Reviewer: Lawrence H. Gard, Ph.D.(Private Practice)
Description: This book describes the ethical challenges facing practitioners working with HIV/AIDS impacted clients. It then offers 10 HIV-related case examples to illustrate a decision-making model for resolving such dilemmas.
Purpose: The authors seek to promote a useful method for addressing the personal, clinical, ethical, and legal complexities arising in HIV-related psychotherapy. They aim to present realistic scenarios and strive to offer a decision-making model that is equally applicable in the real world; they achieve greater success with the former than the latter.
Audience: This book is intended for mental health practitioners of all disciplines and experience levels, and for use in healthcare ethics courses. Those in the mental health professions would likely find it more helpful than would physicians or nurses.
Features: Part I of the book examines ethical quandaries in HIV-related psychotherapy. Difficult situations such as confidentiality versus the duty to protect are explored, and the authors introduce a comprehensive model of decision-making. Chapter four examines how cultural differences can create ethical dilemmas. As a solution, the authors simplistically advocate that practitioners develop cultural competency. They fail to acknowledge that promoting such sensitivity may unintentionally discourage practitioners and their clients from challenging cultural norms that place clients in harm's way. In Part II, the decision-making model is applied to 10 realistic case examples, such as the secretive HIV-positive spouse. The cases are interesting and they clearly demonstrate the authors' complex model of analysis.
Assessment: This book is a needed addition to the discussion of ethics and HIV-related psychotherapy. However, in a typical managed care impacted practice or under-funded treatment center the suggested model of analysis, documentation, and consultation with specialists is idealistic. The authors suggest that their model can help practitioners reduce the risk of a lawsuit, but by promulgating such an overwhelmingly thorough decision-making model they influence the standard of care in an unrealistic direction.