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1 Case Review: Ethical Decision-Making in Substance Abuse Treatment Hattie L Isaac Phoenix University Psych/650: Parapsychology Professor: Nicolle Napier Ionascu October 31, 2023 Introduction-Review

2 Kassi is a 38-year-old White single mother who only agreed to get help for her substance She said her work is very stressful and it makes it hard for her to be a good mom to her daughter. She admitted that she often drinks alcohol when she gets home from work, and usually ends up having more than three drinks every night. Her drinking has gotten worse over time, and it has caused her to skip work and miss her daughters' activities. Her daughter is worried about her mom's drinking and wants her to stop. However, she does not believe that her drinking has labeled her as an alcoholic, and she does not think she has a basis for her problem with alcohol and only came to treatment because her job made her do it. The DSM-5 criteria for Alcohol Use Disorder (AUD) and from the information obtained from the daughter, Kassie has six out of eleven symptoms of AUD, which means she has a severe alcohol use disorder. This case study also presents an ethical dilemma for the mental health clinician who provided services to the client. The clinician must follow the ethical guidelines and make ethical decisions in their practice. The Forester-Miller and Davis model for ethical decision-making will be used in this report's data analysis to analyze the situation and clarify the processes in the ethical decision- making process. The Forester-Miller and Davis model for ethical decision-making will be used in this report's data analysis to analyze the situation and clarify the processes in the ethical decision- making process. The report will also evaluate the clinician's reasoning for the diagnosis given to the client and determine if the diagnosis was ethical or unethical under the codes of ethics. Analyze and Describe the Case using the Forester-Miller and Davis Model

3 A seven-step methodology for making ethical decisions that can be used in this situation is presented in the paper by Forester-Miller and Davis. The steps are as follows: (1) Identify the issue; (2) Apply the ACA Code of Ethics; (3) Assess the nature and scope of the predicament; (4) Come up with possible courses of action; (5) Think through the implications of each option and choose one; (6) Assess the chosen course of action; and (7) Put the chosen course of action into practice (Forester-Miller, 2016). Kassi's drinking is a problem that interferes with both her profession and her relationships. Kassi, her child, and the clinicians are the parties embroiled in this situation. The diagnosis, the tension between Kassi's autonomy and her daughter's well-being, and the clinician's need to give Kassi the best care possible are the ethical considerations in this case. The Ethical guidelines of the APA and the ACA The clinician must follow the ethical guidelines of the APA and the ACA when providing services to Kassi. Concerns including professional competence, informed consent, and confidentiality governed by the ACA's Code of Ethics and the APA's Ethical Principles of (NIAA, 2020). Giving Kassi a diagnosis of severe alcohol, psychologists, and a Code of Conduct

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4 consumption disorder will have ethical ramifications that the clinician must consider. Even if Kassi does not believe she has an alcohol issue, the doctor is obligated by law to provide a precise diagnosis based on her evaluation and symptoms. Kassi's autonomy must be respected, and the clinician must provide her informed permission. But they must also consider her daughter's well-being and how Kassi's activities affect her. The clinician justified Kassi's diagnosis by referencing the six DSM-5 criteria for severe alcohol use disorder. By making the diagnosis, the clinician is recognizing Kassi's symptoms and providing a foundation for treatment that could help her overcome her disorder. Kassi's diagnosis was validated by the doctor based on the six DSM-5 criteria for severe alcohol consumption disorder, which she satisfies. Justifications for the Clinician diagnosis. Kassi’s case has been appropriately and accurately diagnosed by the clinician as severe alcohol use disorder based on her symptoms and the clinician's diagnosis is considered ethical based on the guidelines provided by the APA Code of Ethics. These codes state that using a diagnosis if it is founded on a precise evaluation and diagnosis of the patient's symptoms is ethically acceptable. Based on Kassi's symptoms and her description of her drinking patterns, the clinician correctly diagnosed severe alcohol use disorder in her case. The doctor must also make sure Kassi receives an accurate diagnosis and gives her informed consent before beginning any treatment.

5 This implies that before making any decisions, Kassi needs to be completely informed about her condition and her options for treatment. In addition, the doctor ought to suggest a course of treatment that is suitable for Kassi given her particular needs and situation. This could involve medication, support groups, or individual therapy, based on what would be best for her. Relapse prevention programs entail identifying triggers, coping mechanisms, and support networks, which may be beneficial in Kassi's situation as well. These components play a major role in helping people with alcohol problems stay sober. Overall, considering each of these variables is consistent with the assessment, diagnosis, and treatment of mental health disorders as outlined in the codes of ethics of the APA and ACA. As such, it was considered ethical to use a diagnosis in this case. Her admission of drinking. An accurate diagnosis of Kassi’s condition must be documented, and she must give informed consent for any recommended treatment. In addition, they ought to suggest a suitable course of action for Kassi given her particular requirements and situation; this might entail counseling on an individual basis, joining support groups, or taking medication. Is the Diagnosis Ethical or Unethical? Following the ACA and APA's ethical codes, the diagnosis used in this instance was morally acceptable. Psychologists and clinicians have to be "competent and ethical in the Mental health disorder screening, diagnosis, and treatment," according to the ACA (American Counseling Association, 2014). This means that to evaluate, diagnose, and treat their clients, they must rely on their clinical expertise, understanding of mental health disorders, and adherence to ethical standards. After assessing Kassi's symptoms, if the clinician determined that she satisfied

6 all the requirements for a severe alcohol use disorder, then they will "provide a comprehensive assessment that includes a diagnosis when it is necessary” (American Psychological Association, 2017). When determining the best course of treatment, psychologists must conduct a thorough evaluation of their clients, which may involve asking the difficult questions it takes to get to the truth and for the client to admit their guilt. Kassi’s struggle with trying to live life and control her habit has disrupted many things in her efforts. After speaking with Kassi and going over her symptoms, the clinician determined that she suffered from a severe alcohol use disorder. The diagnosis was an ethical one since the counselor had to diagnose Kassi accurately (through all levels of mental screening) to ensure that she received the appropriate treatment.

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7 Conclusion Sometimes people seek mental health help but may not fulfill all of the diagnostic criteria for a mental illness or do not want a label on their record. The clinician must ensure that they are using diagnosis ethically, according to the ACA Code of Ethics and the APA Ethical Principles of Psychologists and Code of Conduct. There may be occasions when a client questions them or because they are concerned that their diagnosis will cause them harm in other aspects of their life. Sometimes, people seek mental health help but may not fulfill all of the diagnostic criteria for a mental illness or do not want a label on their record. The clinician must ensure that they are using diagnosis ethically, according to the ACA Code of Ethics and the APA Ethical Principles of Psychologists and Code of Conduct. There may be occasions when a client questions their diagnosis and requests that their case be reviewed, maybe owing to insurance coverage problems or because they are concerned that their diagnosis will cause them harm in other aspects of their life, their jobs, and livelihoods. When it comes to working with the mentally ill, it is critical to stay loyal to your calling. We

8 must be concerned about their well-being while also ensuring that we respect and uphold our religious vows. Some rules must never be broken, and difficult decisions must be made to accomplish our best work. The why and when questions should be important to us because we are the ones who guide the hands of those who do not know the answers. HLI References American Counseling Association. (2014). ACA Code of Ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf American Psychological Association. (2017). (n.d.). About APA. Retrieved April 15, 2023, American Psychological Association. From HTTPs://www.apa.org/about/ ETHICAL PRINCIPLES OF PSYCHOLOGISTS AND CODE OF CONDUCT. https://www.apa.org/ethics/code/ethics-code-2017.pdfDrevitch, Gary (2015). Forester-Miller, Holly (2016). Practitioner's Guide to Ethical and Decision-making. https://www.counseling.org/docs/default-source/ethics/practioner-39-s-guide-to- ethical decision-making. pdf?sfvrsn=f9e5482c_10 National Institute of Alcohol Abuse and Alcoholism (NIAA) (2020). Understanding Alcohol

9 Use Disorder. Https://www.niaaa.nih.gov/publications/brochures-and-

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