CP Week 4
pdf
keyboard_arrow_up
School
Southern New Hampshire University *
*We aren’t endorsed by this school
Course
530
Subject
Philosophy
Date
Jan 9, 2024
Type
Pages
6
Uploaded by googledoc411
Group Discussion
1.
Describe the key components of the case described in the Final Project Ethical
Case Study Analysis Guidelines and Rubric document.
2.
Identify the ethical codes that are relevant.
3.
Formulate a plan. What ethical decision-making model would work best to help
resolve this case?
4.
Justify your chosen course of action using historical precedence. When looking at
historical precedence, you are looking at court cases and/or legal events that have
impacted how mental health professionals handle these types of situations.
https://learn.snhu.edu/d2l/le/content/1339287/viewContent/25554252/View
Case Study: You are assigned a new client at your agency. Johnny is a 35-year-old middle-class Caucasian
man who has been mandated to attend counseling. Upon intake, Johnny states that he is angry about being
made to attend counseling. Four months before that, he and his wife had an altercation in which law
enforcement was called. He was subsequently arrested for domestic violence, and the Department of
Children and Family Services intervened because his two children (a five-year-old boy and a seven-year-old
girl) were present at the time of the fight. He has been ordered to successfully complete substance-abuse
counseling because he was under the influence. When prompted about his anger, Johnny tells you that he is
angry that he had to leave his home and attend treatment. He states that his wife had equal blame. Further,
he states that he never wanted children in the first place and feels trapped because of them. Now he feels as
though his freedom has been taken away because he lost his job, his house, and his ability to enjoy a few
drinks because he will lose the children he never wanted. Over the next month, Johnny is compliant with
attending counseling, but he seems resistant and guarded during his sessions. Over the weekend, you go to a
local restaurant with your friends and notice your client drinking in the bar area of the restaurant. You
proceed with your plans and do not acknowledge him. Over the next hour or so, you watch him become
increasingly intoxicated. What do you do?
Good afternoon professor and classmates,
After reading week 4’s case study, I admit this discussion is a little more
difficult for me to break down because there can be a lot of gray areas.
With that said, in this case study, some key components to be addressed
are the presenting issue, the maladaptive patterns, the predispositions, and
the triggers.
According to the American Counseling Association’s article “Practitioner’s
Guide to Ethical Decision Making” written by Forester-Miller and Davis in
2016, the first step of making an ethical decision is identifying the problem.
In this case, the immediate problem is deciding a course of action after
witnessing a client who was mandated to successfully complete
substance-abuse counseling becoming increasingly intoxicated at a
restaurant. Said article also states it’s important to remain objective by
sticking to the facts by avoiding assumptions, innuendos, or suspicions.
With this being said, the facts I know to be true are: I am off the clock at a
local restaurant with friends and my client is in the bar area drinking at the
same restaurant. The maladaptive patterns displayed are Johnny’s rigid
and ineffective thinking that his wife is equal to blame, his freedoms have
been stripped, his unwavering anger towards mandated treatment, and his
feeling of entrapment by being a parent to children he never wanted in the
first place. A possible predisposition could be if alcoholism runs in his
family, to which we are unsure of. I believe the triggers of Johnny are
alcohol, his wife, and his children, the loss of his job and home, and being
mandated to successfully complete treatment. These factors seem to
exacerbate his symptoms of anger.
From here, I am faced with referring to one of this week’s articles, “States
that Have Adopted ACA’s Code of Ethics,” published by the American
Counseling Association at an unknown date, my home state, New York, is
not a state that has adopted the ACA’s Code of Ethics into our rules and
regulations for Professional Counseling State Licensure. To my
understanding, and correct me if I’m wrong, the organization that certifies
New York State Licensure after approval from New York State Department
of Education is the National Board for Certified Counselors or the NBCC.
The NBCC has its own code of ethics and since that is the entity that would
certify my licensure, I would abide by their code of ethics. According to
NBCC’s Code of Ethics which was updated in May of 2023, the Counseling
Relationship Section of the NBCC’s Code of Ethics, number
18. states, Counselors shall respect each client’s privacy, and shall solicit
only information that contributes to the identified counseling goals or
facilitates the counseling process, and is also consistent with counseling
protocols.
If I were to intervene in my client's drinking, I could expose the nature of our
relationship breaching the client’s confidentiality of services, a direct
violation of both the NBCC’s code of ethics and HIPPA. Additionally,
according to our textbook, Intro to Professional Counseling written by
Sangganjanavanich
and Reynolds in 2013, the authors state “confidentiality
belongs to the client, not the counselor.”This could also hurt any report I
have with my client. Knowing he is compliant with showing up to treatment,
but is angry he has to go and remains guarded during sessions, I don't feel
it would be appropriate to approach him while he is under the influence.
Furthermore, located in the NBCC’s Code of Ethics Counseling
Relationship Section, number 19 states:
19. Counselors shall not share client information that is obtained through
the counseling process without specific written consent by the client or
legal guardian except when necessary to prevent serious and foreseeable
harm to the client or others, or when otherwise mandated by Federal or
State law or regulation.
Circling back to the American Counseling Association’s article
“Practitioner’s Guide to Ethical Decision Making” as stated earlier, an
important part of making an ethical decision is to avoid assumptions. While
the NBCC does state “except when necessary to prevent serious and
foreseeable harm to the client or others, or when otherwise mandated by
Federal or State law or regulation” I cannot confidently say his current state
of drinking will definitely result in harm to the client or others. I cannot
assume how much alcohol has been consumed by Johnny, nor his level of
tolerance. While I do know for a fact he is enrolled in a substance-abuse
counseling program that he is to successfully complete, I must recognize it
is out of my control whether or not a client remains sober. I cannot take
personal accountability for client’s actions, I can only meet client’s where
they are at and provide support. An ethical decision making model to
support my stance is Kitchener’s Ethical Principles. Included in this model,
Kitchener emphasizes autonomy. Kitchener states, “autonomy is the
concept of personal responsibility to make one’s own choices and to have
freedom to act on one’s own behalf” and to “allow others the same choices
and freedoms''
A historical preced
ence that highlights therapist-patient confidentiality
would be Jaffee v. Redmound in 1996. The APA submitted the argument that
“psychotherapeutic clients have a strong expectation of confidentiality, (b)
confidentiality is essential to the success of psychotherapy, and the benefits
of the psychotherapist-patient privilege outweigh its costs” The US supreme
count supported the arguments presented by the APA.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Unfortunately, I don’t feel there is enough information within the scenario
that would justify immediate intervention. It does not state whether or not
the client is becoming physically hostile, making threats, or is becoming
belligerent and even if that were the case, I feel in am physically not as
equipped to deal with such a situation. I am unable to mention to the
bartender, law enforcement, or any other entities that I know he is court
mandated to attend substance abuse counseling and to maintain sobriety
while in the program because there are no obvious and immediate threat of
life. I believe the best course of action is to allow the restaurant managers
to follow their policies and procedures that are in place and to handle
customers becoming increasingly intoxicated. I can address the issue at
hand in the next session for my client where we are in a safe and controlled
environment and where his patient confidentiality is upheld. I can further
reach out to Johnny’s parole officer, if he has one, and include in my report
to the courts that during his mandated substance-abuse counseling
program, Johnny was observed to be under the influence and was not
engaged during sessions.
Thank you, and please let me know if I can answer any questions.
References:
Forester-Miller, H., Ph. D., Davis, T., Ph. D., (2016).
Practitioner’s Guide to Ethical Decision
Making
.
https://www.counseling.org/docs/default-source/ethics/practioner-39-s-guide-to-ethical-decision-
making.pdf?sfvrsn=2
Jaffee v. Redmond, 518 U.S. 1
. (n.d.). https://www.apa.org.
https://www.apa.org/about/offices/ogc/amicus/jaffee
National Board for Certified Counselors, Inc. (2023, May).
NATIONAL BOARD FOR
CERTIFIED COUNSELORS, INC. CODE OF ETHICS
.
https://www.nbcc.org/assets/ethics/nbcccodeofethics.pdf
Sangganjanavanich, V. F., & Reynolds, C. (2013).
Introduction to Professional Counseling
.
SAGE Publications.
According to Forester-Miller and Davis’s article “Practitioners Guide to Ethical
Decision Making,” some things to consider are the individual's autonomy,
justice, beneficence, nonmaleficence, and fidelity. To further break these down,
autonomy is the freedom to choose. Counselors must encourage clients to make
positive choices; however, clients must be made aware of how their choices can
be met with consequences to both themselves and others. Justice refers to the
concept that not all individuals must be treated the same to be equal. Some
clients may need additional support that others don’t to obtain successful results.
Beneficence is the counselor's responsibility to promote the welfare of the client
by preventing harm when possible. Nonmaleficence refers to the concept that
counselors shall “do no harm” through various means such as avoiding risky
and harmful behaviors towards the client. Lastly, fidelity refers to a client's
ability to trust the therapeutic relationship that has been established and for
counselors to avoid the threat of tarnishing the therapeutic relationship (2016).
With these considerations, I believe it is important for individuals to make their
own decisions and have autonomy. More often than not, individuals with
alcohol or drug addictions become sober due to their own personal wishes to
become sober; however, our client is mandated. It can make things more
difficult when treating this client because he doesn’t seem to personally wish to
be involved in the counseling services. Because of this, his “justice” may not
look the same as others. He may require additional support and encouragement
during sessions to open up and become less guarded. As for beneficence, I am
on the fence because if we immediately intervene and break confidentiality, it
could cause the client to become irate resulting in the client harming himself or
others. On the other hand, if we don’t intervene, he could still potentially harm
himself or others if he ends up drinking in excess (which we are unaware of
how many drinks he has had thus far or his level of tolerance). With
nonmaleficence, it is our duty to do no harm. We cannot put the client at risk or
harm the client. Would interfering potentially put the client at risk? Lastly,
fidelity- if we breach confidentiality, we would damage the therapeutic
relationship and trust between the client resulting in the possibility of the client
no longer showing up to sessions. This would ultimately diminish the possibility
of success in the program. We would no longer be able to attempt to continue
building trust.
This week’s discussion is difficult; however, I do like hearing all sides and
opinions regarding the ethical decisions being made.
References:
Forester-Miller, H., Ph. D., Davis, T., Ph. D., (2016).
Practitioner’s Guide to Ethical Decision
Making
.
https://www.counseling.org/docs/default-source/ethics/practioner-39-s-guide-to-ethical-decision-
making.pdf?sfvrsn=2
Hello Kimmy,
I agree with your statement regarding the client’s autonomy and telling the
client “he cannot drink would encroach on his rights to autonomy which in the
past has not been well received.” I agree with your decision to observe unless
Johnny becomes incoherent, in which you would intervene, but discreetly.
Intervening discreetly could help keep the therapeutic relationship stable if
Johnny hasn’t recognized you in the restaurant. As you have mentioned,
confidentiality is absolutely necessary for the success of therapy
(Sangganjanavanich & Reynolds, 2013). Another great point you made is that in
the ACA’s code of ethics, counselors are responsible for explaining the required
limitation of confidentiality including what information can be shared and with
whom to clients previous to the beginning of the counseling program (ACA,
2014). If I had to intervene due to witnessing the client become hostile or
incoherent, I would hope to do so discreetly; however, thus far, the case
information we have is too vague for me to confidently intervene immediately.
Thank you for your thoughts!
References:
Sangganjanavanich, V. F., & Reynolds, C. (2013).
Introduction to Professional Counseling
.
SAGE Publications.
American Counseling Association. (2014).
ACA 2014 Code of Ethics
.
counseling.org.
https://www.counseling.org/resources/aca-code-of-ethics.pdf
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help