Answer to Question 1
Confidentiality is an ethical obligation that is basic to psychotherapy in order to establish and maintain trust with patients. However, there are cases when confidentiality must be broken. Confidentiality must be broken when a patient is dangerous to himself or to others; a therapist has the duty to warn or protect potential victims. In particular, cases of suspected child abuse or when the patient has threatened to harm someone override confidentiality. The Tarasoff case established the duty to warn in California; subsequent cases expanded this to the duty to protect, which can involve protective actions like hospitalizing the potentially dangerous patient.
Answer to Question 2
Leaving the decision of child custody in a divorce settlement to the judge is problematic because what is in the child's best interest is only vaguely defined in the law. Many mental health and legal experts believe they serve children and the legal system better if they help settle custody disputes outside of court. In divorce mediation, parents meet with a neutral third party, who may be a mental health or legal professional, who helps them to identify, negotiate, and ultimately resolve their disputes. Mediators adopt a cooperative approach to dispute resolution, treating separated parents as parents rather than as legal adversaries. Mediation reduces custody hearings, helps parents reach decisions more quickly, and is viewed more favorable than litigation by parents. One randomized trial found that five to six hours of mediation causes nonresidential parents to remain far more involved in their children's lives and work together better 12 years later. Many states now require mediation as a more family friendly forum for dispute resolution.
The patient and his family meet with the nurse to discuss progress on the patient care plan.
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Dolores Huerta and Cesar Chavez, leaders of the United Farm Workers, discuss their 1968 strike of ...
A therapist assisting an amputee patient to regain mobility and strength after amputation.
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