What are some potential ethical dilemmas counselors and psychologists face in assessing their clients?

Question

What are some potential ethical dilemmas counselors and psychologists face in assessing their clients? 

Answer 1

My first question is are you talking about actual assessments and testing reports? Or are you thinking more generally about the clinician's overall take on a client.

In regards to psychological assessments, a forensic psychology setting is one place where ethical dilemmas may arise more frequently. A common, but very important, ethical principle that needs to be clear through the entire process is who the actual "client" is. For example, let's say that a man is recently released from prison and placed on parole. A mental health assessment is requested by the parole officer, NOT the formerly incarcerated man. In this case the client is the parole officer, who will have full access to the report and the man's personal health information. In these situations, I want to make sure that I am cognizant of what the goals of the assessment are, what personal information is needed to answer the report's main questions, and what information can be omitted to respect the confidentiality of the man being tested. These results have the potential to significantly impact this man's future and legal standing.

Another big ethical area in all psychological testing, but particularly in forensic settings is how the data is interpreted. On one hand, you want to make sure the data is consistent across various measures and significant enough to support your findings. However, language is everything and has a great impact in how those results are perceived. For example, let's say that this examinee's test showed a mild elevation on an antisocial personality scale. I would be extremely cautious to assert that this man is a manipulative social deviant.

To be as ethical as I could be, I would check all my boxes. First, is there any other data that is consistent with this finding, or are there discrepancies to refute it? How does this score make sense with any other data that is clinically significant? After considering the individual score alone, and with the rest of the data, I would then consider his unique biopsychosocial circumstances. What was going on in society or his environment or did something happen in his past that changes the interpretation of this score? Furthermore, I would also consider the test measure itself. We know that many assessments have inherent biases that may influence data, especially for those in minority groups. Could the test's biases and this man's specific race or income caused this mild elevation? Or is he malingering and downplaying his antisocial traits for his parole officer?

Long story short, to every ethical dilemma lies 100 sub dilemmas and 1,000 questions to constantly be thinking about.

Answer 2

One important thing many psychologist learn is the concept of counter transference. This is when a therapist likens the characteristics of someone in their life and experience onto the client. For example if I were interviewing you and while you were telling me about your life I suddenly thought " wow they remind me of my mom, but wait my mom was always terrible at giving advice and really mean to anyone she didnt like. what if this person is like that too". As you can see this would complicate my assessment heavily. A therapists goal is to always be as objective as one can. Things getting in the way of this create ethical dilemmas. Such as if I ( a white man) didnt take into account the life and culture of a client that was for example a Chinese immigrant studying at university. Is it fair to assess and judge her by my american standards or even the ethnic standards I living around mostly white people in my life have? To an even greater extent where have the standards of mental health and what is normal and healthy come from? Do they come from Freud? From the DSM? Who decides and who are we to impose these views on others.