Nothing is more daunting than finding oneself in the middle of an ethical dilemma and struggling to find a solution. In rural practice, this is exacerbated by challenging ethical scenarios that are perhaps not taught in urban training centers. Rural clinicians are often left to resolve conflicted feelings and clinical dynamics on their own or with limited resources. Much has been written in the professional psychology literature about ethics and decision-making models. Many of these contributions have taken an absolutistic approach, clarifying that what is, and is not, acceptable behavior by clinicians. and is measured by strict adherence to statutes, guidelines, policies, and rules. Others have taken a more relativistic approach, emphasizing that context is crucial and that "ends justify the means." Less has been written about psychologist’s self-awareness of core values and how this influences ethical decision-making approaches.
This presentation begins with the concept of a self-reflective approach to ethics and the practice of clinician self-awareness in assessment of ethical quandaries and, ultimately, in the resolution of such dilemmas. The presentation will highlight the value of self-reflection and adherence, or non-adherence, to a set of personal and professional core values about what is morally right, and will identify a variety of potential threats to successful resolution of complex ethical conundrums, particularly in rural settings. Through enhancing self-awareness of one’s core values, this presentation will support clinicians in practicing a proactive approach to ethical dilemmas. As a rural based example, this approach will be explored in the context of a vignette related to multiple relationships.
1. Apply the concept of clinician self- awareness of personal and professional core values that prepares participants to analyze factors which influence ethical decision making, including client factors, personal factors, organizational, and professional factors.
2. Identify two threats to good ethical decision making related to difficulties with our own self- awareness and self –reflection.
Jeffrey Leichter, PhD, LP, Licensed Psychologist, Sanford Health
Dr. Jeffrey Leichter is a licensed psychologist and earned a Ph.D. in clinical psychology in 1987 and completed a post-doctoral fellowship in primary care health psychology at Michigan State University in 1989. He has worked for Sanford Health since 1990. During most of that time he was in clinical practice, working with adults with a variety of behavioral health concerns, embedded in primary care in the Sanford Detroit Lakes, MN clinic. In 2014, he began to transition to a different role as the Lead Administrator for Behavioral Health Integration for Sanford Enterprise Clinic Services. He was appointed by Governor Pawlenty, and later re-appointed by Governor Dayton, to serve on the Minnesota Board of Psychology (2010-2018) where he held the office of Vice Chair and Chair.
He has presented regionally and nationally on topics related to ethics, rural mental health care and integrated behavioral health. Since 2015, he has also been a faculty member in Sanford’s executive leadership academy teaching courses on boundaries, forgiveness and facilitating leadership skills.