COU 500 Ethical Case Analysis Outline copy.edited

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Southern New Hampshire University *

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500

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Philosophy

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Jan 9, 2024

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Running head: ETHICAL CASE STUDY ANALYSIS OUTLINE 1 [Title Here, up to 12 Words, on One to Two Lines] Indira Jones Southern New Hampshire University

ETHICAL CASE STUDY ANALYSIS OUTLINE 2 Abstract This paper is intended to provide a case study Analysis. The case will be conceptualized along with applying a decision-making model that best fits the case. The decisions made in the case will be justified through a historical precedence case. Lastly, the ACA code of ethics will be used to identify the relevance of working with this case in a professional counseling capacity.

ETHICAL CASE STUDY ANALYSIS OUTLINE 3 [Title Here, up to 12 Words, on One to Two Lines] There are four key components when conceptualizing the case. The first component is the presenting issue, which in this case is the altercation that transpired between Johnny and his wife that led to his domestic violence arrest. The second problem that presents itself is that the altercation transpired in the presence of their five-year-old boy, and seven-year-old girl. This led to the Department of Children and Family Services intervening. The third problem that arises is Johnny’s anger, as evidenced by his domestic violence history, and four months later during his intake process he expresses his transgressions with mandated counseling. Johnny also appears to have a substance abuse problem as he was under the influence at the time of the arrest. The pattern shows that when Johnny drinks he becomes angry, and when he becomes angry he drinks. Johnny's identity seems to be a trigger as he is a 35-year-old middle-class Caucasian with two children. His identity indicates a stressor as Johnny has vocalized his lack of freedom due to his current status, which again triggers both his anger and drinking. Maladaptive The second key component is Maladaptive Patterns, which indicate the client's ineffective perspective of the triggers that led to the current program. Johnny’s perspective is that his wife is owed equal blame for the domestic violence alteration. Based on the statements made by Johnny such as his freedom being taken away, and he is unable to drink because he will lose the kid he never wanted indicates that his perception is that of a victim rather than the attacker. He physically attacked his wife, mentally and emotionally attacked his children, and is now doing the same to himself.

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ETHICAL CASE STUDY ANALYSIS OUTLINE 4 Predispositions The third key component is predispositions, which due to lack of knowledge I’m uncertain if biological factors contribute to Johnny’s substance abuse, however, I would love to navigate down that narrative. His knowledge and understanding of the consequences of drinking, yet sneaking and doing so anyway does present a concern for "Substance Use Disorder" and or "Substance-Induced Disorder". Substance Use Disorder is measured from mild to severe and can either be physical or psychological (Sangganjanavanich & Reynolds, 2015). The diagnosis is determined when two out of the eleven criteria are met(Sangganjanavanich & Reynolds, 2015). Johnny meets at least two criteria as he continues to use despite persistent social and interpersonal problems, and secondly failing to fulfill obligations. Substance-Induced disorder is a problem caused by substance addiction, i.e. intoxication(Sangganjanavanich & Reynolds, 2015). Unfortunately, Johnny was found intoxicated at a bar. Triggers The last key component is triggers, which there are a few within this case. The triggers presented are lack of job, House, freedom, both having and not having his kids, his inability to drink on his terms, and the mandated counseling also appears to be a trigger. Case Conceptualization To work this specific case in a professional counseling capacity there are a few ACA codes of ethics that must be followed. The first code is B.2.a Serious and Foreseeable Harm and Legal Requirements, which states confidentiality does not apply when disclosure is required to protect the clients or identified others from foreseeable harm or legal action(2014). Johnny's anger led to a domestic violence arrest and children were involved which falls under foreseeable

ETHICAL CASE STUDY ANALYSIS OUTLINE 5 harm. There is cause for concern that his violation of drinking can result in the danger of his family again. The second code is A.2.e Mandated clients, stating that Counselors discuss the required limitations to confidentiality when working with clients who have been mandated for counseling services. Counselors also explain what type of information and with whom that information is shared before the beginning of counseling (2014). Being that Johnny is a client who was mandated to counseling, This code of ethics will apply in how to move forward in addressing the concerns displayed at the bar. Lastly, ethics code C.6.b Reports to Third Parties. Counselors are accurate, honest, and objective in reporting their professional activities and judgments to appropriate third parties, including courts, health insurance companies, those who are the recipients of evaluation reports, and others. This is the code that will need to be followed when reporting my findings to a third party such as the Department of Children and Family Services. Decision Making The decision-making model that counselors ought to choose is Welfel’s Model for Ethical Decision Making. “Welfel’s Model encompasses four main dimensions: having sufficient knowledge, skill, and judgment to use efficacious interventions; respecting dignity and freedom of the client; using the power inherent in the counselor’s role responsibility; and acting in ways that promote the public confidence in the mental health professions”( Sangganjanavanich & Reynolds, 2015). Welfel’s Model for Ethical Decision Making contains 10 steps. Step 1 states to become ethically and morally sensitive. This step posits that being ethically sensitive is beyond knowing and following the rules instead it’s a reflection of the professional counselor's work and life.That consists of character traits such as personal virtue and altruism. This step applies to

ETHICAL CASE STUDY ANALYSIS OUTLINE 6 Johnny’s case as it requires counselors to look beyond the professional perspective, especially with the fact that Johnny has two children involved. When children are involved a counselor’s moral belief system will contribute to their decisions as the stakeholders involved will be impacted. The second step is Identifying facts, context, and stakeholders. When applying this step to Johnny’s case the facts are he has anger issues, evidenced by domestic violence history. Johnny’s domestic violence alteration taking place in front of his five-year-old boy and seven- year-old girl, resulted in the Department of Children and Family Services intervening. The stakeholders involved in Johnny's case are his wife, and two minors so counselors must be extremely cautious in their next steps after seeing Johnny at the bar drinking. Due to Johnny's history, the stakeholders could be at risk for harm upon Johnny leaving the bar therefore a counselor ought to document Johnny at the bar and move forward without any biases, or judgment. Step 3 is defining the dilemma and options. This step requires counselors to separate their own cultural and personal values and assumptions from their clients to prevent being unduly influenced by personal history (Sangganjanavanich & Reynolds, 2015). The central issue and dilemma in Johnny's case is that he is drinking at a bar although he was ordered to complete substance abuse counseling. Furthermore, he was ordered to substance abuse counseling as a result of a domestic violence altercation involving his wife in front of his children while intoxicated. Therefore Johnny becoming increasingly intoxicated presents a central issue and dilemma as his wife and children could be at risk. Counselors should consider action steps that aren't from a personal and emotional perspective but rather from a logical and ethical perspective. Step 4 in Welfel’s Model for Ethical Decision Making is Considering professional standards, laws, and regulations. When applying step 4 to Johnny’s case a conflict is apparent. Specifically, the apparent conflict is client confidentiality. Johnny's history while being under the

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ETHICAL CASE STUDY ANALYSIS OUTLINE 7 influence it presents a threat not only to himself but to his family as well, therefore putting a counselor in the position of breaking client confidentiality. Step 5 is to search relevant ethics literature. This requires counselors to consult professional literature and the ACA code of ethics. When applying this step to Johnny’s case the ethical codes counselors ought to consider are B.2.a Serious and Foreseeable Harm, A.2.e Mandated clients, and C.6.b Reports to Third Parties. The next step is applying ethical principles and theories to dilemmas. This step requires counselors to abide by all five principles Autonomy, Nonmaleficence, Beneficence, Justice, and Fidelity( Sangganjanavanich & Reynolds, 2015). However often times it’s not possible for counselors to abide by all five principles. When applying step 6 to Johnny’s case a counselor ought to apply the principle of Nonmaleficence as it requires counselors to avoid doing harm, preventing harmful actions and effects. Applying this principle to Johnny’s case would prevent the harmful effects of Johnny’s intoxication at the bar. Step 7 is to consult with colleagues, supervisors, and ACA. When applying this step to Johnny’s case counselors should consult with colleagues and supervisors to obtain alternative considerations, reduced moral and emotional isolation, as well as comfort. Children, client confidentiality, and substance use are involved in this case therefore any next action steps are crucial, and counselors can benefit from an extra opinion. Step 8 is to deliberate and decide what and how to implement. When applying this step to Johnny’s case counselors ought to consider all perspectives before making a decision and implementing them. Ethical choices may coincide with costs to the counselor, such as increased work hours, and disapproval from clients or others (Sangganjanavanich & Reynolds, 2015). Step 9 is to inform the appropriate people, and implement decisions. When applying this step to Johnny's case counselors ought to notify law enforcement, the Department of Children and Family Services, and the courts that ordered Johnny to complete substance abuse counseling.

ETHICAL CASE STUDY ANALYSIS OUTLINE 8 The last step in Welfar’s model for Ethical Decision Making model is reflecting on the actions taken. When applying this step to Johnny’s case counselors ought to consult with supervisors, debrief, and process the decision. Regardless of the specific decision the counselor makes in Johnny's case, it would be imperative to unpack the emotional reactions associated with the decision. Decision Making: Historical Precedence The historical precedence case that aided my choice in picking this model is Bradley v. Ray. This case transpired in 1995 when a minor child was allegedly sexually abused by her stepfather from the age of four to 13 years old(n.d). The stepfather was arranged for counseling in 1988 by the child's mother when the stepfather met with one other psychologist and Dr.Ray. His services were shortly terminated however both psychologists failed to report the abuse to law enforcement. Therefore alleged that the minor's abuse continued as a result of the psychologist failing to report the abuse. “ The court reversed and remanded the dismissal, stating that the defendants had a duty to warn appropriate authorities of the possible risk of future harm. The court recognized the “right to sue only for failure to warn of specific risks of future harm to readily identifiable victims.” (n.d). In conclusion, The court held that the defendants should have reasonably foreseen that their patient posed a threat of serious harm to Kelly. I have the perception that Dr. Ray believed that the rapid termination of services was enough and that the intent was never to contribute to the alleged continuous sexual abuse of a minor. However, had she applied step 7 from Welfer’s model to consult with colleagues, supervisors, and ACA then termination of counseling services wouldn’t have been enough. As well as applying step 9 to inform appropriate people, would have led to law enforcement being informed. Bradley v. Ray

ETHICAL CASE STUDY ANALYSIS OUTLINE 9 case relates to Johnny’s situation as it provides clarity on how counselors ought to proceed in addressing Johnny’s increasing intoxication at the bar. Decision Making: Considerations The ACA ethical codes originally identified can assist in determining the ethical and legal considerations that need to be applied in Johnny’s case. A.2.e code of ethics Mandated clients indicates that a counselor discusses the required limitations to confidentiality, whom information can be shared with, as well as the type of information. The next ethical code to consider is B.2.a Serious Foreseeable Harm, which indicates that a counselor keeps information confidential, although it does not apply when disclosure is required to protect clients or identified others. The third code of ethics counselors ought to consider is C.6.b Reports to third parties, which indicates that counselors are accurate, honest, and objective when reporting their professional activities and judgments to appropriate third parties. Those parties include courts, health insurance companies, and recipients of evaluation reports. When viewing the Bradly v. Ray case counselors ought to take into consideration the ruling and consequences that transpired to Dr. Ray for not reasonably foreseeing the patient posed a serious threat to the minor. Counselors ought to consider if Johnny’s increasing intoxication poses a threat. Counselors also ought to consider Welfel’s model for Ethical decision-making as it will assist in ensuring counselors can solve dilemmas ethically. In conclusion, when taking action steps in Johnny's case counselors ought to consider the ACA Code of Ethics, Bradly v. Ray case, and Welfel’s model. Reflection Counseling is deeply rooted in protecting others and ensuring they are safe. I'm a nurturer at heart hence my current career as an educator so I take the well-being of others extremely personally. When seeing Johnny in the bar my priority was his wife and children as I remember

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ETHICAL CASE STUDY ANALYSIS OUTLINE 10 what transpired the last time he was intoxicated. In my concern for his family, I negated the idea that Johnny could be concerned for their safety too, and just turn in for the night. However the risk of breaking Johnny's confidentiality and exposing myself as his counselor is worth the repercussions that may or may not arise. Johnny's case is a prime example of a case that can influence the practice of professional counseling in our society. Most individuals would immediately have empathy for Johnny’s wife and children especially if something were to happen to his family. As Johnny has a history of violence when intoxicated, however, it's imperative to remember that Johnny is our client, and his privacy, safety, and well-being are a priority. We must take our personal feelings out of the process and observe Johnny while still taking into consideration his history, however from an objective standpoint.

ETHICAL CASE STUDY ANALYSIS OUTLINE 11 References ACA 2014 code of ethics - american counseling association. (2014). https://www.counseling.org/resources/aca-code-of-ethics.pdf Bradley v. Ray (1995) . ClinicalForensicPsychologyorg. (n.d.). https://web.archive.org/web/20180621060256/http:/www.clinicalforensicpsychology.org/ bradley-v-ray-1995/ Sangganjanavanich, V. F., & Reynolds, C. A. (2015). Introduction to professional counseling . SAGE.

COU 500 Ethical Case Analysis Outline copy.edited

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