Do you think that interventions are permissible under the ethics of psychology/psychiatry?

[LoZoccolo]

[Happyhippychick]

1. Do you mean for a mental health person to lead?

My first reaction would be "no". I am in that field and autonomy is a major theme of what we should be respecting and honoring in our clients. An intervention runs counter to that because it is high pressure and sometimes physical duress. I won't work with patients who are addicts and not in a treatment program so I tell them they need to go into a program in order to work with me. I would tell them that I recommend those programs but I wouldn't lead an intervention.

[LoZoccolo]

3. Yeah, lead, or even give advice about.

I understand if there's a bunch of people enabling an addict, that they all have to get on the same page or the addict will just go to the ones who aren't a part of the intervention, but I was curious how if the therapists feel like they're conducting something that they normally wouldn't tell people to do - threaten to isolate someone from their family - and what is the reason they give that that is permissible in this case. I'm not questioning it antagonistically, I'm just curious how they think about these things.

[Happyhippychick]

16. Therapists shouldn't give ultimatums. I've never been part of an intervention but

I've seen them on TV, no idea if that is a true replication of the event but it looks like it is very direct and based on ultimatums. Therapists should encourage autonomy because at the end of the day nobody is going to change if they are being "forced" to do it, they will only do it when they have come to the conclusion that they must do it. They can explain to an alcoholic the toll that it is taking on the family, and they should also explain to the family what the alcoholic is going through in terms of brain chemistry alterations and their own unhappiness that has led to such excessive drinking. And the genetic component shouldn't be ignored.

Ethics are a judgment call so there is no right or wrong (different from something being illegal in our profession) so if you get ten shrinks in a room we will give you ten opinions. Mine is that a therapist should not lead an intervention but I know that there are colleagues of mine who feel more comfortable pushing boundaries and they would disagree with me.

[HereSince1628]

2. I'd like to know how many 'interventions' turn out to be unnecessary.

Recently published studies in the UK have shown that depression, parasuicidal and suicidal behavior INCREASES following involuntary detention. In other words involuntary interventions create circumstances which produce traumatic stress with all the associated psychological damage to the target that is common to PTSD.

If generating PTSD is a good thing, then interventions are 'good.' If generating PTSD isn't a good thing, then interventions must be undertaken with very serious consideration of ALL the downstream consequences, not simply the notion of preventing a person from engaging in behaviors that are harmful to themselves.

[LoZoccolo]

5. I was talking more about where they get all of a person's friends and family to deliver an ultimatum

that they get help, or that all those people will cut off contact with the person until they do. An involuntary detention is more what I refer to as "committment".

[HereSince1628]

9. Somehow, I think such a confrontation would also be potentially traumatic.

Maybe you relate differently to coercion.

[Canuckistanian]

4. It's all right, LoZoccolo

They're just trying to help you.

[LoZoccolo]

7. While everyone else is watching /Intervention/ on A&E, I'm watching another show named

Existential Hero. It's on at the same time, on the same channel, only I am rooting for the other side. My father watches the Chicago Bears so enthusiastically that when someone is running for a touchdown, he will actually stand up and run in place yelling "go go go go go!" I told my stepmother that I get the same kind of feeling when the addict on Existential Hero tells the family that they can all go forget themselves that he gets when the Bears score a touchdown.

[Canuckistanian]

10. Sounds interesting

I'll watch for it. Not much on the interwebs about it.

[undeterred]

6. What do you mean by an intervention?

Deprogramming is over the top. An intervention can be a good thing.

[LoZoccolo]

8. See #5. n/t

[Little Star]

11. Are you referring to a medical intervention?

I am confused because your OP says under the ethics of psychology/psychiatry and your post #5 says I was talking more about where they get all of a person's friends and family to deliver an ultimatum.

Also, are you talking about drug/alcohol problems or strictly psychological problems?

Regardless, as ‘a last resort’ sometimes it’s the only way to get someone help. I have witnessed more than one successful intervention. By witnessed I mean I was a body in the room who did not speak, but I did nod a few times. lol

[LoZoccolo]

13. I'm referring to addictions, maybe some personality disorders.

Mainly I'm wondering if people think it's a breach of a psychologist/psychiatrist's professional ethics to arrange one.

[Little Star]

15. You got me there.....

I have no idea if it's a breach of a psychologist/psychiatrist's professional ethics to arrange one. I've only been involved in ones by family & friends who are/were in Alanon/AA.

[dbt]

12. Is yet another shit question.

n/t

[bemildred]

14. They have ethics?

Psychiatry and torture


I would like to add to Julio Arboleda- Flórez's excellent discussion of the problem of psychiatric participation in interrogations. There is considerable international support for asking psychiatrists and other physicians not only to decline to participate in torture and related practices, but also to speak out vigorously against its use by governments.

While medical ethics surely disapproves such practices, they are also widely condemned in other quarters. For example, in its aspirational "Body of Principles for the Protection of All Persons under Any Form of Detention or Imprisonment", the United Nations General Assembly, after asserting that "no person under any form of detention or imprisonment shall be subject to torture or to cruel, inhuman, or degrading treatment or punishment", adds in a note: "The term 'cruel, inhuman or degrading treatment or punishment' should be interpreted so as to extend the widest possible protection against abuses, whether physical or mental, including the holding of a detained or imprisoned person in conditions which deprive him, temporarily or permanently, of the use of any of his natural senses, such as sight or hearing, or of his awareness of place and the passing of time" (1).

In addition, the Body of Principles requires that "no detained person while being interrogated shall be subject to violence, threats or methods of interrogation which impair his capacity of decision or his judgement" (1).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525113/