Sample Ethics Case Study Discussionmain Post Case 1 The Case Of ✓ Solved

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1. Identify the Problem Marianne began providing therapy to a client named Ellen, a young woman who originally began receiving therapy to stop being so hard on herself. Several sessions in, Marianne knows that Ellen is fearful of becoming fat and engages in self-induced vomiting after meals, abuses laxatives, and exercises excessively. Marianne determines that these are symptoms of Anorexia- Nervosa/Bulimia Nervosa, which she has little experience treating.

2. Apply the ACA Code of Ethics CRCC Code of Ethics: AVOIDING HARM. Rehabilitation counselors act to avoid harming clients, trainees, supervisees, and research participants and to minimize or to remedy unavoidable or unanticipated harm (CRC, 2010, A.4.a) APPROPRIATE TRANSFER OF SERVICES. When rehabilitation counselors transfer or refer clients to other practitioners, they ensure that proper counseling and administrative processes are completed promptly, open communication with both clients and practitioners. Rehabilitation counselors prepare and disseminate, to identified colleagues or records custodian, a plan for the transfer of clients and files in the case of their incapacitation, death, or termination of practice (CRC, 2010, A.8.d.) BOUNDARIES OF COMPETENCE. Rehabilitation counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, professional credentials, and appropriate professional experience. Rehabilitation counselors demonstrate beliefs, attitudes, knowledge, and skills pertinent to working with diverse client populations. Rehabilitation counselors do not misrepresent their role or competence to clients (CRC, 2010, D.1.a.) ACA Code of Ethics: Primary Responsibility: The primary responsibility of counselors is to respect the dignity and promote the welfare of clients (ACA, 2014, A.1.a). Avoiding Harm: Counselors act to avoid harming their clients, trainees, and research participants and to minimize or to remedy unavoidable or unanticipated harm (ACA, 2014, A.4.a). Boundaries of Competence: Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state, and national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population (ACA, 2014, C.2.a).

3. Determine Nature of Dilemma. The nature of the dilemma is that if she continues to treat Ellen, now that she's aware of more intensive needs related to Anorexia-Nervosa/Bulimia-Nervosa, she may violate her scope of practice and could do harm to the client.

4. Generate Potential Courses of Action & Possible Consequences. Marianne could continue to treat Ellen for her perfectionism issues and allow the possible eating disorder to go undiagnosed and untreated. Marianne could continue treating Ellen and begin treating her for Anorexia- Nervosa/Bulimia-Nervosa and risk practicing out of her scope of practice, out of her competency, and could risk malpractice suits. Marianne could continue to refer Ellen to another therapist better trained in treating Anorexia-Nervosa/Bulimia-Nervosa; therefore, terminating services and not having full confirmation of the diagnosis. Marianne could inform the client of her concerns, recommend receiving outside assessment for Anorexia-Nervosa/Bulimia-Nervosa. If trained specialists determine that she has an eating disorder, continue discussing the importance of referral to a more qualified therapist in this area of treatment.

5. Determine Course of Action. My choice would be option D. I would provide full disclosure of my concern for her overall health and well-being. We'd discuss the effects of untreated eating disorders and how the underlying eating disorder symptoms could manifest itself in other areas of her mental health. I would explain my limited experience in the area and explore with the client the importance of obtaining further assessment by a qualified clinician. If the clinician determines that Ellen does have an eating disorder, we will discuss termination and referral for more intensive services. This course of action aligns with the concept of "duty to care, which is a legal obligation of health providers not to act negligently" (Gladding & Newsome, 2018).

6. Evaluate Selected Course of Action. By sending the client for further assessment, we can prevent unnecessary termination of the counselor-client relationship if the client does not have an eating disorder. If she does not have an eating disorder, we can continue our therapy sessions contingent upon agency policy.

7. Implement Course of Action. I would obtain informed consent to send a referral for further assessment and follow up with the client to review results. If she does not have an eating disorder, I will continue to provide therapy while continuously monitoring for signs of eating disorder and treatment effectiveness. If she does, we will prepare her case for transfer for more suitable treatment. In the client's case, I would also document why and how the decision was made to terminate and transfer services.

Paper For Above Instructions

The ethical case of Ellen and Marianne presents a multifaceted dilemma that compels a thorough examination of professional ethical standards and personal responsibility in counseling. This case is not merely a clinical question but an ethical navigation through the precarious waters of client welfare, professional boundaries, and the moral obligations of counselors.

Initially, recognizing the essence of the problem is paramount. Ellen, the client, exhibits symptoms indicative of Anorexia-Nervosa/Bulimia-Nervosa, conditions that can be life-threatening if left untreated. Marianne's initial role was to help Ellen with her perfectionism; however, she soon finds herself in a situation where her client requires specialized care that exceeds her competence. According to the American Counseling Association (ACA) Code of Ethics, counselors are fundamentally bound to "practice only within the boundaries of their competence" (ACA, 2014, C.2.a). This principle is critical not only for effective therapy but also for ensuring client protection.

Furthermore, the ethical obligation to avoid harming clients is non-negotiable. The ACA emphasizes that therapists must actively work to minimize any potential harm (ACA, 2014, A.4.a). The knowledge that Marianne possesses regarding Ellen's eating disorder compels an ethical imperative to act. Failure to address this issue, or to dismiss it as a secondary concern, can lead to further deterioration in Ellen's mental and physical health.

Marianne's professional challenge is compounded by the potential risks associated with continuing therapy without adequate training in dealing with eating disorders. According to the Council on Rehabilitation Counselor Certification (CRCC), counselors must not misrepresent their competence (CRC, 2010, D.1.a), and any attempt by Marianne to treat Ellen's eating disorder herself could jeopardize her client's wellbeing and open Marianne to liability for malpractice. Thus, an ethical path must be sought that aligns both with the best practices of counseling ethics and the specific needs of the client.

As Marianne evaluates potential courses of action, it's critical to acknowledge the implications embedded within each option. She could choose to ignore the red flags and continue addressing Ellen's perfectionism, yet this presents significant risk to Ellen’s health by allowing the underlying eating disorder to persist. Alternatively, she could attempt to treat the eating disorder herself, which would stretch her competency boundaries and may lead to ineffective treatment. This could ultimately cause Ellen further harm, contradicting Marianne's ethical responsibilities.

Another course of action could be referring Ellen to another specialist equipped with the necessary training. This option aligns with the principle of appropriate transfer of services from the CRC that mandates counselors to ensure proper, timely, and effective referral processes are adhered to (CRC, 2010, A.8.d.). However, initiating a referral without full disclosure and proper assessment could potentially undermine Ellen's treatment, as the diagnosis might not be confirmed, and critical care might be delayed.

Ultimately, Marianne’s best course of action involves transparent communication with Ellen. She should convey her concern regarding Ellen's health and the observed symptoms. By discussing the importance of seeking a thorough assessment by a qualified clinician, Marianne can foster a collaborative therapeutic environment that respects Ellen’s autonomy while prioritizing her safety. This approach also reflects the ethical tenet of client dignity and welfare, championed by both ACA and CRC guidelines.

Furthermore, Marianne's willingness to refer Ellen for an assessment denotes a commitment to continuous client care. This choice allows for flexibility in the therapeutic relationship, permitting continuation of their sessions should it be determined that Ellen does not have an eating disorder. Conversely, should the assessment confirm the presence of an eating disorder, Marianne can proceed with the referral process, ensuring a well-documented transition following standardized protocols.

In this delicate situation, consent plays a pivotal role. Obtaining informed consent for the referral not only provides Ellen with agency but also ensures that Marianne adheres to ethical standards. It is essential to follow up with Ellen post-assessment, which reinforces the dedication to her overall wellbeing and care continuity regardless of treatment direction.

In conclusion, while the ethical challenges in counseling are profound and complex, this case exemplifies the need for conscientiousness, clarity, and compliance with established ethical standards. Engaging in open dialogue, seeking counsel, and prioritizing professional integrity while considering client needs unfold as the cornerstones of ethical practice in the counseling field.

References

• American Counseling Association. (2014). ACA Code of Ethics.
• Council on Rehabilitation Counselor Certification. (2010). CRCC Code of Ethics.
• Gladding, S. T., & Newsome, D. W. (2018). Counseling: A comprehensive profession (7th ed.). Pearson.
• Corey, G., Corey, M. S., & Callanan, P. (2015). Issues and ethics in the helping professions (9th ed.). Cengage Learning.
• Baker, S. B., & Gerler, E. R. (2017). School counseling for the twenty-first century (3rd ed.). Pearson.
• Culley, S. M., & Hughey, K. F. (2016). Multicultural counseling. Routledge.
• Kocet, M. M., & Herlihy, B. (2014). Ethical standards in counseling. In A. J. McAuliffe (Ed.), Handbook of multicultural competencies in counseling (pp. 61-82). Sage Publications.
• Seligman, L., & Reichenberg, L. W. (2016). Theories of counseling and psychotherapy: Systems, strategies, and skills (4th ed.). Pearson.
• Wheeler, S., & Bertram, B. (2015). The clinical supervisor's guide: How to enhance your clinical supervision practice. SAGE Publications.
• Harris, A. (2018). Ethical decision making in counseling. In A. C. P. Johnson & K. D. Joe (Eds.), Foundations for clinical mental health counseling (pp. 267-285). Routledge.

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