Students will write an APA style paper, 12 to 15 pages of text, with a title page and references page.
Therefore, for each case below, you will need to follow Corey’s ethical decision-making model to describe how you would approach each dilemma. Include (but do not limit yourself to) the following elements:
Are there any ethical dilemmas here? If so, what are they?
What ethical value(s) from the 2014 ACA Code of Ethics Preamble underly the dilemma? Justify how they apply.
What ACA ethical codes apply? Explain how they apply.
What Texas LPC Board Rules and Regulations/Ethical Codes apply? Explain how they apply.
Use the code in your own words then site (ACA Code A.6.b)
COREYS ETHICAL DECISION-MAKING MODEL
1. Identify the problem or dilemma
Gather all of the information that sheds light on the situation. Clarify whether the conflict is ethical, legal, clinical, cultural, professional or moral or a combination.
Questions to ask: What is the crux of the dilemma? Who is involved? What are the stakes? What Values of mine are involved? What cultural and historical factors are in play? What insights does my client have regarding the dilemma? How is the client Affected by the various aspects of the problem? What are my insights about the problem?
2. Identify the potential issues involved
List and describe the critical issues and discard the irrelevant ones. Evaluate the rights and responsibilities and welfare of those who are affected by the situation. Consider cultural context if there of the situation. Identify and examine the ethical principles that are relevant in the situation. Consider the six fundamental moral principles: Autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity and apply them to the situation.
3. Review the relevant ethical codes
Consult available guidelines that could apply in your situation. Consider whether your own values and ethics are consistent with or in conflict with relevant codes.
4. Know the applicable laws and regulations
Know the relevant state and federal laws that might apply to ethical dilemmas. This is critical in matters of keeping or breaking confidentiality, reporting child or elder abuse dealing with issues pertaining to danger to self or others, parental rights, record keeping, assessment, diagnosis, licensing statutes, and the grounds for malpractice.
5. Obtain consultation
You do not have to make ethical decisions alone, but it is important to maintain client confidentiality when consulting with others. Consult with trusted colleagues to obtain different perspectives on the area of concern and arrive at the best possible decision.
6. Consider possible and probable courses of action
Take time to think about the range of courses and actions. Brainstorm to identify multiple options for dealing with the situation. Generate a variety of possible solutions to the dilemma. Consider the ethical and legal implications of the possible solutions that you have identified. Be creative and it is okay to be unorthodox as long as its useful.
Consider the implications of each course of action for the client, for others who will be affected and for you as the counselor. Examine the probable outcomes of various actions, considering the potential risks and benefits of each course of action.
7. Choose what appears to be the best course of action
To make the best decision, carefully consider the information you have received from various sources. Evaluate the course of action by asking these questions: How does my action fit with the code of ethics of my profession? To what degree does the action taken consider the cultural values and experiences of the client? How might others evaluate my action? What did I learn from dealing with this ethical dilemma? Then make adjustments if needed.
CASE STUDIES
The Case of Marcy:
You have been working with Marcy in an outpatient private practice for the past year. She originally came to you after having “fired” her past counselor. She reports that he was not very empathic and that she was really bothered by the hole in his cowboy boots. “If you can’t take care of your shoes, how can you help me?” she told you. In therapy she has been working on her past relationships with her father and mother, which are both currently estranged. She is frequently emotionally labile and it seems that you are treading on the same ground for a significant amount of time in therapy. She frequently will show up late or cancel at the last minute. One night she doesn’t show up for therapy, and you call her to see if she will be attending. She doesn’t respond, and you leave a message which Marcy agreed to by signing your informed consent and privacy practices document. The next week, she calls you and informs you that she has been in a terrible car accident and that both of her legs are broken. She is highly emotional and seems very angry at the first responders that arrived on scene. She says that since her legs are broken, she cannot drive to session. She further states that internet service is bad in her home, so internet therapy will not be an option. She has asked if you would be willing to come to her home to perform therapy and if you would also do a joint session between Marcy and her roommate.
The Case of Jack:
You have been seeing Jack for approximately nine months in individual therapy. He originally came because his marriage is in trouble and he is struggling with how to deal with his husband, Peter. Peter loves the club scene and together he and Jack spend about $200 every week on going to bars. Additionally, Peter “Likes to party,” which Jack explains means that he likes to do cocaine. Through therapy, Jack eventually discloses that he was sexually molested by his uncle who was his primary male influence growing up. His father decided he didn’t want to be part of the family, so his uncle stepped in to take care of him and his brothers. He was molested for five years and has never told anyone this before coming to counseling. As you process the trauma, Jack realizes that the men he has chosen to be in relationships with strongly resemble his uncle. In particular, his husband seems like his uncle in his domineering and controlling nature in their relationship. He decides in therapy that he no longer wants to be married to his husband. In one session, Jack says that during his last therapy session his husband texted him about 15 times and called and left 20 messages because he was sure that Jack was cheating on him. The following Saturday at 3:00am you receive an email from someone who identifies themselves as Peter. He says that Jack is “throwing everything away” and requests a couple’s therapy session with you and Jack so that “we can save our marriage.”
The Case of Chitra:
You are working at a free clinic and you start seeing Chitra, a woman who is a former executive at an information technology firm. She left the job for a number of reasons, however, chief among them was that she had been taking benzodiazepines for anxiety, but when she attempted to stop cold turkey, she had severe difficulties. She eventually had to quit her job and use most of her remaining funds to go through an inpatient program to manage her withdrawal symptoms. She seems to have a very adversarial approach to life in general, and you are having a hard time seeing whether you are really connecting with her or not. Some days she says that you’re the best counselor ever and that she’s so happy a free clinic like the one you work at exists. Other days she just glares at you and tells you how “you’re getting it all wrong.” On one of her “good days,” she says that she still has a time-share as a result of the severance package that she negotiated with her work. She says as a result she didn’t have to pay anything for the time-share but won’t be using it and asks if you would like to use it for the weekend.
ACA CODE OF ETHICS:
https://www.counseling.org/resources/aca-code-of-ethics.pdf
TEXAS LPC BOARD RULES:
https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=22&pt=30&ch=681&sch=B&rl=Yhttps://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=22&pt=30&ch=681&sch=B&rl=Y
