Katy is a 25-year-old woman, who has been diagnosed by her counselor Beatrice, with borderline personality disorder. As part of her symptoms, Katy demonstrates a lack of empathy for others, and she has a past of manipulating people to create sympathy for herself. Katy was referred to Beatrice three months ago when she was hospitalized for cutting on her wrists when her boyfriend left her. At first the counseling connection between Beatrice and Katy was very close as Katy was relieved to narrate her story and the many ups and downs, she has had in trying to find an intimate relationship. Beatrice began to employ CBT counseling and started to confront Kay's catastrophizing the lack of trust she has failed to obtain from the personal relationships with both the men and women with whom she lived with over the last seven years. When confronted Katy began to withdraw and she then voiced an attempt to commit suicide. Through empathy, concern and support Beatrice helped Katy to manage the episode. However, when Beatrice once again confronted her ineffective patterns of behavior Katy withdrew, cut on her wrists again, and was temporarily hospitalized. Beatrice has been working with Katy to reduce her manipulative behaviors, (e.g., to get Beatrice's unconditional support) and look at the benefits and consequences of using her attempts of self-harm as attention seeking behavior. To create some boundaries, Beatrice, is utilizing a call service for off hours, providing them a checklist to deescalate Katy’s episodes, and provide her tools to reflect on her manipulative behaviors. Sessions go well for a couple of weeks but one night at 3:00 am the answering service calls Beatrice, stating that their attempts to de-escalate Katy behaviors have failed, and has told them, this time she said she really means it, she will commit suicide. Katy also said if the police come, she will deny everything, refuse to go to the hospital and commit suicide after they leave. Discuss the available options for addressing this ethical dilemma; include the ACA ethical codes and principles.
Katy is a 25-year-old woman, who has been diagnosed by her counselor Beatrice, with borderline personality disorder. As part of her symptoms, Katy demonstrates a lack of empathy for others, and she has a past of manipulating people to create sympathy for herself. Katy was referred to Beatrice three months ago when she was hospitalized for cutting on her wrists when her boyfriend left her. At first the counseling connection between Beatrice and Katy was very close as Katy was relieved to narrate her story and the many ups and downs, she has had in trying to find an intimate relationship. Beatrice began to employ CBT counseling and started to confront Kay's catastrophizing the lack of trust she has failed to obtain from the personal relationships with both the men and women with whom she lived with over the last seven years. When confronted Katy began to withdraw and she then voiced an attempt to commit suicide. Through empathy, concern and support Beatrice helped Katy to manage the episode. However, when Beatrice once again confronted her ineffective patterns of behavior Katy withdrew, cut on her wrists again, and was temporarily hospitalized. Beatrice has been working with Katy to reduce her manipulative behaviors, (e.g., to get Beatrice's unconditional support) and look at the benefits and consequences of using her attempts of self-harm as attention seeking behavior. To create some boundaries, Beatrice, is utilizing a call service for off hours, providing them a checklist to deescalate Katy’s episodes, and provide her tools to reflect on her manipulative behaviors. Sessions go well for a couple of weeks but one night at 3:00 am the answering service calls Beatrice, stating that their attempts to de-escalate Katy behaviors have failed, and has told them, this time she said she really means it, she will commit suicide. Katy also said if the police come, she will deny everything, refuse to go to the hospital and commit suicide after they leave.
Discuss the available options for addressing this ethical dilemma; include the ACA ethical codes and principles.
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