Curt and Katie chat about client autonomy. We look at what patient autonomy is and what therapists need to understand about this very complex topic. We explore how therapists can overstep or abdicate their role in supporting their clients in making decisions. We also look at what true informed consent is and the dimensions of client autonomy. This is an ethics continuing education podcourse.
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In this podcast episode we talk about client autonomy
Therapists are faced with balancing their professional knowledge with the needs and desires of clients. At the core of this issue is the principle ethic of client autonomy. How much autonomy do therapists need to give clients? What do therapists do when clients don’t have the capacity for autonomy in the first place? This workshop explores the considerations that therapists must face when balancing the needs of clients with professional mental health services.hen
What is patient or client autonomy in mental health?
Clients making decisions about their treatment based on solid information and an understanding of that information
There is a debate related to whether we defer to clients’ decisions no matter what versus standing in the role of professional therapist
What do therapists need to understand about client autonomy?
There is a lot of complexity and nuance related to therapist responsibility as professionals versus when therapists can become too paternalistic
There is a not a lot of discussion within the ethics codes related to client autonomy, they are usually in the preamble, so it is more important while also be less discussed
Freedom (or liberty) to make choices versus agency (or capacity) to understand the choices
Therapists need to clarify for clients the options and make sure they can make informed decisions
How is informed consent related to client autonomy?
If clients don’t know what their therapists are doing, do they have client autonomy?
Evaluation of whether someone has the capacity to make treatment decisions can be impacted by bias, but is the role of the therapist within the mental health treatment
We don’t want to equate autonomy with autonomous decision-making
Dimensions of client autonomy and the therapist’s responsibility
Decisional dimension - being able to plan and make decisions about their mental health treatment
Executive dimension - being able to follow through on the plans made
Therapists need to be able to step forward and provide additional support to clients to bring them back to autonomy or hold a line in treatment that will and will not be offered
Informed dimension - understanding the difference between informed consent and informed assent and being able to give instructions ahead of time if have a mental health crises
Looking at a “Mental Health Advanced Directive” - one example is the Wellness Recovery Action Plan (see the resources section in the show notes).
Paternalism and client autonomy
Not all “paternalism” is wrong - when clients are unable to care for self, they may need some paternalism to be able to be safe or get the treatment that they need
Asymmetrical versus libertarian paternalism is discussed
The importance of understanding your own bias and how the way you frame options can be manipulative
Who we are:
Curt Widhalm is a LMFT in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. Learn more at: www.curtwidhalm.com
Katie Vernoy is a LMFT, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. Learn more at: www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves - except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.