Deliveringcounseling to prisoners can be challenging to a therapist, legally,ethically and personally. A counselor working in this environmentmust fight with a range of issues, which are complex and diverse todevelop a therapeutic relationship to promote psychological growth inthat environment (Goodtherapy.org, 2016). Counseling inmates can bevery complicated as the same rules of confidentiality that are usedwhen dealing with the open community are also applicable to them(Pinta, 2009). This is the general principle, but counsellors shouldalso be conversant with correctional facilities policies, and the APATask Force Report in regard to confidentiality issues (Pinta, 2009).Thus, in dealing with ethical and legal issues about theconfidentiality of anything said during therapy or counselingsession, one should determine whether the failure to discloseinformation given would put the public or the patient at risk if itdoes, the counselor is obliged to share the information with relevantauthorities.
Insome instance, it has been noted that people who should be in mentalfacilities have been sentenced to prisons where they face variousissues, which need psychological attention. As a result, prisons haveshifted from their original role, which was a punishment to offendersto assume a correctional duty in an effort to address this concern.For any treatment to be successful, it is important that a patientdiscloses all information that would lead to trauma, depression orany psychological disadvantage.
Forinstance, in ’s case, there are various ethical andlegal issues that arise as while in prison because he is sexuallymolested since he has been a pedophile. To begin with, Billy getsinvolved in a sexual relationship against his will to receive“protection” from the prison gang. As a result, he is subjectedto a relationship that emotionally affects his confidence as a man.Moreover, he does not resist, thus it is possible that Billy blameshimself for being weak to act. This fact greatly affects his feelingabout his gender, which might strain his effort to establish positiveadult-adult relationship.
Thoughhe has been going through this for a while, Billy had not informedthe previous therapists who treated him of his experience. As aresult, he was treated for his pedophile condition only, while thedepression and trauma that he faced while being sexually molested wasnot addressed. This also raises the question whether Billy was honestwith the therapist and might have played along as he had no choice,but to behave in a way that he would receive favorablerecommendations from a therapist.
Theabove issue raises another serious concern whether Billy is ready toface the world out there with his psychological and unknown medicalcondition not being addressed. In addition to being molested, Billyalso shares his fear that he might have HIV/AIDS as he has beenfeeling weak and falling ill often. This makes the counselor considerwhether to recommend for the nullifying of parole for the fear thatBilly poses a threat to the public as a pedophile because of thecondition that he went through, which might make him do things thatare also traumatic to others. Evidence shows that some individualsusually mistreat others as they have also been on the receiving end(Goodtherapy.org, 2016).
Furthermore,there is a legal issue, which arises out of the treatment that Billymight go through. There is a question whether the facility might failto protect Billy from sexual harassment. Under the Eighth Amendmentinmates have right to be free from any treatment that is consideredinhumane (cruel and unusual) punishment (HG.org, n.d). Though what iscruel and unusual is not clearly detailed, violating one’s basicdignity would be considered as such.
Thislegal issue can arise if the counselor decides to disclose the factthat Billy was sexually molested and he is not psychology ready forparole as he was not treated for that and might pose a threat to thepublic. As a result, correctional management reconsiders his earlyrelease after which the inmates learn of his situation and molestBilly because the officer did not provide him with necessaryprotection. Billy can sue the warden as he has a right to beprotected from sexual harassment and being exposed to danger, whichcould have been prevented. Also, Billy has the right to complainabout the jail conditions, which increased the chances for him to bemolested if such case arose (HG.org, n.d).
Also,there is a question of whether the counselor should report to theauthorities about the fact that Billy has been previously molested orassume it. Under the tarasoffduties, physicians are under obligation to report any threats thattheir patient face or undergo in order to ensure that their clientsare safe (Pinta, 2009). Psychologist understands that it is importantfor the presence of a conducive environment if the treatment of apatient should be successful. For instance, while Billy shows apositive response for the pedophile disorder, being molestedpossesses another threat of depression and trauma, which might causea relapse.
Furthermore,there is a question of whether reporting the issue will put Billy ina more threat or not. There is the probability that if a counselorreports the issue to the authorities, Billy’s parole may beextended and in the process, some prison gang members will come tolearn of his secret. This idea puts Billy at danger irrespective ofwhether the wardens will provide security or not.
Moreover,the inmate will undergo psychological trauma as he is uncertain abouthis security condition in prison from gangs. Moreover, he will feelthat the counselor violated his trust irrespective of whether heacted in patient’s interest or the public. As a result, the clientmight lose trust in future therapy procedures, which strains theefforts of therapist and counselors in his treatment.
Thus,in the case of Billy, a counselor if faced with various issueswhether he should let Billy go on parole without knowing that he hasHIV/AIDS, risk the lives of other people if Billy disorder treatmentwas not successful, and without addressing the traumatic experiencehe underwent while he was being molested or to break theconfidentiality and report the issue to the authorities.Subsequently, there is a legal issue, which might arise if thecounselor discloses the condition of Billy and gangs molest him againdue to the failure of the facility to provide the necessaryprotection for him.
Also,there is a concern that Billy might be subjected to more molestingbecause of the disclosure of this information. These are some of thelegal and ethical issues that should be considered. However, thebottom line is that a counselor has a responsibility to breachconfidentiality if the information that comes to his/her attentionputs the public or the patient at risk and report the issue torelevant authorities (Pinta, 2009).
Goodtherapy.org.(2016, August 3). The Mental Health Effects of Sexual Assault andAbuse. Retrieved fromhttp://www.goodtherapy.org/learn-about-therapy/issues/sexual-abuse
HG.org.(n.d.). What Are a Prisoner`s Rights? Retrieved fromhttps://www.hg.org/prisoner-rights-law.html
Pinta, E. R.(2009). Decisions to Breach Confidentiality When Prisoners ReportViolations of Institutional Rules. Journalof the American Academy of Psychiatry and the Law,37(2),150-154.