Our Approach
Our integrative approach in consultations are grounded in our values of:
social justice & inclusivity for all
culturally sensitive and empowering
client centered and client directed
non-shaming & non-judging, empathetic
existential/humanistic
polyvagal & neurobiology
various trauma & grief theories including intergenerational trauma, racial trauma, and prolonged grief
clinical understanding of compassion fatigue, burnout, secondary trauma, vicarious trauma, and resilience
Dr. Alkin identifies as a Turkish/Canadian female. She was born and raised in Istanbul, Turkey and has lived in Vancouver, Maine, San Diego, and Los Angeles. She has spent many summers in Geneva, Switzerland with her grandmother. Dr. Alkin identifies as a cisgender, heterosexual, able bodied female.
Dr. Diep identifies as a 1.5 generation Vietnamese/Chinese-American female, born in a refugee camp in Hong Kong. She grew up in Southern California but has lived, worked and traveled globally. Dr. Diep is also a first generation college student who recognizes her privilege of higher education. Dr. Diep identifies as a cisgender, heterosexual, able-bodied female who uses her experiences of oppression and prejudice to empower others.
Our Goal:
Transforming Moral Dilemma to Moral Integrity,
Together
MCC’s consultations are designed to create a confidential and safe space to allow medical professionals, humanitarian aid workers, and other “helpers” to explore the incidences that created the moral dilemmas. We will investigate the intersection of your personal neurobiology, ethical views, cultural values and other components that may impact your past or present decision making processes that may have led to moral distress and injury.
The purpose of these consultations is to support individuals in identifying sources of moral distress and injury and providing tools to promote moral courage and moral resilience.
Explore the experiences that resulted in moral distress
Provide “ethical listening” with a non-judgmental, non-punitive, compassionate and empathetic lens
Identify the thinking and emotional patterns that create “mismatch” between what you think ought to have happened and the actual consequence.
Investigate the sources of “shoulds” and/or stuck points
Understand your somatic experiences when you revisit the event
Explore neurobiological responses during the incident and afterwards
Examine the impact of personal history and personality characteristics on responses
Assess which orientation you are inclined to perceive and act in a given situation and whether or not that orientation changes in situations of high conflict or crisis
Integrate both intellectual and emotional processing
Examine the discrepancy between decision making and execution
Support you in developing a tool-kit to prevent and/or mitigate any future moral distress/moral injury
Create a realistic self-care plan that empowers you to make choices that are aligned with your values
Moral Distress
Introduced by Andrew Jameton, PhD in 1984, moral distress occurs when, “one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right action.”
Components of moral distress are:
Having to make a moral judgment
Experiencing institutional or coworker constraints
Experiencing constraints in moral deliberation or action
Feelings of powerlessness
Experiencing moral uncertainty
Acknowledging moral responsibility
Experiencing psychological, physical or behavioral effects
Experiencing ethical problems
Experiencing compromise in integrity, moral identity, commitments, or moral identity
Not achieving the desirable outcomes
How is moral distress different from moral injury?
Components of moral injury:
Psychological harm that results from perpetrating, witnessing, or failing to prevent actions that violate one's moral or ethical code.
the psychological and emotional distress that can occur when individuals experience a conflict between their personal values and the demands of their job or other external factors.
In the healthcare context, moral injury may result from actions such as providing inadequate care, making medical errors, or repeatedly feeling helpless.
This can lead to feelings of guilt, shame, anger, and frustration, which can have a negative impact on mental health and well-being.
“But what do all these terms even mean?”
Moral Courage
People who work in helping professions often encounter situations and issues that lead them to consider not only their professional ethics but also question their personal and professional values. Assessing and choosing the ethically right action over wrong one is often easier than evaluating and choosing to act on two seemingly right actions. Moral courage is having the integrity to take a stand when there are competing forces present. Moral courage requires one to act in accordance with one’s values in the face of potential loss.
Components of moral courage are:
Identifying that there is a moral situation and choice
Taking action
Accepting responsibility
Undergoing fear and understanding that the moral action has consequences
Being willing to take risks (i.e. facing disapproval, uncertainty, unemployment etc.) and having capacity to endure the dangers
Adhering to five core values: honesty, respect, responsibility, fairness and compassion
Having capacity to admit to ones mistakes and rejecting injustice and immoral orders
Moral Resilience
In Cynda Rushton’s book, Moral Resilience: Transforming Moral Suffering in Healthcare, she defines resilience as “the capacity of an individual to sustain or restore their integrity in response to moral complexity, confusion, distress or setbacks”
Components of moral resilience are:
Maintaining one’s moral integrity under pressure and adversity
Having the emotional strength to adapt to morally challenging situations while upholding one’s values
Moral resilience can be seen as a form of emotional strength, as it requires individuals to navigate complex ethical dilemmas and maintain their integrity under pressure.
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"In contrast to ethical discourse, moral experience is always about practical engagements in a particular local world, a social space that carries cultural, political and economic specificity."
— ARTHUR KLEINMAN, 1998 THE TANNER LECTURES ON HUMAN VALUES
FAQs
How often are the consultations scheduled?
Our consultations are designed to be short-term and can range anywhere between 3-9 sessions, depending on your needs. Sessions can be scheduled weekly, monthly or bi-monthly. Consultations sessions are 50 minutes in duration.
Is everything we discuss confidential?
Since we are licensed psychologist, information about what you disclose during our consultations will not be shared with anyone unless you provide us with both written and verbal consent.
Exceptions to confidentiality are:
If you disclose that you may be in imminent danger to yourself or others
If there is disclosure of abuse to vulnerable persons, such as elderly person or child
In the highly unlikely event that our records are subpoenaed by court order
What are the limitations of your services?
However, please note that consultations are NOT:
Legal and/or professional ethical advice
Psychiatric diagnosis or psychotherapy
Should you require additional support that is beyond the scope of our consultation practice, we can refer you to our network of mental health and/or legal providers.
Are there any state licensure restrictions?
As consultants, we are not bound by any state licensure restrictions. Therefore, you can be based anywhere in the world. We can provide consultations in English, Turkish, Spanish and French. We use a HIPAA compliant business based platform for our tele-sessions. We also use a HIPAA complaint charting system and all our interactions will be via the platform.
Can I get these consultations reimbursed by my insurance company and/or employer?
Unfortunately, no, via your insurance company but maybe via your employer.
Since we are not providing any CPT codes or ICD diagnoses, you will not receive a Superbill for services. However, we can provide an invoice if your employer reimburses for professional development and/or consultation. You may want to discuss with your HR department and/or your supervisor to ask about their specific policies.
How do we schedule trainings for our organization?
We tailor our trainings for groups and organizations. Our workshops, webinars or trainings range from 1 hour to day long events. Examples of our past individualized trainings include: Understanding and Coping with Loss and Trauma, a training conducted at a private company in Los Angeles, CA and Caring for Self and Others After Unanticipated Death in The Hospital, a bioethics rounds presentation at Kaiser West Los Angeles.
Do you provide services to other professionals?
Yes. Moral distress can be experienced in any occupation. We have provided services to individuals who worked in various sectors such as: non-profit, aerospace, tech, education, law, mental health and hospitality. Please reach out to us if you have any questions about how moral distress/injury may impact your specific industry and profession.