Week_4_KNIGHT_psych650

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1 Week 4 - Summative Assessment: Ethical Decision-Making Crystal Knight University Of Phoenix Psych/650 Nicolle Napier Ionascu, Psy.D. 11/21/2023

2 Week 4 - Summative Assessment: Ethical Decision-Making Kassi is a 38-year-old white female referred to treatment. Kassi expresses ambivalence towards treatment and is only attending to “appease her employer”. Kassi is a “single mother” to her 14-year-old daughter. Kassi admits to working so much that her daughter gets upset because she misses out on being there for her daughter. Kassi works a ‘high-stress job’ and states, she sometimes drinks ‘whiskey on the rocks’ sometimes two or three or more per night. Kassi admits she has had to miss work due to drinking before and states she has experienced nausea, anxiety and trouble sleeping. Kassi appears to be experiencing extreme amounts of stress. Kassi also states that her daughter’s friends say they “Do not like coming over when Kassi I am drinking”. Ethical Decision-Making Model The Ethical Decision-Making Model consists of seven steps that help evaluate an individual and decide a plan of action. The model helps counselors to be able to make decisions following the APA code of ethics and do be able to do their best to help the client. There are four principles at the core of ethical reasoning in this field of work. These are autonomy, justice, beneficence, nonmaleficence, and fidelity. Autonomy is the principle that gives respect to independence, and self-determination. The main purpose of this principle is to give the client freedom of choice and action. This principle gives attention to the counselor encouraging clients to be autonomous. The counselor should be helping clients to understand how their choices and values may be accepted in the society in which they live. This is also related to the client’s ability to make sound judgements. People who are under the age of legal adults or with mental disabilities should not be allowed to make choices that can harm themselves. (Forester-Miller, H., & Davis, T. E., 2016)

3 The second principle is justice, which does not mean treating everyone the same, it simply means treating equals equally and unequals, unequally. If there is a need to treat someone differently it must be provided. Next, beneficence means to observe the counselor’s duty to contribute to the welfare of the client. To do good and be proactive. Then, we have nonmaleficence which is to not cause harm to others, above all. Lastly, fidelity which involves the belief of loyalty, faithfulness, and honoring commitments. Clients need to be able to trust the counselor. (Forester-Miller, H., & Davis, T. E., 2016) The ethical decision-making model is formulated in seven steps. The first is to identify the problem. Preparing all the information you can that will illuminate the situation. Being as specific and objective as possible. Considering if the problem is an ethical, legal, professional, or clinical problem. Considering if the counselor is a part of the problem. The second step is applying the ACA code of ethics. Once the problem has been evaluated, refer to the ACA code of ethics. When reviewing the codes, consider all cultural perspectives and/or bias. The third step is determining the nature and dimensions of the dilemma. This is where the counselor will examine the nature of the problems implications for each principle mentioned above; autonomy, justice, beneficence, nonmaleficence and fidelity. This is the time to decide which principles will be used in this the situation. The next step is to generate potential courses of action. To brainstorm different ideas, considering all consequences of all choices and then determining a course of action. The 6 th step is evaluating the course of action and number seven is to implement the course of action. (Forester-Miller, H., & Davis, T. E., 2016) Diagnosis.

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4 Upon reviewing the DSM-5 criteria for alcohol use disorder, Kassi’s counselor states she fits criteria A. 1, 3,5,6,10a & 11a. Due to Kassi meeting at least 6 of the criteria, Kassi is suitable to be diagnosed with alcohol use disorder; severe 303.90. Kassi does drink often and take in larger amounts or over a longer period than was intended. Kassi also spends time in activities to obtain alcohol, use alcohol or recover from alcohol’s effects. Kassi reported alcohol use resulting in failure to fulfill major role obligations at work, school or home. Kassi also reports continuing using alcohol despite continued interpersonal and social problems. The client also states that she must increase her alcohol use sometimes and that the after-affects cause her physical ailments. (APA, 2013) Ethical or Unethical According to the ACA Code of Ethics, Kassi did receive an ethical diagnosis. From A9a screening, in which the screening sounded as though it follows the regulations. The client reported all the information given in the case study. The diagnosis is an ethical diagnosis. The counselor will need to remember that according to the ACA Code of Ethics they cannot share information with Kassi’s supervisor unless she gives written consent. However, beings that Kassi has reported drinking in the home with a minor and it causing problems there is room to assume that Kassi could be reported to social services to “check-in” on Kassi’s daughter. If the diagnosis was taken into consideration by the counselor, considering cultural backgrounds, social and economic factors and genetic predispositions, the diagnosis is correct and ethical. Conclusion In this case, Kassi would need a biopsychosocial assessment to help “better quantify” Kassi’s diagnosis. Kassi’s level of treatment would need to be measured by Kassi’s assessment. Kassi’s diagnosis was gotten in an ethical way, and it is also apparent that Kassi is not ready for

5 change. There are several things that need to be taken into consideration in this situation. Does Kassi believe alcohol could cause problems in the future with her interpersonal life, physical and mental health, career, etc. Does Kassi show readiness to change? Does the counselor recognize barriers in Kassi’s life? Do Kassi have a mental illness she isn’t aware is there causing her to self-medicate? What is Kassi’s likelihood to relapse? Kassi appears to be in the precontemplation stage of change evidenced by her denial of a problem with the alcohol.

6 References  Forester-Miller, H., & Davis, T. E. (2016). Practitioner’s guide to ethical decision making (Rev. ed.). American Psychiatric Association. (2013). Anxiety disorders . In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.dsm05

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