When adults opt for medical treatment, they should be well informed of the expected benefits, expected pain and discomfort, possible risks and unwanted side effects, and the costs and consequences of alternatives such as no treatment or medication versus surgery (Ollendick and Prinz, 1993). In the case of psychotherapy, many therapists find it difficult to provide specific information regarding the length of the treatment, the nature of sessions, treatment plan, confidentiality, and its limits and alternative treatment options. However, mental health professionals are obligated to provide clients with such information that will enable them to make an informed choice regarding whether or not to pursue treatment. This is generally a time-consuming process. Concepts need to be explained in simple language (Ford, 2000).
Psychotherapy, while being beneficial and therapeutic, can also cause harm. Psychotherapy can involve transference reactions, regressive dependency states, and worsening clinical conditions (Simon, 2001). Therefore patients need to be informed of both the benefits and risks of specific psychotherapies. The following should be discussed with the prospective psychotherapy patient: anticipated benefits, potential risks, a cautious prognostic assessment, expected with and without treatment, and available alternative treatments, including risks and benefits (Simon, 2001). More specifically, Bruce Gross in his research paper titled “Informed Consent” emphasizes that it is against all professional ethics and all states’ law to treat persons without their informed consent.
Legally, consent requires the existence of three conditions: the consenting adult must be mentally competent, the consent must be given voluntarily and it must be informed. For consent to be informed, the potential client must fully understand what they are consenting to. In particular, all clients should be provided with specific information to include: the professional’s title and license, training, and experience in brief, as well as any issues or personal problems that can negatively impact the treatment process; the limits of confidentiality; details of records that will be made and maintained; diagnostic and treatment methods that might be used; availability of the professional in the event of a crisis; anticipated length of treatment; fees and billing practices; alternative treatment options; expected benefits of treatment; possible risks of treatment; and the rights of all clients including the right to not pursue treatment at all or with the given professional (Gross, 2001).
Informed consent is sometimes obtained orally in the first session. But in the case of psychotherapy, the amount of information to be provided is voluminous, and clients are likely to be in an emotionally heightened state. To counter these issues, some therapists elect to send a consent letter to new clients prior to the first session. Other therapists create a standard form that is reviewed with a new client during the first session. The form is signed and dated by the client and well documented. Without such documented consent, the mental health professional is at risk of having his license suspended or revoked.
Bibliography
Ford, George Gary (2000). Ethical Reasoning in the Mental Health. CRC Press. 2000.
Gross, Bruce (2001). Informed Consent. Annals of the American Psychotherapy Association. Volume: 4. Issue: 5. 2001. Page Number: 24.
Ollendick, H. Thomas and Prinz, J. Ronald (1993). Advances in Clinical Child Psychology. Springer Publications. 1993.
Simon, I. Robert (2001). Concise Guide to Psychiatry and Law for Clinicians. American Psychiatric Pub., Inc. 2001.