Today’s Law and Ethics blog and practice question explores the topic of scope of practice. Scope of practice is the definition provided in law that delineates what the profession does and places limits upon (or confines the breadth of functions) that persons within a profession may lawfully perform. It is basically the license that we obtain, such as LCSW or LMFT, together with what that license allows us to do. For instance, as MFTs our license allows us to talk about current family relationships, but does not allow us to give our clients a deep tissue massage. Legally, social workers can talk about ways in which family of origin dynamics have influenced the client, but they may not legally write up a will for the client, as that is something that lies outside of the scope of the social work profession. On the exam, you will likely be tested on what does and does not fall within the scope of practice for your license. Let us take a look at a scenario you could see on the test.
Question:
A therapist is meeting with Gary, a 33-year-old event manager. Gary shares that he is at a loss as to how to communicate with his girlfriend. “Nothing I do is good enough for her. She gets mad if I tell her how I feel. She gets mad if I shut down. I clearly need tools to learn how to talk to her better,” he states. In addition, Gary tells the therapist that he has had a history of depression throughout his adult life. Recently, however, it has gotten worse and he is barely able to get out of bed. Gary reports having a psychiatrist and taking Lexapro for the past few years. In order to stay within the scope of practice, the therapist should make which of the statements?
- “It seems like your medication dose needs to be increased. Why don’t you talk to your psychiatrist about it?”
- “It seems like you are on the right dosage of medication and the problem lies in you being relationally unhappy.”
- “It might be best for you to tell your psychiatrist that your depression has gotten worse. They will be able to determine the role, if any, that your medication is playing."
- “It might be best for you to tell your psychiatrist that your depression has gotten worse. Your body might have developed tolerance to Lexapro and you might need to switch medications.”
Share your answer and rationale in the comments section below and check back in tomorrow for an explanation of the correct answer!
Comments
Answer C is correct as it is the only answer in which the therapist stays within their scope of practice. In A, B, and D the therapist is making a direct connection between the meds and their symptoms.
Answer A and B therapist is making an assumption about medication. Answer C, therapist is informing the clt that the psychiatrist will determine what is happening. Answer D, the therapist is still discussing medication which is out of his scope of practice.
C, making any determination related to medications is out of a MFT’s scope but encouragement client to reach out to psychiatrist is good quality of service
My answer is: C. Making statement about the dosage or effect of the medication on the client's current condition is out of my scope of practice, thus C is the answer.