Individual chapters of this book are available to purchase online.

Perhaps no other population exposes the clinician to more moral and legal dilemmas than working with HIV positive clients. What does the therapist do about the HIV+ client who is having sex with unnamed partners and refuses to stop? What should be said in end-of-life issues? What of the adolescent who is HIV+ but whose guardian does not wish the youth informed of his status? The questions are clearly practical but the published literature tends to be theoretical and offers little in the way of down-to-earth advice.

While no book can provide absolute answers to such questions, this volume provides a practical decision-making model. It begins with an overview of the most common ethical dilemmas that are encountered in HIV-related psychotherapy and discusses the degree of risk of legal malpractice and how to reduce this risk. Then ten diverse case studies are presented that highlight common ethical conflicts. Each case study includes comments from an ethicist and an attorney. The power of the decision-making model, the realistic depiction of the cases, and the cutting-edge nature of the ethical issues described make the volume ideal not only for seasoned therapists but also for graduate ethics courses in psychology, counseling, social work, and related mental health professions.

Table of Contents





I. Critical Factors Influencing Clinical Decision Making in HIV-Related Psychotherapy

  1. HIV-Related Psychotherapy: Personal and Career Influences
    —Bob Barret
  2. Ethical Issues in the Practice of Psychology With Clients With HIV/AIDS
    —Sara R. Stevenson and Karen Strohm Kitchener
  3. Thinking Well About Dong Good in HIV-Related Practice: A Model of Ethical Analysis
    —Karen Strohm Kitchener and Bob Barret
  4. Cultural Considerations in HIV Ethical Decision Making: A Guide for Mental Health Practitioners
    —Sally Jue and Sandra Y. Lewis
  5. The Effects of Grief and Loss on Decision Making in HIV-Related Psychotherapy
    —Lynn Bonde
  6. Clinical Decision Making in the Shadow of Law
    —Scott Burris

II. Case Examples Using a Systematic Decision-Making Model With HIV/AIDS Clients

  1. A Decision Model for Ethical Dilemmas in HIV-Related Psychotherapy and Its Application in the Case of Jerry
    —Bob Barret, Karen Strohm Kitchener and Scott Burris
  2. The Secretive HIV-Positive Spouse: The Case of Ruben
    —Sally Jue, Karen Strohm Kitchener, and Scott Burris
  3. The HIV-Positive Sex Worker: The Case of Rhonda
    —Vivian B. Brown, Karen Strohm Kitchener, and Scott Burris
  4. The Mentally Ill, HIV-positive Client: The Case of Mildred
    —Robert A. Washington, Karen Strohm Kitchener, and Scott Burris
  5. The Adolescent at Risk of AIDS: The Case of James
    —Robert A. Washington, Karen Strohm Kitchener and Scott Burris
  6. Keeping Secrets From the HIV-Positive Adolescent Client: The Case of Kamau
    —Sandra Y. Lewis, Karen Strohm Kitchener and Scott Burris
  7. The HIV-Positive Disabled Client: The Case of Mike
    —Bob Barret, Karen Strohm Kitchener, and Scott Burris
  8. The Substance-Abusing, HIV-Positive Client: The Case of Angela
    —John R. Anderson, Karen Strohm Kitchener, and Scott Burris
  9. Multiple Roles With a Dying Client: The Case of Pat
    —Tom Eversole, Karen Strohm Kitchener, and Scott Burris
  10. Suicide and Confidentiality With The Client With Advanced AIDS: The Case of Phil
    —Bob Barret, Karen Strohm Kitchener, and Scott Burris


Appendix: American Psychological Association Ethical Principles of Psychologists and Code of Conduct

Subject Index

Author Index

About the Editors

Editor Bios

John R. Anderson received his PhD in clinical psychology in 1988 from the University of Kansas. He was the director of the APA AIDS Community Training Project, and he is currently director of the APA HIV Office for Psychology Education and director of the APA Office on AIDS, which provides training and technical assistance on a wide range of HIV/AIDS-related topics associated with coping, mental health services, prevention, technology transfer, community collaboration, public policy, and ethics. His primary area of research and writing has focused on the relationships among hope, coping, adjustment, and health. In addition, he has authored numerous articles and training curricula on the mental health and psychosocial aspects of HIV/AIDS. Since 1986, he has conducted a private, mental health services practice in Washington, DC, where he specializes in individual, couples, family, and hypnosis therapies for people living with or affected by HIV/AIDS.

Bob Barret is professor of counseling at the University of North Carolina-Charlotte. He received his PhD in counseling psychology from Georgia State University. His professional career extends from business to high school teaching, university appointments, and clinical practice as a psychologist in San Francisco and Charlotte, NC. After working with cancer patients for several years, he began to do volunteer work with persons with HIV/AIDS and eventually became known as a skilled HIV/AIDS trainer and practitioner. He was a senior faculty member of the AIDS Community Training Project and the HOPE Program, both sponsored by the APA, and he has worked with the APA's Office on AIDS in several capacities. He is the coauthor of three books; the latest, Counseling Gay Men and Lesbians (with Colleen Logan), is to be published in 2001. His research articles cover topics 367 such as gay fathers, gay and lesbian spirituality, and social advocacy for sexual minorities. He has served as president of the Association for Gay, Lesbian, and Bisexual Issues in Counseling, a division of the American Counseling Association. In addition to his teaching he participates in a clinical practice that focuses on gay and lesbian counseling, grief and loss, and relationship enhancement.