- Center for Ethical Practice - https://centerforethicalpractice.org -

Oops! What Now? Ethical Dilemmas With Difficult Patients

Certain categories of patients create difficult ethical dilemmas for therapists.  Using information from the research literature, as well as our own experience of various types of patients, how can we anticipate the predictable dilemmas, avoid the avoidable ones,  and respond ethically to the “unavoidables”?

I. Potential Pitfalls & Ethical Dilemmas With Various Patients

Depressed

Anxious/Fearful

Angry/Rageful

Clinging/Dependent

Demanding/Entitled

Detached

Ambivalent

“Characterologically Difficult”

………………

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 II. Avoiding the “Avoidable” Ethical Dilemmas

Conscientiously Following Ethical Standards

Maintaining Clear Boundaries

Respecting Informed Consent Rights

Obtaining Consultation

Respecting Autonomy (Empowered Collaboration)

Attending to Documentation

Using “Redundant Protections” When Appropriate                                           

III. Anticipating & Preparing for the “Unavoidable” Ethical Dilemmas

 IV. Recognizing One’s Own Vulnerabilities With Certain Patients

Screening and Choosing Patients

Noticing Danger Signals

Recognizing Personal “Red Flags”