Discussion post about Client’s rights and Counselor Responsibility and Confidentiality. Instructions attached.  

Module 4 Case Study Discussion Forum

This week we will cover Client’s Rights and Counselor Responsibility and Confidentiality. Confidentiality is one of the most violated ethical principles and not on intention but because of a lack of knowledge about what to disclose and what not to disclose, to whom, and when. The ASCA Codes of Ethics that are used in school counseling is attached. The ACA Codes of Ethics is attached.
Both
codes of ethics MUST be referenced. You should label each section of the codes of ethics prior to beginning the ethical forum. 

This week will begin your ethical decision-making case study discussion forum. Remember, for these forums, you will choose ONE ethical scenario.

Please see the attachment for a sample of what your ethics case study discussion forum should look like. The RUBRIC is also attached. APA formatting with in-text citations.

 Case Study #1: The Case of Joan 

Joan, a counselor in private practice in central Texas, has been asked to accept a new client who is Asian-American and who is having difficulty adjusting to her new home in Texas.  There are very few Asian-American individuals in Joan’s community.  Joan is wondering whether she is competent to accept this new client.

Case Study #2: The Case of Marcie

Marcie is a new client, a 22-year-old female who works as a receptionist in a doctor’s office.  She has just revealed to you during the intake session that she has recently lost interest in most activities, has been experiencing fatigue despite sleeping a great deal, and sometimes wishes she could cease to exist.  She mentioned feeling as though she were “on an emotional roller coaster” during the past year, throughout her on-again, off-again relationship with a 35-year-old married man.  The last breakup with him seemed really final, and Marcie has felt herself sinking deeper and deeper ever since.  When probed further about suicidal ideations, Marcie admitted that she has considered killing herself, although she is uncertain whether or not she would actually do it.  She said that she is currently in possession of a gun that her friend allowed her to keep in her home following a rash of burglaries in the neighborhood, but she doesn’t know whether she would actually use it.  You have consulted with your supervisor, who has agreed that Marcie should be referred immediately for a psychiatric evaluation and has instructed you to arrange for Marcie to go directly from your office to a nearby hospital.  Marcie told you that her mother accompanied her to this appointment and is in the waiting room, but she has emphatically stated that she does not want her mother to know what is going on with her.

Sample Ethics Case Study Discussion

Main Post: Case #1: The Case of Marianne

1. Identify the Problem

Marianne began providing therapy to a client named Ellen, a young woman who originally began receiving therapy to stop being so hard on herself. Several sessions in, Marianne knows that Ellen is fearful of becoming fat and engages in self-induced vomiting after meals, abuses laxatives, and exercises excessively. Marianne determines that these are symptoms of Anorexia- Nervosa/Bulimia Nervosa, which she has little experience treating.

2. Apply the ACA Code of Ethics CRCC Code of Ethics:

AVOIDING HARM. Rehabilitation counselors act to avoid harming clients, trainees, supervisees, and research participants and to minimize or to remedy unavoidable or unanticipated harm (CRC, 2010, A.4.a)

APPROPRIATE TRANSFER OF SERVICES. When rehabilitation counselors transfer or refer clients to other practitioners, they ensure that proper counseling and administrative processes are completed promptly, open communication with both clients and practitioners. Rehabilitation counselors prepare and disseminate, to identified colleagues or records custodian, a plan for the transfer of clients and files in the case of their incapacitation, death, or termination of practice (CRC, 2010, A.8.d.)

BOUNDARIES OF COMPETENCE. Rehabilitation counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, professional credentials, and appropriate professional experience. Rehabilitation counselors demonstrate beliefs, attitudes, knowledge, and skills pertinent to working with diverse client populations. Rehabilitation counselors do not misrepresent their role or competence to clients (CRC, 2010, D.1.a.)

ACA Code of Ethics:

Primary Responsibility: The primary responsibility of counselors is to respect the dignity and promote the welfare of clients (ACA, 2014, A.1.a).

Avoiding Harm: Counselors act to avoid harming their clients, trainees, and research participants and to minimize or to remedy unavoidable or unanticipated harm (ACA, 2014, A.4.a).

Boundaries of Competence: Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state, and national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent

counselor in working with a diverse client population (ACA, 2014, C.2.a).

3. Determine Nature of Dilemma

1. The nature of the dilemma is that if she continues to treat Ellen, now that she’s aware of more intensive needs related to Anorexia-Nervosa/Bulimia-Nervosa, she may violate her scope of practice and could do harm to the client.

4. Generate Potential Courses of Action & Possible Consequences

1. Marianne could continue to treat Ellen for her perfectionism issues and allow the possible eating disorder to go undiagnosed and untreated.

2. Marianne could continue treating Ellen and begin treating her for Anorexia- Nervosa/Bulimia-Nervosa and risk practicing out of her scope of practice, out of her competency, and could risk malpractice suits.

3. Marianne could continue to refer Ellen to another therapist better trained in treating Anorexia-Nervosa/Bulimia-Nervosa; therefore, terminating services and not having full confirmation of the diagnosis.

4. Marianne could inform the client of her concerns, recommend receiving outside assessment for Anorexia-Nervosa/Bulimia-Nervosa. If trained specialists determine that she has an eating disorder, continue discussing the importance of referral to a more qualified therapist in this area of treatment.

5. Determine Course of Action

1. My choice would be option D. I would provide full disclosure of my concern for her overall health and well-being. We’d discuss the effects of untreated eating disorders and how the underlying eating disorder symptoms could manifest itself in other areas of her mental health. I would explain my limited experience in the area and explore with the client the importance of obtaining further assessment by a qualified clinician. If the clinician determines that Ellen does have an eating disorder, we will discuss termination and referral for more intensive services. This course of action aligns with the concept of “duty to care, which is a legal obligation of health providers not to act negligently” (Gladding & Newsome, 2018).

6. Evaluate Selected Course of Action

1. By sending the client for further assessment, we can prevent unnecessary termination of the counselor-client relationship if the client does not have an eating disorder. If she does not have an eating disorder, we can continue our therapy sessions contingent upon agency policy.

7. Implement Course of Action

1.

I would obtain informed consent to send a referral for further assessment and follow up with the client to review results. If she does not have an eating disorder, I will continue to provide therapy while continuously monitoring for signs of eating disorder and treatment effectiveness. If she does, we will prepare her case for transfer for more suitable treatment. In the client’s case, I would also document why and how the decision was made to terminate and transfer services.