Whether you are preparing to take the MFT Law and Ethics exam or the LCSW Law and Ethics exam, you are very likely to see questions on the topic of self-determination and patient autonomy. So why is patient autonomy important and what does the concept of self-determination mean? Well, it means that we do not tell our clients what to do and meet them exactly where they are at in the moment.
Examples of patient self-determination:
- A client makes the decision of whether or not to stay in a relationship, even if the relationship is abusive in nature.
- A client chooses to focus on a particular issue in therapy, even though there are other glaring problems present.
As therapists, our job is to remain non-judgmental and help the client foster a sense of independent decision-making regarding their lives.
Practice Law and Ethics Exam Question:
Now, let us take a look at the type of question you might encounter during your law and ethics exam regarding self-determination.
While meeting with a long-term client, a 28-year-old graduate school student, the therapist learns that the relationship the client is in is abusive. The client tells the therapist that her partner was very warm, communicative and kind at the beginning. With time, however, he became increasingly jealous, possessive, and began belittling her. Eventually their fights became physical in nature. “I am so confused,” states the client, “I know he is a very good person underneath. I know his behavior is unacceptable;he is just wounded and I know he means well. All my family and friends want me to leave him, but I care for him so much. I am so confused. What do you think I should do?” Taking into account a strong and trusting relationship, what action should the therapist initially consider?
A. Educate the client on the nature of partner relational violence and develop a comprehensive safety plan
B. Acknowledge the difficult nature of the situation and explore client’s ambivalence
C. Educate the client on the nature of partner relational violence and gently note that her friends and family have her best interest at heart
D. Acknowledge the difficult nature of the situation and emphasize feelings of love and understanding the client has for her partner
Share your answer and rationale in the comments section below and check back tomorrow for a discussion of the answer and rationale for this week’s Law and Ethics practice test question.
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A) allows the client to have self-determination through educating her and also helping the client to think a safety plan just in case she needs one.
I would say (A). It educates the client on the cycle of violence, as well as not deciding option for the client. Based on education the client is able to determine what direction she would like to choose, also allow therapist to meet patient where she is. The safety plan assures that the client is safe, if she does decide to continue relationship.
I pick answer B
Though I know that the therapist would need to do a safety plan... the question asks Initially... I would think that initially you would validate her feelings and therefore I choose D
I am going with B! We need to explore her ambivalence!
I chose A, To allow the client to decide when she feel it is time to go , providing the safety plan for when she decides she is ready to leave that type of relationship. And as long as the Therapist doesn't speak against what the client feels about her partner, she will continue to confide in the therapist.
I choose A as well. I feel the member has the right to self determination after educating her about relational violence. Designing a comprehensive safety plan and having it in place is essential since member is in an emotional and physical abusive relationship.
A) As a Therapist we must put the client's safety above all. So Safety Plan must be put in order first. Then education about Domestic Violence and how it evolves over time, but Safety must come first.
I meant B
I would select B, which acknowledges the difficult nature of the situation for the client and explores her ambivalence. The client has presented that she is confused and doesn't know what decision to make.
I picked A - the therapy session is in the middle - this is a long standing client. Safety issues - the partner is abusive - therefore, educating her on the cycle of violence, and creating a comprehensive safety plan would be something the therapist can do initially. Then explore her ambivalence and confusion.
I think is B.
The suspense is killing me! Whats the answer?
Looking at question stem again - I am moving on the side of B - acknowledge her ambivalence and confusion and then create a comprehensive safety plan.
I picked D. I would want to validate the clients feelings initially. I would ease into the educating later.
I would choose D then EDUCATE a
Where can I find the answer to this question?
Found it!! Yey!! B was correct!
Look at the answer in blog! It is there!
I choose A, because this could be the last opportunity, or session. Besides this, educating the client could serve as validation that the client's thinking was right, when she made the decision to seek help. Educating the client on stats, the wheel, and other information in a nurturing tone could go over big. It might just saw the client's life. Naturing verbal tones, utilization of therapeutic skills, including body language will show that I have acknowledge the difficult nature of the situation.
Educating the client can assist with a breakthrough for the ambivalence, thereby helping the client with making a better decision on what's best for the client, and this will also allow for self-determination. Once the client is educated, and returns (perhaps not) to the violence environment, she/he will be better equiped to recognize what he/she is experiencing. Afterwards, and hopefully she/he will understand what family and friends has been trying to communicate.
Client is asking what she should do? and Taking into account a strong and trusting relationship. is A
The client is confused regarding whether too stay or leave; however, answer A help educate the member on the risk of staying in a DV relationship, and gives her a safety plan, if in fact she feel the need to leave the relationship. No directive from the therapist, but place the decision on the client.
I choose B
Acknowledging clients feelings validates clients concern and exploring ambivalence provides information that the therapist and client can allow client to be part of the solution.
I am going with A. It is best practice to educate and put a safety plan in place just in case.
I would choose B