Module 1 · Section 6 · Case Illustrations
Competing Obligations
Three cases in which two legitimate obligations stand in direct conflict. Each is worked in three steps. Taken together they show something no single case can, which is what a decision-making model does and does not settle.
The three cases
The HIV disclosure. A sex therapist is working individually with a client who discloses in session that they have recently tested positive for HIV and have not informed their primary sexual partner, with whom they continue to have unprotected sex. The client states they are not ready to disclose and asks the therapist to maintain confidentiality.
The conjoint disclosure. A clinician is conducting conjoint sex therapy with a married couple presenting with desire discrepancy and sexual avoidance. During an individual check-in that occurred without a previously established policy regarding confidentiality within conjoint treatment, the female partner discloses an ongoing sexual relationship outside the marriage that her husband does not know about.
The insurance report. A client who has been in sex therapy for six months requests that the clinician produce a detailed report for their insurance company summarizing the clinical work. The insurance company's form requests a full diagnostic description, treatment rationale, and session-by-session progress notes. The client has signed a release.
Case 1 · Step 1 of 3
The HIV disclosure
A sex therapist is working individually with a client who discloses in session that they have recently tested positive for HIV and have not informed their primary sexual partner, with whom they continue to have unprotected sex. The client states they are not ready to disclose and asks the therapist to maintain confidentiality.
Which obligations are in direct conflict here?
Select the three the case identifies. You get one submission.
References
- Canadian Psychological Association. (2017). Canadian code of ethics for psychologists (4th ed.). https://cpa.ca/aboutcpa/committees/ethics/codeofethics/
- College of Psychologists of Ontario. (2022). Standards of professional conduct. https://www.cpo.on.ca/en/public/standards-of-professional-conduct/
- R v Mabior, 2012 SCC 47, [2012] 2 SCR 584. https://decisions.scc-csc.ca/scc-csc/scc-csc/en/item/9985/index.do