Commentary: Writing About Clients: Ethical and Professional Issues in Clinical Case Reports

Abstract

From the standpoint of a former journal editor and long-time professional, this commentary challenges the direction of the profession as demonstrated in this special section. The ongoing creation of more and more ethical constraints not only harms the profession but also loses sight of fundamental ethical principles. T he helping professions (counseling, social work, psychotherapy, psychology, family therapy, and psychiatry) are learning more and more about less and less, and I fear that the profession has lost the gestalt, or larger picture. Many practical dilemmas are best handled by general guidelines such as "do no harm" rather than by creating elaborate layers of legal and ethical constraints.Professionals and professionals-in-training are spending too much valuable time conforming to insurance company guidelines that are based on economics and not health care. Ethical guidelines have become ethical constraints that do not serve our clients or the profession but serve to avoid litigation and stifle creativity.Students and professionals have lost their natural curiosity and seldom pursue knowledge or inquiry with passion but rather for the continuing education units needed to maintain the license to practice. The central message of my invited response is to create a call to go beyond current ethical constraints and learn to make decisions based on broader principles that are best for clients, society, and the profession.

Using composite case material to develop trauma‐informed psychoeducation for social care workers looking after unaccompanied minors in residential care in Ireland

“…The aim of this study was twofold: first to demonstrate how the voices of UM and the professionals involved in their lives could contribute to the identification of psychoeducation training content which would enable SCW to maximise their support for UM and second to highlight the use of the innovative composite clinical journal and vignette data sources in this process. The composite case approach, which removed the requirement to obtain informed consent, was developed after carefully considering the critical debate which questions whether bona fide informed consent can ever be truly obtained in the therapy context (Carlson, 2010 ; Sperry & Pies, 2010 ). The distinctiveness of this study lies in its unique capturing of UM experiences and needs and the use of this material to inform training content.…”

“…It is also important to acknowledge that this decision-making process is complex and nuanced. Although Carlson (2010) and Sperry and Pies (2010) question whether informed consent can ever be fully obtained in this context, Bridges (2010) reports clients feeling appreciated and validated when asked. Furthermore, McKinnon's (2017) sensitive collaborative account with a former refugee client of his experiences of the therapy process, driven by his desire to deliver key messages to other therapists, includes an insightful exploration of the potential impact of publishing clinical material.…”