Managing Clinical Concerns

James C. Raines and Nic T. Dibble

in Ethical Decision Making in School Mental Health

Published in print September 2010 | ISBN: 9780199735853
Published online January 2011 | e-ISBN: 9780199863457 | DOI:

Series: SSWAA Workshop Series

Managing Clinical Concerns

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It is important to remember the importance of the therapeutic relationship throughout the ethical decision making process. Most codes of ethics emphasize the importance of clinical competence. Ethical decision making requires clinical competence in three major areas. Threat assessment skills are important when determining whether to break confidentiality in the case of a client who may be a danger to themself or others. This includes skills in both suicide risk assessment as well as violence risk assessment. In both cases, clinicians should have a dual focus on the safety and personal growth of the student. This requires expertise in developmental decision making, especially in knowing which factors lead to risky decisions. Then practitioners can work within students' zone of proximal development to support them in making good decisions. Finally, there are six common conflictual issues between minority cultures and dominant Western ethics: communitarianism, emotional control, reciprocity, professional boundaries, self-disclosure, and child-rearing practices.

Keywords: clinical competence; crisis intervention; cultural sensitivity; developmental decision making; risk factors; school violence; suicide; threat assessment; warning signs; zone of proximal development

Chapter.  10381 words.  Illustrated.

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