Case+11+-+Ethical+Codes+and+Considerations

Case 11 - Ethical Codes and Considerations media type="youtube" key="8gkCqWw1qmI" width="448" height="251" align="center"

Ethically this is a very difficult case. There is no clear right or wrong way for the counselor to proceed in this scenario that is correct for every counselor and every client in every situation. This is made all the more difficult by the fact that this counselor did a good job in upholding the ethical standards of the ACA Code of Ethics. Many counseling situations become ethically critical because counselors fail to follow these guidelines, this is not the case in this scenario. That being said, the following are some ethical considerations that the counselor clearly used to guide her decision making process thus far, and some that she should consider moving forward.

Counselors protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification.
This is the crux of the problem for the counselor for the scenario. She is concerned about whether or not to disclose sensitive information about her client to that client’s mothers and is unsure about the legal or ethical justification.

B.2.A - Serious and Foreseeable Harm and Legal Requirements
=== The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues. ===

This code is a gray area in this case. Does a 15 year old having sex with an 18 year old constitute serious and foreseeable harm? It is clear that if she has sex with an 18 year old the counselor would be legally obligated to tell the mother, but the client hasn’t actually done that yet, only discussed it as a possibility with the counselor.

A.1.D - Support Network Involvement
=== Counselors recognize that support networks hold various meanings in the lives of clients and consider enlisting the support, understanding, and involvement of others (e.g., religious/spiritual/community leaders, family members, friends) as positive resources, when appropriate, with client consent. ===

Does the counselor involve the mother on the grounds that she is part of the child’s support network? If so, then this would lend credibility to her decision if she chose to disclose the information to the mother.

B.5.B - Responsibility to Parents and Legal Guardians
=== Counselors inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements. Counselors are sensitive to the cultural diversity of families and respect the inherent rights and responsibilities of parents/guardians regarding the welfare of their children/charges according to law. Counselors work to establish, as appropriate, collaborative relationships with parents. ===

One of the most important ethical guidelines for this case. All of the points in this guideline were accomplished by the counselor before actual therapy began. It is possible to argue that the counselor did not discuss every detail that would require her to break confidentiality to the mother and the client, but this is not a realistic expectation.

A.2.D - Inability to Give Consent
=== When counseling minors, incapacitated adults, or other persons unable to give voluntary consent, counselors seek the assent of clients to services and include them in decision making as appropriate. Counselors recognize the need to balance the ethical rights of clients to make choices, their capacity to give consent or assent to receive services, and parental or familial legal rights and responsibilities to protect these clients and make decisions on their behalf. ===

This was done by the counselor in the initial session with the mother. She was not required to gather consent from the child as she is a minor, but still included her in the entire process as was appropriate.

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References

http://www.counseling.org/resources/aca-code-of-ethics.pdf