Commentary: Critical Reflections on the Ethical and Professional Considerations in Writing About Clients

Abstract

From the standpoint of a journal editor and researcher, this commentary critically reflects on some of the primary notions addressed in the 4 featured articles of the special section, discussing areas of agreement and divergence. As a way of further exploring these ethical and professional concerns, the contentious issue of using school children as case studies in publications and in graduate counseling courses is briefly examined.

Obtaining clinical writing informed consent versus using client disguise and recommendations for practice.

“…Further, many other journals leave the decision of whether to disguise or obtain client consent up to the individual author-clinician (Gabbard, 2000). Sink (2010) asserts that as a journal editor, he "assume[s] the author has accurately portrayed and discussed the client's story in an ethical manner . .…”

“…Further, many other journals leave the decision of whether to disguise or obtain client consent up to the individual author-clinician (Gabbard, 2000). Sink (2010) asserts that as a journal editor, he “assume[s] the author has accurately portrayed and discussed the client's story in an ethical manner… because [in] most case studies… the client's identity [is] so well disguised that it is virtually impossible to trace the source of the information and check its reliability” (p. 160). The overall lack of information about how to create an appropriate disguise of the client, how to engage in the clinical writing informed consent process, or how to acquire a client's written consent may be sending an implicit message that it is not absolutely necessary to ensure a client's anonymity or receive the client's permission to serve as a subject of clinical writing.…”

“…Further, the clinician runs the risk of the client identifying himself or herself in the published article, which could result in psychological or litigious consequences (Clifft, 1986). Although a case composite (in which several real clients are combined to create a hypothetical client) may allow the clinician to construct a "client" who perfectly illustrates a specific theory or intervention, validity is again in jeopardy (Sink, 2010). This conflict between confidentiality and pedagogy is at the heart of the ethical complexities of clinical writing.…”

“…State psychological associations can be consulted to learn more about specific state laws. Further, the journal or publisher's policies on clinical writing informed consent, confidentiality, and privacy must be considered (Sink, 2010).…”

Ketamine for Bipolar Depression: Biochemical, Psychotherapeutic, and Psychedelic Approaches

“…Using composite clinical vignettes, we illustrate the three approaches to ketamine treatment for refractory depression in patients with bipolar disorder (type 1). These composite cases are based on patients in our clinical practices ( 10 , 11 ). We also describe a variety of clinical considerations for using ketamine with this population, including notes on route, dose, frequency, chemical mitigators, adverse events, etc.…”