Growthtrac Community

[SAM]

Exactly. You can pschologically diagnose a family member's issue, but true objectivity goes out the window.

[DLW52]

KM:

Im not sure how your figure a father in law performing a life saving surgery on his son in law is a bad idea. If the father in law is the best person for the job, certainly anyone in their right mind wants the best. Also, in those types of surgical procedures you have a team of certified people who are just as knowlegeable for support, so as not to make a critical error. It seems youre making a very bold assumption the father in law would attention to detail would some be compromised.
I would think the father in law would take even more so caution being that it is his son in law but more importantly it is a life he took an oath to preserve.

As Ive said in a prior post I can see both sides of the arguement regarding accountability partner being the father in law, but if/when its a life saving matter such as the example you gave, that to me is a no brainer.

[km]

A close relative is NEVER the best person for the job of performing the surgery - the closeness of the relationship in and of itself makes the person "not the best person for the job".

It is very clear that we disagree here, so I'll leave it alone.

But I am curious as to what the people here who are in the counseling field could advise us - does the counseling field have an ethical standard that prohibits or recommends against treating family members?

[SAM]

Okay - I am in school, and still learning, which does not make me an expert. However, let's take a look at the following:

Interestingly, the American Medical Association in its initial, 1847, "Code of Medical Ethics" addressed treatment of physicians' families when it said of the physician, "the natural anxiety and solicitude which he experiences at the sickness of a wife, a child, or anyone who by the ties of consanguinity is rendered peculiarly dear to him, tend to obscure his judgment and produce timidity and irresolution in his practice."

Section E-8.19 of the AMA Code of Medical Ethics (available online at http://www.ama-assn.org/ama/pub/category/8510.html) states that "physicians generally should not treat themselves or members of their immediate families" because their professional objectivity may be compromised in those situations. Exceptions are allowed for "short-term, minor problems" or "in emergency or isolated settings." The American College of Physicians (ACP) Ethics Manual (available online at http://www.acponline.org/ethics/ethicman.htm) similarly asserts that "physicians should avoid treating themselves, close friends or members of their own families." It goes on to comment that "physicians should be very cautious about assuming the care of closely associated employees."

[km]

SAM - Thanks, I figured as much.

I would also figure you'll see similar guidelines from the APA and other counseling organizations (where it is license ending and bankruptcy inducing malpractice to have a personal relationship with counselees, no?).

If professionals can't do it - inspired amatuers should doubly not do it.

[DLW52]

Okay - I am in school, and still learning, which does not make me an expert. However, let's take a look at the following:

Interestingly, the American Medical Association in its initial, 1847, "Code of Medical Ethics" addressed treatment of physicians' families when it said of the physician, "the natural anxiety and solicitude which he experiences at the sickness of a wife, a child, or anyone who by the ties of consanguinity is rendered peculiarly dear to him, tend to obscure his judgment and produce timidity and irresolution in his practice."

Section E-8.19 of the AMA Code of Medical Ethics (available online at http://www.ama-assn.org/ama/pub/category/8510.html) states that "physicians generally should not treat themselves or members of their immediate families" because their professional objectivity may be compromised in those situations. Exceptions are allowed for "short-term, minor problems" or "in emergency or isolated settings." The American College of Physicians (ACP) Ethics Manual (available online at http://www.acponline.org/ethics/ethicman.htm) similarly asserts that "physicians should avoid treating themselves, close friends or members of their own families." It goes on to comment that "physicians should be very cautious about assuming the care of closely associated employees."

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Sam:
Im interested to know is there some sort of comprehensive listing of what is deemed "short term", or "emergency" ? If not, then wouldnt this would leave it up to the subjectivity of the physician to make this determination on his/her immediate relative ?
Also , Im sure the code is as specific as possible, but what about those close to us, not blood related, but considered family, would this apply as well ?

[km]

DLW52 - note the "anyone who by the ties of consanguinity is rendered peculiarly dear to him" - particularly the "rendered peculiarly dear to him" part. Yes, simply "very, very close friends" situations would be covered.

"short term minor problems" are relatively trivial matters (the minor cut, the run of the mill flu) that don't raise great emotional issues so as to make clouded judgment an issue. "Emergency" is also very common sense - for example, the accident with life-threatening injury where other assistance is not readily available so as to render aid while the injured party is still alive.

[DLW52]

DLW52 - note the "anyone who by the ties of consanguinity is rendered peculiarly dear to him" - particularly the "rendered peculiarly dear to him" part. Yes, simply "very, very close friends" situations would be covered.

"short term minor problems" are relatively trivial matters (the minor cut, the run of the mill flu) that don't raise great emotional issues so as to make clouded judgment an issue. "Emergency" is also very common sense - for example, the accident with life-threatening injury where other assistance is not readily available so as to render aid while the injured party is still alive.

Thanks for the further clarification.

[SAM]

Thanks for clarifying, KM.

In this situation with this young man and his pornography addiction, this is not a stitches needed, kiss the boo-boo type of treatment. Surgery would be needed for the wife and husband. Both are wounded. Both need help. Pornography addiction is a life-long struggle, that is very difficult to surrender to God.

The absolute best form of treatment that I have read about is for a spouse to participate in the treatment. Mostly women, but there is a growing community of men, who have been traumatized repeatedly by their spouse's problem and broken promises, and usually have a huge trust issue and may be debating divorce. The couple is seen together so they know everything that goes on in treatment; and fears are addressed, the kinds of acting-out, as well as their stressed marriage. Also, a 12-step program is extremely beneficial for accountability.

If this couple is going to heal, her father needs to be out of the picture, and they need to be in treatment "together".

There is a wonderful ministry called http://www.faithfulandtrueministries.com
Deborah Laaser wrote a book called Shattered Vows, which is for women. In this she not only talks about her husband's treatment, but hers too.

If a man wants insight into the devastation this does to the woman he says he loves, this book is a must read.

[camelback]

Hello all. I was gone on vacation and just now got on to see the discussion. I have a comment/question becuase one of the q's I have been mulling about is weather my husband should get another accountability partner. Here is my q: I know I am a bit bias, but in regards to my dad, my sister once put it this way "if God was still in the practice of taking a godly man up to heaven in a blazing chariot, my dad would be wisked away in a heart beat." He truly is the most godly man I know and he has been blessed with a wisdom that exceeds most preachers/counselors I know. You mentioned surgery and objectivity, and in my opinion not only is my dad the best, but he has an extra stake in the matter becuase i am his flesh and blood and he loves me and cares for our marriage and healing better than a stranger does. As far as leaving and cleaving, once i was married, I left our house phy/spi/and emotionally and I never went back : ) Our parents are our best friends, and they made it clear when we got married we were welcome over any time, but we were never to take our marrital issues to their house to involve them and we have never done this. I considered this incident an exception, and the incident never got outside my husband, myself and my father. I feel it would be humitiating for my husband to seperate himself from an accountability partner he has worked with for a year inorder to try to confide in a casual friend to ask for accountability.

I also wanted to say a huge thanks for everyone who has posted coments and responded to e-mailes. I feel like a huge breakthrough has taken place and have experienced a freedom from fear and suspision! I appreciate this community of beleivers!!!

[SAM]

If your husband and father have a good relationship, that is wonderful. However, he should not be your husband's ONLY accountability partner. Have you been a partner in sessions and discussion so you are aware of all that has to go into the healing process? Are you participant in his struggles? This isn't solely about him and his addiction. It's about your marriage, which is something you said your family would not be brought into. If not, the feelings of suspicion and fear are likely to resurface.

To be very realistic, it is not unusual have relapses or waves. Waves come in cycles, like the ocean. Some are small and easy to control, and occasionally there are tsunami's that are uncontrollable. Are you prepared if that happens?

[km]

The "extra stake" you mention your father having is EXACTLY the basis for every professional treatment/counseling group forbidding them - that is why you don't have him as the accountability partner. Close support from family is great - but taking the lead is simply a counterproductive scenario.

[camelback]

Not to beat a dead horse......

In a medical situation where extreem measures or procedures may become necessary, which although needed, may result in death, you are right, that is a bad situation for a family member to be in. To ask a father to preform a procedure on his child that may save him, but may also kill him, could cloud judgment or result in indecision. It appears to me in certian counciling situations, if done correctly, the inverse wouldcould be true. There would be no indecision, becuase the loved one knows that the absence of adressing the issue, making marked steps toward change and healing.....results in "death" In my husbands situation, he has a handful of men he could ask to keep him accountable, but all live some distance away, have other lives, duties, jobs to do, and I have seen many times the accountability between "friends" falter, become uneffective/inconsistent ect becuase the motivation to hold accountible is not personal. My dad's qualifications and love for both of us and his desire to see our marriage healthy and grow motivates him to make the calls each week, and ask the tough prodding questions. I am not saying in all counciling situations the same could be said, but it seems In our situation becuase both of us want the same outcome and are in agreement it works. (I could see objectivity would be an issue in a divorce or physical abuse situatuation)

Just some thoughts.,......

[SAM]

It's okay to disagree - open discussion is a good thing from different perspectives.

However, let's go back to the original post from this young woman.

I have no idea how my dad checks in with him or what they discuss.

How do I handle my situation and fears?

I have no idea what's going on inside his head.

For this particular situation, for all of dad's wisdom and credentials in helping her husband - dad has made one HUGE misstep. And, I imagine the reason is, he doesn't want to hurt his daughter further by having her hear all that her husband has revealed about his addiction.

Dad's professional glasses are fogged over, and that makes successful surgery impossible. The most successful healing with pornography addiction is when the husband and wife are BOTH involved in the healing process. This young woman has been left out of that process.

I have children in their 20's and both are married. My husband and I are qualified to mentor them. There was a serious issue in one of their marriages a few years back. However, as a parent, there are boundaries of involvement in our children's lives and we felt helping them through their marital issues was not one to cross. We told them we would be praying for their situation, then we recommended a Christian counselor. Because of their financial situation at the time, they could not afford it. We asked if they could use some help with the costs. So we did help out with that.

The transformation in their relationship was amazing, and I see a renewed strength and commitment in both of them. I know I would not want to know all the "details" of their relationship. I believe that is too personal.

They are more then welcome to come to us for advice. However, we don't offer it up unless we are asked for it.

Personally, I still believe that outside accountability through outside support groups is more beneficial to a couple's progress.

So, we'll just have to disagree - and that's okay.

[km]

camelback

In a medical situation where extreem measures or procedures may become necessary, which ... may result in death, you are right .... To ask a father to preform a procedure on his child that may save him, but may also kill him, could cloud judgment or result in indecision. It appears to me in certian counciling situations, if done correctly, the inverse wouldcould be true. There would be no indecision, becuase the loved one knows that the absence of adressing the issue, making marked steps toward change and healing.....results in "death" .... My dad's qualifications and love for both of us and his desire to see our marriage healthy and grow motivates him to make the calls each week, and ask the tough prodding questions. I am not saying in all counciling situations the same could be said, but it seems In our situation becuase both of us want the same outcome and are in agreement it works. (I could see objectivity would be an issue in a divorce or physical abuse situatuation)

Your very own statement reveals precisely the conflict I have raised - and you're sailing right past it. Here the "patient" is your marriage (which encompasses both you and your husband as well). Your dad, like the medical doctor in the analogy, wants the patient to survive and thrive, abundantly and totally, without any hint of doubt of reservation. He has a huge emotional investment in that happening even. And that emotional investment is precisely the reason that he is absolutely wrong to be doing the work.

In fact, it is an even bigger problem here - if we view the "patient" being the marriage, so as to involve both you and your husband, your dad may be put into a position of divided loyalties - where something that ought to happen for YOUR best interests conflicts with something relating to YOUR HUSBAND's best interests.

Judgment in a multiple loyalties counseling situation is even more likely to be a problem than in a medical situation.

SAM notes a good illustration of this - why aren't you fully involved in a couples' counseling component to this? Is dad avoiding getting himself too deeply involved in his daughter's sexual relationship with her husband? Indeed, shouldn't he avoid that (yes, of course!)? But if a fully effective counseling job would require it, he's conflicted.

I do understand that we all here will occasionally just have to recognize a disagreement and move on all without achiving consensus. If that is the case here, so be it (and it isn't my marriage that is at stake). I just think - very strongly - that you're glossing over the point that you say you understand. I certainly don't mean this as any slight or disrespect to your dad. He may even be so capable as to do a less disasterous job that the vast majority of others would inevitably do, but professionals in every area of practice are strongly warned against, if not ethically forbidden (under penalty of loss of license), from getting into divided loyalty situations and situations where personal relations could cloud professional judgment.

I wish you well, and that God will see fit to bless you and your marriage - delivering you from this trial quickly and fully.