Irina, a 13-year-old girl of Arabic cultural heritage living in Boston, Massachusetts, was brought by her parents to a hospital emergency room after an assault by a stranger. Based on her injuries, the hospital staff suspected that the attacker had also sexually assaulted the girl, but she and her parents refused medical evaluations for rape. The family received a referral to see Janet Matthews, a clinical psychologist specializing in adolescent trauma. During their initial meeting with Dr. Matthews, the parents asked the psychologist not to discuss any sexual aspects of the assault with their daughter but to treat the psychological trauma from the assault in general. They told the psychologist that admitting a rape had taken place would cast a stigma on their daughter and make her ineligible to be married to men in their closely knit ethnic community. When asked in private, the girl also requested that sexual issues not be discussed for the same reason. Ethical Dilemma Dr. Matthews does not know if she should agree to the parents’ and child’s request. FOR THE USE OF UNIVERSITY OF PHOENIX STUDENTS AND FACULTY ONLY. NOT FOR DISTRIBUTION, SALE, OR REPRINTING. ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED. Copyright © 2013 by SAGE Publications, Inc. Appendix B——357 Discussion Questions 1. Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma? 2. Who are the stakeholders and how will they be affected by how Dr. Matthews resolves this dilemma? 3. How might Irina’s age and parents’ involvement in the referral affect how Dr. Matthews can resolve this dilemma? How might state law on treatment of minors and HIPAA rules on access of guardians to a minor’s health care records influence Dr. Matthew’s decision? (See sections on “A Word About HIPAA” in the Preface of this book, on parental rights under Standards 3.10b, Informed Consent, in Chapter 6, and the Hot Topic at the end of Chapter 7 “Confidentiality and Involvement of Parents in Mental Health Services for Children and Adolescents.”) 4. What attitudes, knowledge, and skills are required to develop a culturally competent treatment plan for Irina (see the Hot Topic for Chapter 5 “Multicultural Ethical Competence”)? 5. Is Irina likely to benefit from the treatment if the possibility of sexual aspects to the trauma is not explored? 6. How are APA Ethical Standards 2.01a, b, and c; 2.04; 3.04; 3.06; 4.01; 4.02; and 10.10a relevant to this case? Which other standards might apply? 7. What are Dr. Matthews’s ethical alternatives for resolving this dilemma? Which alternative best reflects the Ethics Code aspirational principles and enforceable standards, legal standards, and Dr. Matthews’s obligations to stakeholders? Can you identify the ethical theory (presented in Chapter 3) guiding your decision? 8. What steps should Dr. Matthews take to ethically implement her decision and monitor its effect? ...

1. Irina, a 13-year-old girl of Arabic cultural heritage living in
Boston, Massachusetts,
was brought by her parents to a hospital emergency room after
an assault by a
stranger. Based on her injuries, the hospital staff suspected that
the attacker had
also sexually assaulted the girl, but she and her parents refused
medical evaluations
for rape. The family received a referral to see Janet Matthews, a
clinical psychologist
specializing in adolescent trauma. During their initial meeting
with Dr. Matthews,
the parents asked the psychologist not to discuss any sexual
aspects of the assault
with their daughter but to treat the psychological trauma from
the assault in general.
They told the psychologist that admitting a rape had taken place
would cast a
stigma on their daughter and make her ineligible to be married
to men in their
closely knit ethnic community. When asked in private, the girl
also requested that
sexual issues not be discussed for the same reason.

2. Ethical Dilemma
Dr. Matthews does not know if she should agree to the parents’
and child’s
request.
FOR THE USE OF UNIVERSITY OF PHOENIX STUDENTS
AND FACULTY ONLY.
NOT FOR DISTRIBUTION, SALE, OR REPRINTING.
ANY AND ALL UNAUTHORIZED USE IS STRICTLY
PROHIBITED.
Copyright © 2013 by SAGE Publications, Inc.
Appendix B——357
Discussion Questions
1. Why is this an ethical dilemma? Which APA Ethical
Principles help frame the
nature of the dilemma?
2. Who are the stakeholders and how will they be affected by
how Dr. Matthews
resolves this dilemma?
3. How might Irina’s age and parents’ involvement in the

3. referral affect how
Dr. Matthews can resolve this dilemma? How might state law on
treatment
of minors and HIPAA rules on access of guardians to a minor’s
health care
records influence Dr. Matthew’s decision? (See sections on “A
Word About
HIPAA” in the Preface of this book, on parental rights under
Standards 3.10b,
Informed Consent, in Chapter 6, and the Hot Topic at the end of
Chapter 7
“Confidentiality and Involvement of Parents in Mental Health
Services for
Children and Adolescents.”)
4. What attitudes, knowledge, and skills are required to develop
a culturally
competent treatment plan for Irina (see the Hot Topic for
Chapter 5
“Multicultural Ethical Competence”)?
5. Is Irina likely to benefit from the treatment if the possibility
of sexual aspects
to the trauma is not explored?
6. How are APA Ethical Standards 2.01a, b, and c; 2.04; 3.04;

4. 3.06; 4.01; 4.02;
and 10.10a relevant to this case? Which other standards might
apply?
7. What are Dr. Matthews’s ethical alternatives for resolving
this dilemma?
Which alternative best reflects the Ethics Code aspirational
principles and
enforceable standards, legal standards, and Dr. Matthews’s
obligations to
stakeholders? Can you identify the ethical theory (presented in
Chapter 3)
guiding your decision?
8. What steps should Dr. Matthews take to ethically implement
her decision
and monitor its effect?