisor, I will advise my employee to first to do not leave the client alone, secondly express to the individual although it is their right to confidentiality, and we as professionals respect that right, due to the extent of such a statement it warrants us to break that confidentiality. It is best to communicate with the client the importance of limits to privacy and why they must break the confidentiality.

As a behavioral and mental health therapist, in this scenario, the effective clinical work with potentially suicidal adults’ rests with two distinct yet overlapping functions, 1) making an appropriate determination regarding the level of suicide risk and 2) implementing an appropriate safety plan and mobilizing the necessary action to minimize the risk. On the surface, the tasks seem relatively straightforward, yet in practice, this type of decision-making is often fraught with many complications and conflicts with ethical protocols and laws. The ethical obligation of confidentiality may conflict with the objective of preventing harm to others (Granich, (n.d.)). One of the questions I am sure was going through the employee’s mind was under what circumstances can I justify breaking confidentiality? I believe many therapists, not only this employee asks themselves this question due to the ethical challenge which can often arise out of a context of competing sets of interests, such as the right of the person to be self-determining versus the responsibility of the employee to protect a client who is at risk for self-harm. Resolving issues around such release of information required a combination of sound clinical judgment as to what the employee did, an appreciation for the broad social context to which the behavioral crisis is emerging, and a sound working knowledge of the relevant legislation.

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