Triad

Respecting Self-Determination with Our Clients

Elizabeth Price — Tue, 03 Nov 2026 21:12:59 GMT

Come back soon for a question related to this topic!

Self-determination is an ethical principle that recognizes the right and need of clients to be free to make their own choices and decisions. As a mental health professional, your ethical responsibilities with regard to client self-determination include the following:

• You respect and promote the right of your clients to self-determination whenever it is socially responsible to do so.

• You help your clients determine and clarify their goals and work to improve your clients’ capacity and opportunity to change and meet their own needs.

• You may limit a client’s right to self-determination when, based on your professional judgment, you conclude that the client’s actions or potential actions pose a “serious, foreseeable, and imminent” risk to self or others.

Help Clients Clarify Their Goals, Change, and Meet Their Own Needs:

As noted above, you should help your clients to determine and clarify their goals and to improve their capacity and opportunity to change and meet their own needs. Effective ways of fulfilling this responsibility are described below.

a. Establish Mutuality at the Start of the Relationship: “Mutuality” refers to mutual efforts by you and client to work on the problem. Establishing mutuality with a client involves adopting a posture of professional competence, while at the same time, communicating that you and the client are equal partners in the helping relationship who are both responsible for what happens in the helping process.

b. Allow the Client to Choose the Focus of Treatment: The principle of self-determination dictates that a client has the right to choose which problems will be addressed by the intervention. You may make recommendations, when appropriate, but should allow the client to make the final decision unless a problem is mandated. Even an involuntary client who has been mandated to see you should be given as much choice as possible. You or your agency might mandate one problem (i.e., the problem mandated by the court or other legitimate authority) but allow the client to choose the second or third.

Sometimes, you and the client will disagree about the treatment goals or objectives or some other aspect of treatment planning. With regard to this issue, Persons, Davidson, and Tompkins (2001) suggest the following as a useful principle for determining whether or not a disagreement is manageable: “If the disagreement is not likely in [your] judgment or as determined empirically to prevent the patient from reaching his or her goals or to lead to a catastrophe (e.g., financial insolvency), then disagreement is acceptable” (p. 44). When this is not the case, consultation or referral is often the best course of action.

c. Facilitate Decision Making and Problem Solving by the Client: As a mental health professional, your primary role in the helping process is to facilitate decision making and problem solving by the client, and to do this appropriately, you must respect the client’s right to and need for self-determination.

The following guidelines can help you to do this effectively:

• When helping clients explore alternatives and make decisions, be sure to respect their values and belief systems and avoid imposing your own. You don’t have the right or responsibility to make decisions for your clients. A client might make a decision that you disagree with, but because the client is the one who must live with the decision, he/she has the right and responsibility to make it.

• You may help clients understand how the values they hold influence their goals and decisions, but you should never tell clients how to proceed based on your values.

• You should expect clients to work toward the intervention goals and convey this expectation to them. Be willing to challenge or confront clients when they are not making reasonable progress.

• To avoid creating dependence, use interventions that allow clients to learn problem-solving skills and that prepare and empower them to ultimately function and cope without your assistance.

• Allow clients to participate as much as possible in decisions that affect their lives and keep them informed of what you’re doing on their behalf.

Practice Question

Elizabeth Price — Tue, 03 Nov 2026 21:05:00 GMT

Select your answer and share in the comments. The answer and rationale will be posted in the comments soon...

A social worker is meeting with a client who has been taking an antipsychotic medication for several years to manage symptoms of schizophrenia. During a session, the social worker notices that the client has begun making repetitive, involuntary movements of the mouth and tongue, including lip smacking and tongue movements. The client reports feeling embarrassed and asks the social worker whether the medication is causing these symptoms. What is the MOST appropriate response by the social worker?

a. Recommend that the client stop taking the medication immediately to prevent further neurological damage.

b. Explain that the symptoms are consistent with tardive dyskinesia, a potential side effect of long-term antipsychotic use, and encourage the client to discuss the symptoms promptly with the prescribing provider.

c. Reassure the client that these movements are common with schizophrenia and will likely resolve without intervention.

d. Recommend that the client request a lower medication dosage because reducing the dosage is the most effective way to eliminate the symptoms.

Practice Question

Elizabeth Price — Tue, 03 Nov 2026 21:02:15 GMT

Select your answer and share in the comments. The answer and rationale will be provided in the comments soon...

A married couple seeks therapy because of frequent arguments and difficulty resolving disagreements. During sessions, the therapist observes that when one partner becomes critical and raises their voice, the other partner responds by becoming increasingly defensive and raising their voice as well. Each partner attempts to gain control of the conversation, and neither is willing to back down. According to communication theory, this interaction is best described as:

a. Complementary communication, because each partner responds by assuming a different role in the interaction.

b. Symmetrical communication, because both partners mirror and escalate each other's communication behaviors in an attempt to maintain equal control.

c. Complementary communication, because one partner's aggressive communication encourages the other partner to become passive.

d. Symmetrical communication, because one partner assumes authority while the other partner consistently defers to that authority.

Weekly Intention Setting

Kiana Ansari — Mon, 02 Nov 2026 21:18:20 GMT

Happy Monday, everyone!