Dual Households: Issues and Ethics

Gaps currently exist between providers’ current domain of knowledge and what protocols exist for handling the sensitive subject of dual households. This course seeks to disseminate current research regarding laws, legislation, and policy related to dual family households. This course seeks to address knowledge levels related to current considerations needed to work with dual family households, including what to do in the event of being subpoenaed, and the legal, ethical, and  treatment considerations needed in working with dual households.This course has been divided into several sections, with each section containing information on various aspects of dual households and ethical issues that surround dual households.In the Background and History section, we will examine the history of divorce and separation in this U.S. In the section on statistics on dual households and divorce, we will cover current rates of divorce and separation. It is a well known fact that rates of divorce have been increasing over the past few hundred years, and we will further examine these trends.

Next, in the section “Effects of dual households on children”, we will discuss the effects of dual households on children. These include the effects of family stress on the child’s overall well-being, emotional health, and academic performance. We will also consider factors often leading to separation or divorce and how these factors may impact the child. It is imperative to take these factors into account while working with children of dual households. In  “Definitions of Important Legal Terms”, we will define legal terms that providers are likely to encounter when treating dual households. For example, we will discuss and define common types of custody arrangements, define joint physical custody, etc. In the “Consent and Confidentiality” section, we will highlight important considerations when obtaining consent from dual household families. We will discuss confidentiality issues that may arise in treating dual households; for example, what to do if parents disagree on who they would like you to have permission to speak with.

In the next section, “Treatment Considerations of Dual Households”, we will go into detail about treatment considerations that are specific to dual households. For example, we will discuss a “therapy log” that will travel between households to improve consistency for clients, other staff, and families. We will discuss ways to improve communication, including team meetings, and the importance of preparing agendas ahead of time to discuss pre-planned points relevant to the child’s therapy in order to not allow the meeting to become derailed. In the section “Legal considerations of dual households (including court subpoenas)”, we will examine legal issues of dual households. This section will address what to do when served with a court subpoena for records or for showing up in court. We will go over guidelines to keep therapy notes streamlined and to exclude extraneous information which would not be useful in a court setting. In the section entitled “Ethical considerations of dual households”, we will discuss the ethical considerations of dual households; for example, who is considered the client of a dual household family if one household initiated and is paying for therapy. There are various ethical conflicts that can arise when working with dual households and examples of these conflicts will be discussed here and in the case example section.

 In the “Case Example” section, we will go over a case example of dual households and apply principles of the course to the case. We will answer quiz questions and review the rationales for the questions. In the final section, “Summary, Conclusions and Final Recommendations”, we will review a summary of the course, discuss conclusions about working with dual households, and also discuss final recommendations.  Eligible for two Type II BACB CE under Ethics and Professional Issues with successful completion.