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__**ACA Decision Making Model **__

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The severity of a [|closed head injury] can vary tremendously from a simple [|concussion] to possibly [|fatal traumatic brain injuries] and injuries that lead to the brain’s shutdown and eventually a [|vegetative state]. Our client Berice, a thirty-five year old Jamaican male that has recently sustained an injury of this type and has since searched for an employment opportunity that would keep his head and brain injuries from causing the minimum amount of disturbances. Berice has shown interest in becoming an alarm-system installer. The only problem keeping Berice from making an attempt towards receiving training to become an alarm-system installer is that at the moment he does not have the financial resources to pay for the education. Due to this problem Berice has reached out to Jim to counsel him and help him attain the financial backing for such training.


 * 5 Principles **
 * [|The ACA ethical decision making model] gives five principles that coincide with our ethical guidelines as counselors. These principles are Autonomy, Nonmaleficence, Beneficence, Justice, and Fidelity. Berice’s case is somewhat complicated due to the cultural complications that have risen during Dr. Kinney’s neuropsychological assessment. First of all, it seems rather unethical of Jim, Berice’s counselor to send Berice to Dr. Kinney knowing that Dr. Kinney does not use any assessments that might account for cultural differences. According to the ACA code of ethics, E.8., (Multicultural Issues/Diversity in Assessment) “counselors use with caution assessment techniques that were normed on population other than that of the client”. If Jim and the agency that he works for is thoroughly informed of the lack of assessments given to culturally different clients by Dr. Kinney it is not professional to continue sending clients such as Berice to him. To continue to do so is a direct violation of both nonmaleficence and beneficence.


 * Ethical Codes That Apply **
 * [|Ethics codes E.5.b. and E.6.c.] (ACA, 2005) are very important in this case due to the importance put upon counselors to understand that all cultures and individuals are different and because of these differences we are obligated to be considerate and thoughtful of each and every assessment. It is true that Jim is not the one making the assessment directly, however, he is the lead counselor within this case and is therefore liable for the incorrect assessment made by Dr. Kinney. It is possible that in Berice’s Jamaican culture some of the occupations and skills that a typical American alarm system installer is supposed to have is not a necessity in Jamaican culture. Without the correct culturally relevant assessment given to Berice it is possible that the answers and results will be misinterpreted and incorrect.
 * [|Beneficence] is the main principle that seems to be broken with the continued use of Dr. Kinney for all clients that need neuropsychological assessments. Beneficence is thought to have the simple definition of “doing the right thing”. However, on a much deeper level beneficence means to promote the well-being of others, show altruistic values, and have a moral code that is dedicated to bring about the best in others and yourself. Jim fails to uphold this principle by not taking the time to speak with Dr. Kinney about cultural sensitivity or find a more competent psychologist who can better assist Berice.

** Moving Forward **
 * There are various scenarios that could occur in this case. If things are left as they are it would definitely be an emotional and psychological toll on Berice’s mentality. At the moment Berice is most likely fragile and needs as much support as possible from any source willing to give it. If Jim does not correct his mistake he risks receiving a complaint and could possibly come before an ethics board that has the authority to fine him for incompetence. At this point it would be very wise for Jim to listen to Berice and his feedback concerning the assessment and why he feels that Dr. Kinney did not understand him. Depending on the agency that Jim works for it might be possible to have Berice sent elsewhere to a different psychologist for another assessment. Speaking with Dr. Kinney about the lack of understanding felt by Berice could also be an important step towards a better working relationship between both parties. However, the best plan of action at this moment is for Jim to talk with the head of his agency and then research more about the Jamaican culture since this is becoming an issue.


 * Summary **
 * In conclusion, it is true that Berice has suffered a brain injury and this has caused changes to his personality, memory, concentration, and emotions. However, it is unethical to give an assessment of a person’s new found and misunderstood changes without taking into account the cultural differences that are already existent within the person. As difficult as it may be, it would pay more to have a client worked with in a correct and ethical manner than to risk charges of incompetence by an unhappy client. If after a thorough and correct assessment has been made the results are the same, then it is possible to move on with the case and help a client such as Berice find a likeable more suitable employment position for which he can work.