ultural Values and Competent, Mental Health Services to Minors, Case Study Discussion Questions

Case
2. Cultural Values and Competent

Mental
Health Services to Minors

Irina, a
13-year-old girl of Arabic cultural heritage living in Boston, Massachusetts,

was
brought by her parents to a hospital emergency room after an assault by a

stranger.
Based on her injuries, the hospital staff suspected that the attacker had

also
sexually assaulted the girl, but she and her parents refused medical
evaluations

for rape.
The family received a referral to see Janet Matthews, a clinical psychologist

specializing
in adolescent trauma. During their initial meeting with Dr. Matthews,

the
parents asked the psychologist not to discuss any sexual aspects of the assault

with
their daughter but to treat the psychological trauma from the assault in
general.

They
told the psychologist that admitting a rape had taken place would cast a

stigma
on their daughter and make her ineligible to be married to men in their

closely
knit ethnic community. When asked in private, the girl also requested that

sexual
issues not be discussed for the same reason.

Ethical
Dilemma

Dr.
Matthews does not know if she should agree to the parents’ and child’s

request.

Discussion
Questions

1. Why
is this an ethical dilemma? Which APA Ethical Principles help frame the

nature
of the dilemma?

2. Who
are the stakeholders and how will they be affected by how Dr. Matthews

resolves
this dilemma?

3. How
might Irina’s age and parents’ involvement in the referral affect how

Dr.
Matthews can resolve this dilemma? How might state law on treatment

of
minors and HIPAA rules on access of guardians to a minor’s health care

records
influence Dr. Matthew’s decision? (See sections on “A Word About

HIPAA”
in the Preface of this book, on parental rights under Standards 3.10b,

Informed
Consent, in Chapter 6, and the Hot Topic at the end of Chapter 7

“Confidentiality
and Involvement of Parents in Mental Health Services for

Children
and Adolescents.”)

4. What
attitudes, knowledge, and skills are required to develop a culturally

competent
treatment plan for Irina (see the Hot Topic for Chapter 5

“Multicultural
Ethical Competence”)?

5. Is
Irina likely to benefit from the treatment if the possibility of sexual aspects

to the
trauma is not explored?

6. How
are APA Ethical Standards 2.01a, b, and c; 2.04; 3.04; 3.06; 4.01; 4.02;

and
10.10a relevant to this case? Which other standards might apply?

7. What
are Dr. Matthews’s ethical alternatives for resolving this dilemma?

Which
alternative best reflects the Ethics Code aspirational principles and

enforceable
standards, legal standards, and Dr. Matthews’s obligations to

stakeholders?
Can you identify the ethical theory (presented in Chapter 3)

guiding
your decision?

8. What
steps should Dr. Matthews take to ethically implement her decision

and
monitor its effect?