You have a friend who is a mental health practitioner. He or she was invited to attend the bar mitzvah of a thirteen-year-old child he or she is treating. After considering the offer, he or she decides to go but has asked for your advice.
A Bar Mitzvah marks a Jewish boy thirteenth birthday and the day he becomes responsible for his actions (“Elegant Woman”, 2015). From birth until age thirteen, the boy’s parents are responsible for his actions, at thirteen, he is obligated to observe the commandments marked through a formal and public religious service followed by a celebratory “party” afterward (“Judaism 101”, 2011). The guests attending the Bar Mitzvah are typically close friends and family as well as the entire congregation (“Judaism 101”, 2011). However, the celebration “party” generally contains relatives and close friends of the boy (“Elegant Woman”, 2015). Each gift should bring a gift, typically, a monetary donation of eight-teen dollars or a material gift (“Elegant Woman”, 2015). Insight and knowledge into a cultural celebration allow a mental health practitioner to establish the importance of the event and the potential outcome of attending.
Assuming the practitioner agreed to attend the Bar Mitzvah because it is in the best interest of the client, recommendations would include setting boundaries, emphasize the attendance implication for support, and attaining informed consent. Setting boundaries with the client avoids potential ethics violations in privacy and confidentiality. The practitioner is bound to protect patient privacy and confidential information about the client (American Psychology Association). Attending the function holds potential for the practitioner to be questioned by others not included in the client’s treatment. Therefore, it is essential to maintain the privacy and confidentiality rights of the client while attending the function.
Attending the Bar Mitzvah allows the client to feel full support from the practitioner eliciting validation of the client (Zur, 2015). It is common for young adolescents to feel a lack of external validation and support in conjunction with low self-esteem (Zur, 2015). Attending the “coming of age” event elicits the desired support and validation which in turn leads to an increase in therapeutic alliance and effectiveness (Zur, 2015) rendering the decision positive. Additionally, affirming and celebrating the client’s achievements also strengthens the therapeutic alliance and efficacy (Zur, 2015). However, if the practitioner declined the invitation, the client may perceive the declination as unsupportive holding potential to nullify trust, sever the therapeutic alliance and hinder the effectiveness of treatment (Zur, 2015).
The APA created the Ethics Code as a guide for professional conduct, not a basis for civil liability, and therefore contains modifiers which allow professional judgment, elimination of injustice and inequality, and “ensure applicability across” activities (American Psychological Association). The Ethics Code states that the aim of psychologists includes increasing knowledge of behavior and self-understanding to improve the individual’s condition (American Psychological Association). Zur declares the therapeutic relationship as a predictor of therapeutic effectiveness, and out-of-office experiences have proven to enhance the relationship (2015).
Despite the modifiers, it is imperative the professional attain an informed consent that outlines the purpose and expectation of his or her attendance as well as any potential risks of the participation (American Psychological Association). Attaining consent validates the professional’s ideas and substantiates his or her decision to attend. However, it is recommended that the professional only attend the ceremony, briefly, congratulate the client and leave without attending the “party” celebration after. It is customary and expected for the boy to receive a gift for his Bar Mitzvah. However, the APA frowns upon gift giving as described in section 6.04 (Barter with Clients/patients) of the Ethics Code. Others perception of the gift may include an exchange from other attendees and therefore more prove more appropriate in the confines of a therapeutic setting.
If therapeutic services had concluded, the advice would change. If the professional proceeded with a non-therapeutic relationship with the client after terminating services, the perception may include conflict of interest, potential breach of confidentiality, and may violate the code 3.05 about Multiple Relationships. A conflict of interest occurs when there are questionable motives in regards to an individual’s actions. If the professional attended the Bar Mitzvah, he or she holds the potential of exposing the previous relationship with the client as well as possibly revealing confidential information (American Psychological Association). Multiple Relationships may occur when new relationships develop after concluding services (American Psychological Association). In the event the professional attends the Bar Mitzvah, the professional relationship becomes jeopardized, and the general perception may include the conclusion of services attributed to the intention of developing a deeper relationship with the child or family member.
Recommendation of Type of Provider
Mental health providers obligate them to the same code of ethics established by the APA. Although different disciplines and specialty areas have developed further guidelines, the similarities in principles remain. Excusing one practitioner necessitates exclusions for the next. The aim of the APA Code of Ethics is to guide professionals in the highest ethical ideals while maintaining respect and protecting human civil rights (2010). Studies indicate the vitality and effectiveness in an individual circumstance of out-of-office therapeutic services, especially regarding celebratory events regarding achievement (Zur, 2015).
The case study proves to be highly controversial and supports the need for professional judgment in the mental health field. Ethical decision making requires the measurement of all possible outcomes, positive and negative. The Bar Mitzvah scenario poses risks that could hinder therapeutic effectiveness as well as benefit therapeutic effectiveness. The belief that the benefits outweigh the risks remains intact after weighing all possibilities. However, it is important to point out; the difficult decision caused an ethical dilemma. The dilemma consisted of the welfare of a child versus societal perception. However, a vulnerable child’s potential mental health takes precedence over conforming to societal expectation.
American Psychological Association. (n.d.). Ethical principles of psychologists and
code of conduct including 2010 amendments. Retrieved from http://www.apa.
Elegant woman. (2015). Retrieved from http://www.elegantwoman.org/bar-mitzvah-etiquette.html
Judaism 101. (2011). Retrieved from http://www.jewfaq.org/barmitz.htm
Zur, O. (2015). Beyond the Office Walls: Home Visits, Celebrations, Adventure Therapy, Incidental Encounters and Other Encounters Outside the Office Walls. Retrieved month/day/year from http://www.zurinstitute.com/outofofficeexperiences.html.