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There is a lot going on here, although my initial thoughts are that this is a sensitive area for both the husband and wife to address, and I applaud them for seeking help through therapeutic intervention since the nature of the problem can be embarrassing for the husband as well as the wife. I chose the first option to refer the husband back to his doctor to evaluate the cause of the erectile dysfunction since it could be based on a medical condition. In addition, the wife complains that her husband has been angry and irritable for months, which is related to mood, which can be a result of a hormonal imbalance or the onset of a psychiatric condition. As a MFT, I have this knowledge base; however, it is not within my scope of practice to assess the cause of a hormonal imbalance or erectile dysfunction. Therefore, the first option is the most suitable: to refer the couple back to the primary doctor to assess the symptoms and side effects of the medications for hypertension. It is unethical for a MFT to discuss medications with a patient without the collaboration of a prescribing provider. Once the patient sees his.
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