Analysis of therapeutic, legal, and ethical decision-making in spouse abuse cases
Stulberg, Tracey L.
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There has been a growing controversy between the therapeutic and legal professicns around the therapeutic and legal frames professionals endorse for effective clinical treatment. This lack of consensus has contributed to increases in malpractice suits against •jlinicians, in complicated cases, where appropriate treatment is not clear-cut. ccn.plicated cases, such as spouse abuse, involve issues of confidentiality, prediction of dangerousness, and duty to warn. The present study was designed to help reduce the confusion that exists in the family therapy and legal fieids regarding legal/ethical and therapeutic issues. Three types of treatment frames were identified to underlie clinical practice: legalistic, side-by-sic:>', and therapcutic. Previous research dictated the necJ to compare the legal and ethical judgments of atLorneys ancl therapists, as well as examine certain therapist and attorney demographic variables in relation to making legal and ethical decisions (practice setting, Lheoretical orientation, area of law practiced, rT'^lpractice experience, and experienco with spcuse abuse cases). Attorneys and therapists were asked to judge four issues (legal, ethical and therapeutic) in case scenarios where the therapist, in each, had conducted th.'rapy out of one of three frames (legalistic, side-by-side, and therapeutic). I^esults suggested that there were differences in the manner in which therapists and attorneys judged therapeutic, legal and ethical issues. In addition, the Jeqalistic frame was endorsed by all subjects a the mr^st appropr i ate ; therapeutical] y , legally and ethically. In addition, there were some consistent patterns of relations among the three frames. Finally, attorneys' practice setting, experience with spouse abuse cases, theoretical orientation, and area of law practiced were found to be related to therapeutic, legal , and ethical decision-n.aking. It seems that the increase in legal action against therapists has had an impact on treatment choices endorsed by attorneys and therapists. It may be that the fear of legal action ill lead therapists to engage i:i clinical work that sacrifices the quality of therapy. Hopefully, this research will help professionals dialogue about therapeutic, legal, and ethical difíiculties inherent in dealing with spouse abuse cases, so that they can be prcpared to make appropriate treatment decisions in the future.