solved Prior to beginning work on this discussion, be sure to

Prior to beginning work on this discussion, be sure to read the required articles for this week. .
You are a consulting psychologist for a local clinic and have been asked to review an ethically complex case. Please review the PSY699 Week four discussion case filefor detailed information on the case under review.
In your initial post, explain how the APA Ethical Principles and Code of Conduct can be used to guide decisions in this ethically complex situation. Provide a suggested course of action for the clinic staff. Given the daughter’s age and the situation presented, integrate concepts developed from different psychological content domains to support your suggested course of action. Be certain to use evidence-based psychological concepts and theories to support your arguments. You may wish to consider the following questions as you construct your post.

Does the daughter have a right to know her diagnosis?
Does the mother have a right to not disclose the diagnosis to her daughter?
Does the mother have a right to privacy regarding her own diagnosis, which could be threatened if her daughter learns of her own status?
Should the staff tell the daughter if the mother does not want her to know?
If the daughter wants to know more about her condition, what should the staff say?
Are there other approaches the staff can take? If so, what are they?
Is further information required in order for you to create an ethically sound suggested course of action?

Guided Response: Review several of your colleagues’ posts and respond to at least two of your peers by 11:59 p.m. on Day 7 of the week. You are encouraged to post your required replies earlier in the week to promote more meaningful interactive discourse in this discussion. 
Was the suggested course of action presented ethically sound based on the APA Ethical Principles and Code of Conduct? If so, how? If not, why not?  Did your colleague consider the legal ramifications of the course of action he or she suggested? Were the arguments for the suggested course of action supported by appropriate evidence-based psychological concepts and theories? What other resources might you suggest to your colleague that would inform the response to this case? Was the recommendation made culturally sensitive? What developmental issues did your colleague consider? What other issues might you suggest for further review in this case?

POST 1

Does the daughter have a right to know her diagnosis?

Yes, the daughter has the right to know her diagnosis or at the very least begin the process of disclosure. The World Health Organization guidelines suggest disclosing HIV diagnoses to school-aged children is appropriate and necessary to accommodate their emotional and cognitive development (Sariah et al., 2016). These processes help the individual adjust to their illness and the associated life challenges. It is the responsibility of the psychologist to (a) ensure culturally appropriate and accessible resources are available to the child and parent, (b) develop a plan for the child and parent how to disclose to relatives, friends, and others, and (c) prepare parents for short and long-term emotional responses to the disclosure (Sariah et al., 2016).

Does the mother have a right to not disclose the diagnosis to her daughter?

The mother does have a right to refrain from disclosing the diagnosis to her daughter. Typically, parents who disclose the HIV status to their children are from higher socioeconomic statuses, report lower maternal depressive symptoms, have older children, perceive more satisfaction with their social support systems, have greater family expressiveness, and live in urban areas (Wiener et al., 2007). One study implied that a 12-month baseline for disclosure had positive outcomes for 123 caregivers disclosing statues to their children (Finnegan et al., 2019).

Does the mother have a right to privacy regarding her own diagnosis, which could be threatened if her daughter learns of her own status?

The mother does have a right to non-disclosure of her own diagnosis. However, withholding that information would avoid full disclosure and might cause more anger toward the mother for the omittance. Depending on the parent-child relationship, it could bolster the connection and improve authenticity and communication between the mother and daughter, as facilitated by the mental health practitioner. However, this is a multilayered decision and more information about the family dynamic and history of both the mother and daughter are needed prior to forming a conclusive decision.

Should the staff tell the daughter if the mother does not want her to know?

Staff should not disclose to Victoria without Tina’s knowledge. A more appropriate route is for a psychologist to sit with Tina and better understand her history and reservations about disclosing Victoria’s condition to her. It is common for parents to believe that their child is not “old enough” or “ready” to receive the news about their HIV diagnosis. Studies indicate parents are primarily concerned that their child will experience shame or ostracization in the family or community (Wiener et al., 2007). Additionally, Tina is likely concerned that Victoria will be angry with her for transmitting the virus, which is common for mother’s in similar circumstances (Wiener et al., 2007).

If the daughter wants to know more about her condition, what should the staff say?

Given the intricacies of this case, it is not advisable for staff to disclose any information about Victoria’s condition. A mental health practitioner with an emphasis in marriage and family therapy and working with populations of HIV status/applicable cultural experience is recommended to discern the disclosure process to Victoria with her mother’s involvement. It is likely several subsequent sessions will occur during this process over the course of a minimum of one year.

Are there other approaches the staff can take? If so, what are they?

Staff can conduct their own credible research about disclosing HIV status to gain more education about these cases. I would recommend they consult with a felicitous mental health practitioner before taking any action, specifically the one working with the applicable individuals. Nevertheless, all staff involved can continue to imbue a compassionate, accepting environment and take the time to listen to Victoria and Tina while validating their emotions and experience.

Is further information required in order for you to create an ethically sound suggested course of action?

Yes, additional information is needed to further assess the situation and initiate suitable steps for the disclosure process. Overall, the predominant ethical concerns are to avoid foreseeable harm, discuss the limits of confidentiality between Victoria and Tina, refrain from any conflicting relationships, and maintain confidentiality during all professional interactions (APA, 2010). There are minimal psychological differences in typically developing children who are disclosed of their HIV status. Furthermore, children who are educated about and provided resources for their condition reported lower scales of depression and anxiety (Wiener et al., 2007). Notwithstanding, Tina’s and Victoria’s community resources and familial dynamics must be further explored before initiating disclosure. Additionally, I would recommend assessing Victoria’s cognitive, emotional, and physical development, perceived support, and sense of self before taking any course of action.

POST 2
The mother should tell her daughter abut her diagnosis. I would recommend to the mother that I understand her wanting to protect her daughter, however she could potentially be putting her daughter at more risk. The daughter has already disclosed that there are times when she does not tale her medication. If she continues to not take it she is going to be at risk of developing full-blown Aids and a very high risk of developing a secondary infection. If the daughter discontinued her meds and develops pneumonia that could be the beginning of a downward spiral for her that she may never recover from.
The mother is confident that her daughter will not be in a hurry to have a sexual relationship, however studies have shown that children who have HIV positive mothers tend to have intercourse at an earlier age (Edwards et al., 2013). The age of the daughter is a justified concern about her lack of knowledge of her disease, even though she does not know her mother shares the same disease. The mother’s behaviors are most likely the same as other mothers who are HIV positive.
Not only does this put her daughter’s health at risk it can put others at risk. If she goes to a friend’s hours and gets cut or gets cut at school and others come in contact with her blood, she could spread the virus (Aultman & Borges, 2011).
Research has shown that not disclosing critical information to family members, especially children can have a significant impact on their emotional and psychological being as well as a negative impact on the family dynamics (Nam et al., 2009)
The daughter does have the right to know her diagnosis. She needs to know soon, as she will need to be educated about her disease, she will need to know how to properly dispose of sanitary supplies, how to handle nicks and cuts so not to put others at risk. She also needs to know how to take care of her own health to prevent secondary infections.
The more education she has about her disease the better choices she can make when it comes time to developing and entering relationships and have access to support groups with others her own age that also have HIV.
The mother does have the right to not tell her daughter, however the mother needs to be aware of the higher risks she is exposing her daughter and other to by not telling her.
The mother does have the right to her own privacy, however she has to give consideration to what is best for her daughters physical and psychological health.
Ethically the staff cannot tell the daughter about her diagnosis. She is a minor and her mother still has to give consent for the information to be released. If the psychologist can justify protecting the daughter and others from harm and that disclosure of this information will protect others, they could cross the fine line that the daughter is not always compliant with her medications which puts her and others at a higher risk 3.04a (APA, 2010).
If the daughter asks for more information about her condition the staff cannot provide her with any information. They can refer her to her mother for the information. They can provide the mother with the benefits of telling her daughter about her condition and they can offer her support in doing so or they can try to get mom to sign a release allowing them to tell her.
The mother not telling her daughter about her illness violate her human rights. The daughter has a right to know about her disease. This can place ethical concerns on ethics code 1.02. The psychologist is in the dilemma of law and ethics. The psychologist in this case can inform the mother of conflict, tell her they are ethically committed to tell the daughter of her disease and they can not justify the mother violating the daughters right to know. (APA, 2010).
Ethics code 3.10(b): the psychologist must consider what is in best interest of the client. In this case the daughter. It is important for her to know, especially if she is not 100% compliant with taking her medications. If the mother is not willing to give consent or to inform her daughter of her condition, the psychologist can take the steps necessary to protect the welfare of the daughter.
REFRENCES
APA. (2010). Ethical Principles of Psychologists and Code of Conduct. https://www.apa.org/ethics/code/index

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