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The Four Box Approach to Resolving Ethical Dilemmas in Primary Care Behavioral Health Practice

Session # D3A Friday, October 11, 2013 – 3:30- 4:10 (40 minutes). The Four Box Approach to Resolving Ethical Dilemmas in Primary Care Behavioral Health Practice. Christine Nicole Runyan , Ph.D., ABPP, University of Massachusetts Medical School Jeffrey T. Reiter, Ph.D., ABPP,

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The Four Box Approach to Resolving Ethical Dilemmas in Primary Care Behavioral Health Practice

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  1. Session # D3A Friday, October 11, 2013 – 3:30- 4:10 (40 minutes) The Four Box Approach to Resolving Ethical Dilemmas in Primary Care Behavioral Health Practice Christine Nicole Runyan, Ph.D., ABPP, University of Massachusetts Medical School Jeffrey T. Reiter, Ph.D., ABPP, Health Point Clinics, Seattle, WA Patricia Robinson, Ph.D. Mountainview Consulting Group, Inc., Zillah, WA Collaborative Family Healthcare Association 15th Annual Conference October 10-12, 2013 Broomfield, Colorado U.S.A.

  2. Faculty Disclosure • I/We currently have or have had the following relevant financial relationships (in any amount) during the past 12 months: • Book royalties: New Harbinger • Book royalties: Gilford • Book royalties: Springer

  3. Objectives • Participants will be able to • Name ethical dilemmas that occur somewhat often in delivery of PCBH services • Describe and apply the four box method as a model for considering ethical dilemmas using case studies • Practice using the four box model in small groups with their own ethical scenarios

  4. Common Ethical Dilemmas in Delivery of Primary Care Behavioral Health Services • The Context makes a difference: Specialty vs PC • The Model makes a difference: Specialty Psychotherapy vs PCBH • See Handout: Table 1

  5. Ethical Guidance • AMA • APA, AASW • Family Systems and Health Special Issue, March 2013 • Jonsen, Siegler, & Winslade (2002). Clinical Ethics, Fifth Edition

  6. The Four Boxes or Four Topics Method: Case Analysis / Four Topics See Handout: Table 2

  7. Skill Practice • Review Case • Use Four Boxes / Topics to assess for ethical issues and identify a course of action • Report to large group in 10 minutes: • Case description • Key Box / Topic • Ethical Issue(s) • Recommended Course of Action

  8. Learning Assessment What is the name of a practical tool that members of the PCMH may use in making ethical decisions arising in the course of delivery of PBCH services? The Four Box Tool (or Four Topics Method) (Jonsen, Siegler, & Winslade) Name one common ethical quandary in primary care behavioral health practice. Multiple relationships, patient autonomy, confidentiality

  9. Session Evaluation Please complete and return theevaluation form to the classroom monitor before leaving this session. Thank you!

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