Mental Health Services to Minors

Case 2. Cultural Values and Competent
Irina, a 13-year-old girl of Arabic cultural heritage living in Boston, Massachusetts, was brought by her parents to a hospital emergency room after an assault by a stranger. Based on her injuries, the hospital staff suspected that the attacker had also sexually assaulted the girl, but she and her parents refused medical evaluations for rape. The family received a referral to see Janet Matthews, a clinical psychologist specializing in adolescent trauma. During their initial meeting with Dr. Matthews, the parents asked the psychologist not to discuss any sexual aspects of the assault with their daughter but to treat the psychological trauma from the assault in general.
They told the psychologist that admitting a rape had taken place would cast a stigma on their daughter and make her ineligible to be married to men in their closely knit ethnic community. When asked in private, the girl also requested that sexual issues not be discussed for the same reason.
Ethical Dilemma
Dr. Matthews does not know if she should agree to the parents’ and child’s request.
Suggested Readings
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist,
58, 377–402.
American Psychological Association. (2007b). Guidelines for psychological practice with
girls and women. American Psychologist, 62, 949–979.
Arredondo, P., & Toporek, R. (2004). Multicultural counseling competencies = ethical
practice. Journal of Mental Health Counseling, 26(1), 44–55.
Gallardo, M. E., Johnson, J., Parham, T. A., & Carter, J. A. (2009). Ethics and multiculturalism:
Advancing cultural and clinical responsiveness. Professional Psychology: Research and
Practice, 40, 425-435.
Vasquez, M. (2012). Social justice and civic virtue. In S. Knapp, M. Gottlieb, M. Handelsman,
& L. VandeCreek (Eds.), Handbook of ethics in psychology (Vol. 1, pp. 75–98).
Washington, DC: American Psychological Association.