The professional codes of ethics and standards of practice for licensed mental health professionals provides guidelines for therapists when faced with ethical issues that are difficult to resolve. Therapists are expected to engage in a careful review of ethical decision-making process and utilize available resources as needed. This paper provides summary of a journal article titled “When Good Enough isn’t” It identifies legal or ethical issues relating to clinical practice and stresses the need for therapists to know when and how to terminate therapy.
Dr. Myron Liptzin, was about to retire as chief of psychiatry at the University of North Carolina, Chapel Hill. He provided treatment of psychotic episode to second-year law student Wendell Williamson from March 8 to May 25 of 1994, Dr. Liptzin saw Williamson six times, and prescribed an antipsychotic medication that proved effective in relieving all symptoms. Dr. Liptzin documented the steps taken to terminate and transfer Williamson’s treatment in anticipation of his retirement and the end of the term. Although documentary evidence showed that Dr. Liptzin had a history of noncompliance with prior inpatient and outpatient standard procedures, Williamson was exceptionally compliant with Dr. Liptzin’s treatment recommendations and demonstrated a remarkably speedy recovery.
Unfortunately, Williamson's compliance ended with the term: he stopped taking his medication and did not follow Dr. Liptzin's recommendation to continue outpatient treatment. Following the winter break Williamson returned to campus and began the spring semester but suddenly deteriorated with his symptoms of paranoia, grandiosity, and delusional thinking re-emerging. Apparently, in Williamson’s mental state made up and practiced a plan to retaliate against his perceived persecutors. On January 26, 1995, on the streets of Chapel Hill, Williamson, heavily armed with automatic raffle shot and killed two people unknown to him and seriously wounded a responding police officer. Williamson was shot in the legs during the officers' suppression of his shooting spree. The officer’s wound required surgical intervention from which he recovered without any complications.
Tried on 15 counts of...