Ethical Implications and Outdated Practices
Ethical Implications
Legal Challenges and Licensure Restrictions When discussing the legal challenges associated with licensure restrictions, it is crucial to understand the current regulations and their potential implications for both therapists and clients. Therapists are typically regulated by state licensing boards, which set standards for education, training, and ongoing professional development. These boards also establish scope of practice guidelines, which dictate the types of therapies and interventions therapists can legally provide. Regulations can vary significantly from state to state, impacting how therapists operate within legal boundaries (Levy & O’Hara, 2010).
- Implications for Therapists Therapists must adhere strictly to their state’s scope of practice regulations. This ensures they provide services within their competencies and legal permissions. Licensure restrictions may limit therapists from providing services across state lines without obtaining additional licenses or meeting specific requirements such as temporary permits or telehealth regulations. Non-compliance with licensure regulations can result in legal repercussions, including fines, sanctions, or license revocation. Therefore, therapists must stay updated on regulatory changes and maintain compliance to protect themselves legally (Levy & O’Hara, 2010).
- Implications for Clients Licensure regulations may impact clients’ access to therapeutic services, especially in rural or underserved areas where licensed therapists are scarce. These regulations are designed to ensure therapists meet minimum standards of education and competence, thereby safeguarding clients against potential harm from unqualified practitioners. Telehealth regulations have become crucial in recent years, affecting how therapists can provide services remotely across different jurisdictions. Clients may benefit from expanded access to therapy but must navigate state-specific regulations governing telehealth (Yellowlees et al., 2010).
The Neosystemic framework has significant implications for the legal and ethical aspects of therapy, particularly in light of its emphasis on cultural competence, recognition of complexity, and responsiveness to diversity.
Within the Neosystemic framework, cultural competence extends beyond a superficial understanding of cultural differences to a deep appreciation of the complexity and diversity of individuals’ lived experiences (Anderson & Gehart, 2023). Therapists and supervisors are called upon to recognize the influence of cultural, social, and systemic factors on clients’ identities, values, and behaviors, as well as their own infinite influences. This requires a commitment to ongoing education about how the world is evolving (techno), self-reflection, and humility to ensure that legal and ethical practices are culturally sensitive and responsive.
The traditional legal and ethical standards in therapy may not adequately account for the complexities of the modern world, including immigration, globalization, and cultural diversity. Therapists and supervisors are encouraged to challenge assumptions and biases embedded within existing legal and ethical guidelines, advocating for policies that reflect the evolving understanding of human diversity and complexity (American Association for Marriage and Family Therapy [AAMFT], 2015). They are prompted to question the relevance and applicability of these standards in a multicultural, interconnected world.
By questioning what is taken for granted, therapists and supervisors can contribute to the evolution of their profession and ensure that legal and ethical standards align with the values of diversity, equity, and social justice (Fisher, 2017). The Neosystemic framework invites a critical reevaluation of these standards to ensure they align with the principles of inclusivity, respect, and responsiveness to diverse populations. This may involve advocating for reforms to outdated regulations, policies, and licensure requirements to better reflect the realities of diversity, complexity, and immigration (Sue et al., 2009).
Examples of Outdated Practices Supporting Ethical Implications
Immigrants and Restriction of Practice/License
The current code of ethics, which typically restricts therapists from practicing outside of the states where they are licensed, fails to adequately address the complexities of the immigrant experience and the realities of a globalized world. This limitation poses significant challenges for immigrant clients, who may not have family members or support networks in the same city, state, or country where they reside. According to recent data, approximately 13% of the U.S. population is foreign-born, highlighting the substantial number of individuals potentially affected by these restrictions (Migration Policy Institute, 2023). From a cultural competence perspective, this restriction fails to recognize the unique needs and circumstances of immigrant clients, who often rely on the involvement of family members or other important individuals in their therapy. In many cultures, therapy is viewed as a collective process involving not only the individual client but also their family or community members (Chang, 2020). By prohibiting therapists from providing services to clients located outside of their licensed state, the code of ethics may inadvertently perpetuate cultural insensitivity and hinder the therapeutic progress of immigrant clients. Moreover, this restriction may lead to potential harm for clients, both in terms of abandonment and in terms of limiting their access to quality care. Research indicates that immigrants facing barriers to mental health services are at increased risk of untreated mental health conditions, which can exacerbate their overall health outcomes (APA, 2019). Clients who are unable to receive therapy due to state limitations may experience feelings of abandonment or isolation, which can worsen their mental health concerns. Additionally, by restricting access to therapy based on geographical boundaries, the code of ethics may prevent clients from accessing culturally competent care that meets their unique needs. Studies have shown that culturally competent care significantly improves treatment outcomes for immigrant populations, underscoring the importance of flexible and inclusive therapeutic approaches (APA, 2019). From a Neosystemic framework, this limitation overlooks the interconnectedness of individuals and systems within a globalized world. Immigrant clients often maintain strong ties to their home countries and communities, necessitating a flexible approach to therapy that acknowledges and accommodates these connections. By embracing a more systemic viewpoint, therapists can better understand the complex web of relationships and influences that shape the experiences of immigrant clients and work collaboratively with them to address their needs (Sue et al., 2009). In conclusion, the current code of ethics falls short in addressing the complexities of the immigrant experience and the globalized world. By restricting therapists from practicing outside of their licensed states, the code of ethics may hinder the therapeutic progress of immigrant clients, perpetuate cultural insensitivity, and limit access to quality care. To promote cultural competence and provide effective therapy to immigrant clients, it is essential for therapists and professional organizations to advocate for a more flexible and inclusive approach to therapy that recognizes the interconnectedness of individuals and systems within a global context.
Social Media Restrictions
The limitations imposed by the code of ethics regarding the use of social media and technology fail to fully acknowledge the evolving nature of human connection, particularly in a globalized world. These limitations may stem from an old-school perspective that emphasizes the need to protect clients and maintain professional boundaries (American Counseling Association, 2014), but they may overlook the cultural nuances and shifting expectations of clients, particularly younger generations. The ethical limitations on social media use may be informed by a cultural perspective that prioritizes professional distance and boundaries. However, this perspective may not fully align with cultural norms and expectations, where individuals may value authenticity and personal connection. In many cultures, the distinction between professional and personal identities is less rigid, and sharing aspects of one's personal life, including imperfections, can enhance the therapeutic relationship (Kaplan & Haenlein, 2010). By imposing strict limitations on social media use, the code of ethics may inadvertently hinder therapists' ability to connect with clients on a human level and convey authenticity and relatability. Additionally, the limitations on social media and technology fail to recognize the agency and empowerment of clients, particularly in an age where information is readily accessible. Clients, especially younger generations, are often well-informed and have higher expectations of their therapists. Social media platforms and technology provide clients with avenues to seek out information, connect with others, and express their needs and preferences (Pew Research Center, 2022). By restricting therapists' use of these platforms, the code of ethics may limit clients' ability to engage with therapists in ways that are meaningful and relevant to them. Furthermore, the code of ethics may not fully comprehend the ways in which new generations connect and communicate in a globalized world. Social media has become an integral part of daily life for many individuals, serving as a primary mode of communication and information sharing. Younger generations, in particular, may prefer to interact with therapists through social media platforms, where they feel more comfortable and empowered to express themselves. By embracing social media and technology, therapists can meet clients where they are and adapt to their preferred modes of communication (Fitzgerald et al., 2021). In conclusion, the limitations imposed by the code of ethics regarding social media and technology usage may reflect a perspective rooted in professional boundaries and client protection. However, they may fail to fully acknowledge the cultural, generational, and informational complexities of modern society. To promote ethical practice, it is essential for therapists and professional organizations to reconsider these limitations and adopt a more flexible and culturally responsive approach to social media and technology use in therapy.
Decision Making in Supervision and Therapy
Effective supervision involves a profound awareness of the complexity inherent in the therapeutic process and the reflective practices that occur during and after sessions. Supervisors play a critical role in fostering supervisees' autonomy, encouraging them to take responsibility and trust their own judgment. This process hinges on open dialogue where supervisees voice their perspectives and supervisors provide constructive feedback, engaging in a parallel process of self-awareness (Bernard & Goodyear, 2018). It is crucial to recognize that the conceptualization of situations, problems, and solutions in therapy is influenced by multiple variables. Gregory Bateson, a pioneer in systems theory, famously quoted Korzybski, stating, "A map is not the territory it represents" (1933, p. 58). This notion reminds us that therapy and supervision processes are interpretations of reality at specific moments, capturing snapshots rather than encompassing the continuous complexity and change present in individuals and systems. Awareness of the continuous influence and complexity prompts supervisors and therapists to explore the broader systems influencing clients and their own perspectives. Our perceptions shape how we interpret reality, emphasizing the subjective nature of our understanding. It is imperative to tread carefully in supervision, acknowledging the potential for unintended harm when offering advice or interventions. The client's system, as well as the therapist's system and therapeutic alliance, are subject to ongoing change. Therefore, interventions must be contextually relevant and dynamically responsive to the evolving needs and dynamics of each session (Bernard & Goodyear, 2018). Supervisors create a safe space for supervisees to cultivate their unique therapeutic style and develop autonomy. This process involves guiding supervisees in analyzing the context, time, and space before applying strategies, and empowering them to adapt these strategies immediately when necessary. Ultimately, therapists gain confidence and authenticity by taking responsibility for decisions during sessions, informed by their reflections on available options and interactions in the moment. This autonomy fosters professional growth and enhances the therapeutic process, aligning with the principles of continuous learning and adaptation in dynamic therapeutic environments (Friedlander et al., 2018).
Conclusions
Neosystemic framework is a response to the need for diversity and culture to transcend traditional boundaries, viewing each individual as a unique culture in constant flux. This approach is increasingly necessary in a society where therapists and Marriage and Family Therapy (MFT) students often rush from one workshop to another in a quest for additional knowledge. Neosystemic framework advocates for a return to foundational systems, suggesting a more respectful way to apply the general systems process to what the family or organizational system is experiencing. Recognizing the infinite influence and the perpetual nature of change in each person and the system where that person belongs, Neosystemic framework calls for a humble return to the origins of systemic theory. To navigate this diversity with respect and humility, Neosystemic framework proposes a non-judgmental, egalitarian perspective drawn from a postmodern and collaborative-dialogic perspective. This framework emphasizes ethical responsibility and the creation of spaces that are respectful and inclusive, avoiding the tendency to succumb to an overwhelming influx of new theories and models that often merely repackage foundational problems. Neosystemic framework reminds us of the importance of common factors that bind us together as we navigate the intricate maze of contemporary therapeutic landscapes. By focusing on these shared elements, therapists can foster a deeper understanding and connection with their clients, ensuring that therapeutic interventions are both effective and culturally sensitive.