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Do you think peer support for depression is ethical if a

psychologistt who oversees it is...
do you think peer support for depression is ethical if a psychologistt who oversees it is able to make decisions (detrimental ones, such as withdrawal of access) on mental health grounds without consulting the client or the client's health professional?
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Answered in 11 minutes by:
8/3/2009
Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience: 20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
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Hello:

By definition if it is peer support, then what is a professional doing there? I especially am concerned if there is any fee involved. I think it is a mislabeling of a group therapy session into peer support. If this is done with the information that I have just provided, then yes I think it is detrimental and unethical. Not wishing to brag, but I am a certifed group psychotherapist of the American Group Psychotherapy Association. I believe that a member or members should challenge in an appropriate way the actions of the leader. Please click green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your feedback and bonuses are always welcome. As always you can email for further info.

I will be signing off for about an hour and 20 mins. to see a patient, but will be back on line at approx 8PM Eastern Time US

Ralph LMHC, CGP

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Customer reply replied 8 years ago
Dear *****

Thank you for your answer. I realised I didn't properly clarify that the peer support I am referring to is an online group, that was originally just a relatively informal chat/support group but has been 'professionalised' as a 'service'. So the psychologist who is making these decisions has not only not consulted personally with the client, but has never laid eyes on them. Clients are required to provide a great deal of personal and health-related information on applying to join the service and people are excluded if their depression is deemed too severe, since the site caters only to those with mild to moderate depression. But it is the manner of exclusion and lack of consultation when access is withdrawn that disturbs me. The site is depressionservices.org.au.

warm regardsCustomer

Hello

On line, it does not manner a licensed psychologist is responsible for professional conduct whether hr is or is not paid. On line or not, He can run the chat group and be dititorial if he wishes. This is properly more of bad practices than it is unethical. If you wish there is nothing to stop you and your peers from forming your own group, but with a profsional to moderate it could be somewhat dagerous to the more gragile group members. I still don't think it is peer support with a professional involved. You might wish to a pproach a licensed therapist and present him/her with a group already formed. A good referral source would be the american group psychotherapy foundation and ask for the registry of certified group psychotherapists. Please click green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your feedback and bonuses are always welcome. As always you can email for further info.

Ralph LMHC

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Customer reply replied 8 years ago
Dear *****

Thank you again for your answer. Of course, I am in Australia and yes a number of former (or exited) members of the site I referred to have formed their own group, although this is not for group therapy as such. Here is an example: me. I was a member of this group for over 2 years without difficulties, but ran into trouble once I sent a letter protesting the removal of another person (in very measured terms, I might add) and constructively criticising some aspects of the service - which, by the way, is almost totally funded by the Australian government. The service also includes professional counselling and this is overseen by the same psychologist - I started counselling but since they only offered me a supervised student (no choice given) it was not successful (slow, laborious and process driven) so I believe there are some conflicts there as well. I guess the main question is whether it is ethical for a psychologist to remove a person on mental health grounds (without notifying the person of that reason - in my case, I discovered this via a former member of staff who overheard a conversation concerning me) when they haven't had consultation with the person or their health professional. I suppose in reality I am trying to get a handle on what is ethical and what isn't, and I realise this might be a difficult and not very straightforward question. I cannot find any other sites on the web that operate in the same way this one does.

In fact, the other thing I am concerned about is that if a person is ejected from the site - which occurs with a statement that they will no longer correspond with you - and goes on to do something harmful that is triggered by the rejection - what is the ethical position on this? Again, in this case, I suppose noone would ever know because the site insists on totaly anonymity, they won't communicate with you, and unless the person leaves a detailed suicide note or the like, it can never be connected back to the site - which if it was, no doubt would be met with a response saying the person was depressed, and not their fault. I think this is a possible and very scary prospect.

I will click the ACCEPT button but wasn't sure if I could then also reply, so I will do this once I receive your response. Thank you again for giving this consideration.

Warmest regardsCustomer

Don t press the accept press info and and ask.

Ralph

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Customer reply replied 8 years ago
um, what info button?

I am sorry I pressed the info button, you need to press the reply button , not the accept button so that you are not charged until your question is answered satisfactorily.

Sincerely,

Ralph LMHC

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Customer reply replied 8 years ago
oh okay, thanks for that, ralph. I understand now. Did you get my last (as in third) rather lengthy message?Customer
I got your long messsage and understand it better as we have nothing like it in the States. That being said to eject someone from a group without an explanation and a new referral if appropriate is in my opinion unethical.
Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience: 20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
Verified
Ralph LMHC and 87 other Mental Health Specialists are ready to help you
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I hope I have provided you with the information that you required. If I wewre to be ejected from a group without explanation let alone cause I would probably bothered. But at a certain point it is time not to fixate upon it and move on.

Ralph LMHC

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Good luck and thank you for the bonus.

Sincerely,

Ralph LMHC

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Customer reply replied 8 years ago
Thanks Ralph, yes you were helpful but I still have difficulties with this. I have lodged complaints with two separate authorities about these events, and have discovered many others in the same situation. So I guess I will wait to see what they do about it. I am fixated yes, but for me, according to my psychiatrist, it has actually been a relatively good thing, having been uninterested in anything much for some time. And, as I said, I am deeply worried about others in this situation who may be hurt by what i consider to be unethical practices. Incidentally, the psychologist concerned does not actually participate in the group - it is overseen by volunteer moderators - so makes her decisions based on her interpretation of the textual interaction only. Anyway, thanks again for your time. I do appreciate it.

Warm regardsCustomer

It was most challenging and you introduced me to a novel type of forum which we may be soon faced with under our new health regulations. I understand how working on this issue has been good for you. What I meant is that you have a limited amount of energy as everyone does. You will need to save some for th other things in life, but I am sure you are aweare of this. Good luck and even if you do not win there is something to be said about fighting the "good fight".

Best wishes,

Ralph LMHC

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Ralph LMHC
Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
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Experience: 20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs

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