Counseling ethical dilemma vignettes

Counseling ethical dilemma vignettes

An attorney refers many clients to you for psychological evaluations. A close friend of yours has retained this attorney, who refers your friend to you for a very important psychological evaluation. You are strongly encouraged by both the attorney and your friend to do the evaluation.

counseling ethical dilemma vignettes

The recommendation made by the attorney may be based on my professional qualifications but it could provide a legal and ethical dilemma that could prove detrimental to the case under scrutiny.

As a psychologist, one would expect the occasional consultation from a close friend or family member with the context of such conference being non-professional. However, any supply of counsel to individuals with prior close relationships should not be extended to continued therapy sessions or psychological evaluations of a specialized nature such as this.

The ethical clash emanates from the potential of transference and counter-transference which is in turn as a result of mutual emotional involvement of personal relationships such as that of close friends. In order to provide professional mental health help, the needs of the client have to be catered to in a bid to achieve psychological improvement within a predetermined timetable that ceases to be in effect once this goal is achieved.

As a result, combining friendship with a professional relationship of any nature may lead to harmful effects to both parties due to disparities in expectations and trust in the psychological process. These ethical issues have the potential to be used against my credibility and that of the psychological evaluation of my close friend.

Among the issues that may be raised include my ability to endorse a qualified decorum to deal with the intrusive and often uncomfortable process of psychological evaluation, considering the prior relationship that exists with the client. As a result, the emotional involvement with my friend will probably bring about the question of possible bias towards the client when making an assessment of the situation.

This will in most cases be considered as a violation of professional trust as well as an abuse of my skills as a mental health professional. To avoid further legal complications that would include an undefined region between proper mailing address format information obtained during the psychological evaluation and knowledge on issues pertaining to the prior relationship; I would opt not to take on the case of the close friend.

My professional expertise may be considered biased and should therefore be directed at providing emotional support, information and suggestions on an emergency support basis if required. The most ethically practical and legally sound approach would therefore be directed at referring the case to an equally competent professional that has no prior emotional relationship to my friend.

You have a client who has adjusted a very busy schedule in order to be able to attend therapy sessions. You cancel a session to attend a funeral for a family member. The client becomes irate and demands to be told the reason why you cancelled. Self-disclosure on the part of a psychologist should be controlled to as minimal a level as possible.

At the same time, total disclosure on my part may lead to a form of transference where the client is inclined to identify, sympathize or even empathize with my recent loss, further derailing him from directing his attention to the initial goal of the therapy sessions. Further ethical concerns stem from the fact that self-disclosure on my part will probably lead to the initiation of other personal discussions that will not only derail the therapy process but leave it biased towards issues that compromise my professionalism.

This will result in additional emotional stress on the client who may have underlying issues that are related to the loss of loved ones or dealing with related forms of grief. Unless such a situation is controlled, it could have the potential to lead the therapy sessions to follow a more detrimental route for both parties involved.A counselor's relationship with a client depends on trust, and it is up to the counselor to maintain appropriate boundaries.

The nature of the relationship between a counselor and a client creates vulnerability to ethical dilemmas. A counselor is not only privy to sensitive information, but holds a position of power over the client. Ethical conflicts may also embody legal and moral complications.

The American Counseling Association and the American Psychological Association provide counselors with general guidelines to consider when faced with potential ethical violations. Powell, assistant clinical professor of psychiatry at Yale University School of Medicine, identifies four main reasons why clients sue their counselors.

These reasons include inappropriate sexual behavior, improper treatment, violation of confidentiality, and wrong diagnosis. As part of its documentation on "Ethical Principles of Psychologists and Code of Conduct," the APA states counselors "do not engage in sexual harassment. Violations of confidentiality may stem from what the APA defines as "multiple relationships.

This includes having a personal relationship with a client's friends, significant others or close relatives. Counselors face the challenge of collecting and documenting only what is necessary.

In other words, they should not violate their clients' privacy rights. According to APA guidelines, counselors must get their clients' informed consent.

When a counselor conducts research or gives therapy, clients need to provide documentation stating they agree. Exceptions to this standard are permissible if local law does not require informed consent.

As a precaution, the APA recommends that counselors obtain only the personal information relevant to therapeutic treatment or research. A counselor should share clients' personal information with other colleagues only if it is necessary. The American Counseling Association advocates the development of "ethical sensitivity. Someone who does not possess "ethical sensitivity" may be more prone to making unethical decisions. The development of "ethical sensitivity" involves examining your socioeconomic background.

Counselors need to recognize how these backgrounds affect their professional decisions and values. Part of identifying ethical dilemmas means examining what is appropriate. This includes the facts and who stands to gain or lose something in the relationship between counselor and client.We use cookies to give you the best experience possible. I will reflect on a video presentation as well as the North Carolina rules and regulation and the ACA Code of Ethics as it relates to confidentiality and ethics.

I will explain why confidentiality is important and what the rules says about it. This will help me and others to become a better counselor. Don't use plagiarized sources. The video presentation made me look at the types of decisions that have to be made and the thought process of making these decisions. Nellie the niece of the judge had good points on a lot of the cases that where presented to them and Joseph the Lawyer had some good points as well, but it all comes down to what is the right decision for the good of all.

Making sure that no one is taking advantage of and everyone is protected by the law. This video presentation also helped me to see that even though you might think something is right you have to make sure that the law is clear on the matter to make sure that you as a counselor will a sound decision. I next looked at my state board rules and regulation that apply to confidentially and ethics. They also stated confidentiality is a right of all clients under the principles of autonomy, beneficence, and fidelity.

In Section B. Also in Section C. I began to change my thought process on how serious this really is. Making sure that confidentiality is at the top of the list and that my ethics are always at the forefront of my decision making. Action Based on the video Presentation, North Carolina Boards rules and regulation, and the ACA Code of Ethics I will make sure that I have an available copy of these documents near my work station and also an electronic copy on my Ipad so that I can easily reference them in counseling sessions or while talking with other colleagues.

I will also look at our company polices to make sure that we are in line with all regulations. This will help the company as well as the employees so that no one will be in violation of in state or federal laws when it comes to confidentiality and ethics.

Ethical Vignette Essay. Accessed April 18, This is just a sample. You can get your custom paper from our expert writers. All you need to do is fill out a short form and submit an order. See Pricing. What's Your Topic? Hire a Professional Writer Now. The input space is limited by symbols.

Approach to Clinical Vignette Part 1 of series of 3

What's Your Deadline? How Many Pages? Sign Up and See Pricing. Please enter valid email. Back Get Offer. Write my paper. Paper Type: Essay. Pages: 4 words.Counselors make hundreds of decisions as they work with clients. They use professional skills and knowledge to gather information in order to assess, clarify, categorize, and respond to client concerns.

Most often, counselors, after some consideration and reflection, know how, or if, to respond to situations.

Supervision and peer consultation are two recognized and typically effective methods that counselors use in order to clarify concerns related to clinical or treatment questions.

These questions, by their very nature, can create a heightened sense of concern or urgency for counselors. Ethical codes include a general rather than a specific description of mandatory and aspirational behaviors and beliefs. Counselors are expected to be familiar with and to adhere to these codes as a privilege of membership in the organization. Compliance with the ethical codes ensures client welfare, standardizes the practices of the professional, and is a means of professional self-regulation.

Counselors use these codes to guide their practice and determine the appropriateness and degree of obligations they may have in relation to their clients.

The ethical codes are necessary but not sufficient to prevent counselors from encountering these circumstances or ethical dilemmas.

Vignettes and commentaries

A dilemma is generally defined as a circumstance or situation that is perplexing because a decision is required between equally unacceptable or unfavorable choices. An ethical dilemma incorporates the concepts in the preceding definition and is a situation in which there is an apparent conflict of moral standards or imperatives.

In essence, to uphold one standard would mean violating another. For example, many of the ethical codes in counseling and psychology are based on what some define as universal moral principles. The most commonly identified moral principles are autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity. These moral principles are typically presented to counselors as a holistic set of discrete and equally occurring ideals, yet in reality these principles are in relative contextual tension to each other.

Upholding one principle will have some impact, positive or negative, on the others. Counselors may encounter an ethical dilemma when they consider the circumstances of involuntary hospitalization of an imminently suicidal client.

counseling ethical dilemma vignettes

For most counselors, an ethical dilemma is apparent when they encounter a confounding situation in which they feel hindered in their decision making because a there appears to be conflict between or inconsistency among the ethical standards, b the situation is so complex that the ethical codes offer little guidance, c there appears to be a conflict between ethical and legal standards, and d there appears to be a conflict between the moral principles that underlie most ethical codes.

Counselors can be involved in ethical dilemmas directly, as in the case of client care or supervisory responsibilities, or they can be involved as a colleague, as in the case of witnessing a peer, supervisor, or supervisee struggle with a predicament.

Ethical dilemmas differ from ethical violations in that the counselors have not yet engaged in any action that would violate the rights of the client or the ethical or legal standards. Ethics have their conceptual roots in philosophy and as such are open to interpretation and influence from many sources e. Because of these influences, ethical dilemmas vary in their degrees of clarity and distinction.

Some issues or questions may be readily apparent to some individuals but not to others, and some dilemmas emerge only upon reflection or after consultation or supervision. Identifying, addressing, and resolving ethical dilemmas is a dynamic process that requires counseling professionals to do more than simplistically apply the codes with respect for the uniqueness of each situation or circumstance.

Ethics and ethical codes are bounded by the cultural contexts in which they were produced. An act that might appear to be an ethical violation to a White male counselor may not be considered unethical when viewed by first generation Hispanic American female. For example, consider this scenario: Both counselors are providing counseling to male teenagers from Korea.

In the course of the counseling sessions, each counselor asks his or her client to have his family attend the next session in order to begin family counseling. Each family is composed of some combination at least one biological parent, one biological grandparent, a couple of siblings, two cousins, and another person who is generally described as a neighbor or friend.Basket Login Register.

In this section we present a series of vignettes about ethically challenging situations and dilemmas which are quite common in residential and hospital care settings. These will be followed by commentaries on how these situations might have been effectively approached. Some of the commentators have structured their commentary around most or all of the components with less emphasis on the first two so as to avoid repetition of the vignettewhereas others have focused more on one particular aspect such as values or approaches to show how these can be incorporated into ethical reflection and deliberation.

After you have read each vignette, reflect on, and if in a group discuss with others, different possible scenarios for how the situation might have evolved. Be creative. You can imagine any kind of continuing scenario based on how you imagine the dialogue with the different people involved, their values, the constraints on the situation etc.

When you have done this, read the commentary we have provided and again see how this relates to your own thoughts and your discussions within the group.

There was an uproar at the nursing home. One of the residents had been found in her bedroom, naked to the waist, snuggling into the arms of a male resident, whispering endearments to him. This was witnessed by a care assistant who had entered the room to deliver some laundry.

She had gone out in the night in her nightclothes and was taken to the emergency room at the hospital because the police thought she would not be safe at home. She had a fall at the hospital so it took a while to discharge her.

Her daughter and son persuaded her to go into the care home, though she was very reluctant at first and wanted to go back to her own house. Mrs Brown was sent for respite to the care home and never left. The man, Mr Green, was an unmarried former seaman, with a younger brother and sister. The sister had power of attorney. He was in the home because of alcohol-related brain damage.

His dementia was not getting worse with good food and care, but he was incapable of surviving at home. His behaviour was problematic, with some violent incidents when he was looking for alcohol, which is not allowed in the home.Case Study 1 Omar and Johna al-Hakim come to therapy to address the increasing level of conflict that they have been having in their relationship. They have been married for five years, and explain to you that their religion Islam is a central part their relationship.

Omar has been growing increasingly concerned that Johna is not adhering to traditional Islamic practices for a woman, while Johna complains that Omar is becoming too strict and imposing rules that are meant to keep her from performing her job as a nurse at a local hospital.

You have only a passing knowledge of Islam and are unsure of how to define whether this is an issue of a wife dealing with an overbearing husband, or a conflict over differing interpretations of cultural and religious standards by two adult individuals. What would you do? Case Study 2 Arthur is a couples and family therapist in a group practice with several other practitioners. The psychiatrist has a staff in charge of the billing and the distribution of any income. The billing staff and the psychiatrist discussed with Arthur that if he could diagnose the children in the family with Attention Deficit Hyperactivity Disorder ADHD or Depression, then insurance companies would be more likely to pay for the sessions, which would mean more money for him and the practice.

Case Study 3 You are a therapist in private practice, and seeing clients individually. You are licensed in your state as a social worker, but not as a couples and family therapist which your state offers since you have neither had the requisite number of classes nor supervised practice by an approved supervisor in couples and family therapy.

Ethical Vignette Essay

However, one of your clients that you have been seeing individually has been discussing issues related to his marriage and asks if he might bring his wife in for couples counseling. The therapist also saw their 8-year old son children at the request of both parents to help the child cope with their arguments and frequent separations.

When the couple decided that the marriage was unsalvageable, one of the spouses subpoenaed the therapy records to support their argument for custody of the son. Included in the records were the psychotherapy notes of the sessions with the son in which he stated that they would like to live with one parent, if they divorced.

The therapist was called to testify, and agreed to render an opinion on the matter. Do you agree or disagree with this decision? The Submit Answers for Grading feature requires scripting to function.

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Chapter Case Vignettes for Review. All rights reserved. Legal Notice Privacy Policy Permissions.The National Association of Social Workers NASW Code of Ethics is a set of guiding principles to assist social workers in making decisions in the best interests of their clients, even if they might contradict what we might do in our personal lives.

These decisions are not always easy — especially when two guiding principles come into conflict. These conflicts are called ethical dilemmas. These situations are much more complicated than they seem because there are cultural, societal, and relationship factors to consider on top of the bond you and your client share.

Regardless of your social worker breed, at some point you will come across a client who intends to harm himself or someone else. These are some of our most challenging moments as helpers.

However soul crushing this may be, you are required by law to report not only to the parent sbut to the Department of Social Services or Law Enforcement. Sometimes good clients do bad things. Other times, however, the rules are a little grey. This is especially common for social workers who are working with clients who are incarcerated or abusing drugs. Ten years ago it was considered unethical to email our clients.

Now our Code of Ethics specifically addresses the best practices for conducting therapeutic services over the internet. One issue that remains sticky is social media. There is no easy answer, and sometimes there is no right answer. Spend some time reading through the code. Identify the principles that come into conflict in the specific situation and why they are important to social work practice. Be sure your decisions are sound, not only ethically but legally.

Everyone needs a second opinion once in a while. Supervisors can be particularly helpful in guiding you to make the best decision possible in a difficult situation. One of the most vital benefits to being a member of the NASW is having the support of a national organization to back up your work.

Most states have a hotline social workers can call when they experience ethical dilemmas. You can discuss your situation confidentially, without using identifying client details, and get professional advice on how to handle things. Sometimes a neutral party is the best resource to help you consider things from a new perspective.

counseling ethical dilemma vignettes

At the end of the day, you need to be able to live with your decision and to feel confident you are doing what is in the best interest of your client. Integrity — Part of our job is to serve as role-models by maintaining healthy and appropriate boundaries in professional relationships.

Involuntary Commitment Regardless of your social worker breed, at some point you will come across a client who intends to harm himself or someone else. Ethical values and principles involved Dignity and Worth of the Person — We want to support the right to self-determination, even our youngest clients.

Integrity — We must behave in a trustworthy manner, not only with our clients, but with their families and the communities we serve. Commission of Illegal Acts Sometimes good clients do bad things. Importance of Human Relationships — Trust is paramount to a client-worker relationship.

Integrity — We must practice in a way that is honest and responsible. We are also beholden to the laws and policies of the agencies and communities we serve. Interacting on Social Media Ten years ago it was considered unethical to email our clients.

Importance of Human Relationships — Social media is a ubiquitous part of modern culture, particularly for younger clients. Integrity — Social workers must act in a way that is consistent with agency policies, even if that creates a bump in the smooth working relationship you have with a client.

Competence — In addition to being a competent social worker, you need to be a competent user of technology. Handling this ethical dilemma involves working knowledge of the privacy capabilities and limitations of both the devices and applications involved. Steps for handling ethical dilemmas: 1. Review State and Federal Laws Be sure your decisions are sound, not only ethically but legally.


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