ethical dilemmas in counseling vignettes

The Center is solely responsible for all aspects of the programs. (1993). To use provided clinical vignettes to practice how to recognize the ethical and legal issues. You have shared a couple of patients with the psychiatrist in the past and have spoken with him by telephone a few times. He indicated that Dr. Cooper recommended that he discontinue a psychotropic medication in favor of an herbal remedy. endobj Dr. Jordan calls you on the phone for an ethics consultation. << /Length 5 0 R /Filter /FlateDecode >> He does not view it as a therapy group. The mother further reports that the patients cousin has been driving the patient around town. Has data issue: true A psychologist receives a phone call from a well-known internist in her area. It then provides six vignettes where supervisors are faced with ethical dilemmas. % Divide and Rule? With her husband, the patient and the ex-wife? Published online by Cambridge University Press: During the last two years, she required total care. Programs that do not qualify for NBCC credit are clearly identified. Dan recently came out to his parents, who were accepting of his gay orientation and lifestyle. She is not sure that he completely understands what is happening or understands her version of informed consent for the additional services. The most frequent ethical dilemmas involved the limits of confidentiality, confusion about counsellors professional roles in school settings, uncooperative behaviours among stakeholders, and suspected child sexual abuse. Medical personnel never questioned the death as the woman had been quite sick and It was only a matter of time.. Innuendos are that she allegedly killed her neighbors pet, but this has been unproven by the police. Are there any other concerns about the web developer/consultants strategies? %PDF-1.3 Ethics Rounds Multiple relationships: A vignette Finding oneself in a multiple relationship is not necessarily a sign that one has engaged in unethical behavior. Dr. Tell explained that the alleged perpetrator was several times removed from their sessions and she did not believe that she had the obligation to report it. And, Dr. Tell agreed to determine whether or not reporting this information would put her clients confidentiality at risk. The patient has trust issues with his parents, especially his father. In actuality, Mr. Biggys wife is a very close friend of Dr. Smiths wife. Plenty engaging in a multiple relationship role in Mr. DiMenchas care? There is nothing unusual that stands out about their therapeutic relationship. Buddy phoned Dr. Goodfriend in an apparent emotional anguish by the tone of his voice. Book Description For undergraduate and graduate courses in Counseling Ethics, Legal Issues in Counseling; a supplement for Introduction to Counseling, Practicum, or Internship courses. As social isolation, loneliness and depression are regular themes in treatment; the therapist frames this as positive progress. What would you need from the attorney? Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. He explains that he recently lost his job and has been worrying about the financial impact that this is having on his family. Dr. Jordan returns the phone call. After reviewing the information presented, it is clear to the treating therapist that the other therapist breached confidentiality. They follow legal guidelines in risky situations and insist on working within their areas of competence; they are not willing to accept noncounselling tasks. The executor is Mr. Palmers brother, who lives in a different state. What, if anything, should the therapist do? The therapy focused on depression and anxiety related to work-related issues, interpersonal limitations, and relationship difficulties. (Log in options will check for institutional or personal access. Because of his status as a well-known internist, he does not want to refer his daughter to a psychiatrist because he believes that he can handle the medication piece of her treatment. Would your answer differ if the advanced directive was created 7 years ago or greater? Mr. Tellanyone is feeling quite guilty about his mother. The patient has never met the attorney face-to-face, only by email and phone contacts. are } What steps does the psychologist need to take? A therapist receives a letter from an attorney indicating that he has inherited an old car from Frank Palmer. locating a long-time friend who is willing to help him at home, referring him to a neuropsychologist for testing, engaging in lengthy discussions with his primary care physician and neurologist, participating in multiple conversations with the attorney, and trying to find a guardian or power of attorney. Case Vignettes for Review Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. Feeling somewhat uncomfortable with the medication management issue, the therapist indicates that she will have to look at her schedule and call him back. Psychological Counselling and Guidance Department, Dokuz Eyll University, Izmir, Turkey, Get access to the full version of this content by using one of the access options below. With whom does the therapist discuss the multiple roles? Mr. DiMenchas co-worker, Janet, helped him find an attorney so that his rights are protected. She mentions that she is still in communication with her ex-husband because they share three children. What are the possible downsides to entering the dual relationship? Qualitative content analysis in practice. Dans vision is that the group would meet periodically to provide one another with support, to do problem solving, to share information and personal struggles, and perhaps to provide some psycho-educational work on campus. While these teaching tools have been developed by psychologists, the vignettes are likely similar to those dilemmas faced in other mental health, counseling, or helping professions. An exploratory survey of school counsellors in the UK, their perceptions of confidentiality, information sharing and risk management, British Journal of Guidance & Counselling, Bir ilkretim okulu psikolojik danma ve rehberlik servisine yaplan bavurularn incelenmesi [An analysis of cases admitted to an elementary school guidance and counseling service during a period of four years], Teachers perceptions toward school counselors in selected private schools in Lebanon, Qualitative research: Introducing focus groups, Child abuse and neglect: A practical guide for professional school counselors, Social-cognitive development, ethical and legal knowledge, and ethical decision making of counselor education students, Can a parent do too much for their child? What are some actions that you, as the treating therapist, may have done differently? Consider the following scenarios, presented initially in the Ethical Dilemmas column in Therapy Today. Can the client contact Child Protective Services anonymously in this case? An ongoing theme in therapy revolves around his sexual orientation. Additionally, none of the treatment issues had to do with impulse control or antisocial tendencies. The attending psychiatrist concurs with the discharge plan and advised Dr. Solomon not to worry about it. In fact, the psychiatrist encouraged the psychologist to omit any reference to the patients comments about the neighbor in treatment summaries or clinical notes as hysterical nonsense.. During the next session, Mr. and Mrs. Drapier arrive separately, but on time. He asked the attorney if anyone is contesting the will. He also states that if she does not accept what he is offering, he will lose respect for her as a professional and probably not return for treatment. Ethical Dilemmas in Counseling: A Case Study Examination The American Counseling Association (ACA) Code of Ethics was amended in 2014 to reflect the ever-changing social, political, and technological landscape which clinicians must navigate. The therapist does not dwell on the situation with the patient. Tara has been working as a therapist for the past two years in a local community mental health center that primarily treats middle-aged adults who suffer from depression. What are some likely emotional reactions would you have in this situation? What obligations does the therapist have to the parent? The therapist knows her new boss, Mr. Biggy. Dr. He indicates that Mr. Biggy is a good family man. The patient is reassured, and reported less anxiety. First and foremost, the client, Dominique, has disclosed that he has been diagnosed with AIDS. For example, the first vignette, which The purpose of these psychological evaluations is to identify individuals who have gross psychopathology, strong personality disorders, or other characteristics that would make them incapable of performing their religious duties adequately. Mrs. Simpson thought it would be good for Dr. Smith to review the report in order to help him with their therapy. of study and a further neglect of ethical decision making in non-Western cultures in the professional literature on counseling and ethics. Dilemma6: Referral and Treatment Boundaries, Dilemma9: Therapist as Character Witness, Dilemma 10: Multiple Relationships Revealed, Dilemma 14: The Psychology of Advertising, Dilemma 15: To Evaluate or Not to Evaluate, Dilemma 18: Co-authorship with a Former Patient. Furthermore, she felt that because she was now in private practice, she could treat whoever she chose to, regardless of the specific needs of her clients. Dan indicates that they may also want to engage in fundraising in order for GLBTQ students to attend state or national events. What are some recommendations that you would make to the psychologist? hasContentIssue true, The Author(s), 2022. They start spending more time together. The Center for Ethical Practice (provider 1287), is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Yet the dilemmas above speak of the profound difficulties we can face when thinking of our responsibilities and potential actions in real-life situations, especially difficult situations we might inadvertently find ourselves in. The therapist and the attorney-patient meet for the initial session. His patient reveals, during the course of therapy, th A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. ; & Hartshorne,T.S. Workers Compensation refuses to pay for the case management services of an independent social worker. From: PsychBuilder High Tech Psychology at Low Cost, Subject: Online Assessment Tool to Promote your Practice. Uncertain, she calls you for an ethics consultation. Of course, they exist in all forms of counseling, from short-term advising . Plenty lives and practices psychotherapy in a rural area. If you decide to provide information, would you consider communicating with the prior patients attorney? endobj Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy. School counsellors often encounter ethically challenging situations due to contradictory values and roles. Mr. Drapier smelled as if he had been drinking, and he admitted that his alcohol use has increased. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. Applicable State Codes/or Mental Health Laws Under the legislative information system code, it explains the standards of practice by counselors. The counsellor is also conscious. Currently, the patient is denying the fact that she has made past threats toward her neighbor. Cynthia had already invested quite a bit of money into her private practice, and was determined to make it work, regardless of the type of clients she had to treat. What factors make this situation potentially difficult for you as a therapist? of family ties, but counselors in many other specialties will run into these issues too. It was revealed that counsellors prioritise the students' benefit and respect students' privacy. Ethical dilemmas. <> She went on to detail how her boyfriend described how his uncle was involved in collecting and distributing child pornography but remained faithful to his aunt. You may access the ACA Code of Ethics and other ethics code at the WEBLINKS button on this website. He indicates that, in order for him to benefit from the treatment, he feels a need to pay what he makes an hour. 8 0 obj She began to provide psychotherapy to Mr. DiMencha, a 52-year-old, who suffered with depression. When Dr. Jordan attempts to clarify the request, it becomes clear that the former patient is not asking to return to therapy, but instead is asking Dr. Jordan to become the co-author or a consultant for the book. The client, Mr. Don Tellanyone, is a 47-year-old man who is seeking services for depression. During some individual time, the patient indicated to the psychologist that she has had it with her neighbor and has something planned that will make you all finally understand once she is discharged. In hindsight, what triggered some possible difficulties in this situation? After reiterating the purpose of the session (which was to assess the marital situation and not to assess his current treatment), Dr. Miller states that she feels uncomfortable with the request, although she is concerned about the therapists reported behavior. Fowers and Davidov (2006) link the "multicultural movement" to classical writings about ethics in the philosophy literature,contrasting "virtue ethics"with merely following the rules. image.jpg Liberty University Ethical and Legal Issues in Counseling . tiny black tadpole looking bug in bathroom; ff14 plasmoid iron lake location; top 10 most dangerous areas in cape town; cockapoo rescue michigan; floris nicolas ali, baron van pallandt cause of death; Close this message to accept cookies or find out how to manage your cookie settings. Buddy states that he has been feeling stressed over the last month. She calls you for an ethics consult. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> She recently received an offer to become a sales representative for a pharmaceutical company. At that time, Dr. Miller not only wanted to evaluate the marriage, but to evaluate how impaired the husband was, and to decide whether Mrs. Drapier had assessed her husbands depression and the marriage accurately. As soon as he looked at the intake form, he realized that she is the ex-wife of his former client. The physician wants the psychologist to treat his 17-year-old daughter . 7 0 obj How would you feel if you were the consultant? Some of the sessions focused on a sexually abusive relationship between a basketball coach and the patient when she was age 13 to 16. However, the attorney has little awareness about how impaired Mr. DiMencha is. outside her scope of practice? During this meeting, he realizes that while the other counselors generally behave in an ethical manner, they do not know the specifics of the code as well as hed like to. Review each of the scenarios and indicate whether you agree or disagree with the counselors action. Since the web developer/consultant wants to get that page up and running, he suggests that they use some positive ratings and responses from Angies list and several other online rating sites that tell positive stories and experiences with Dr. Popeil. : ethical dilemmas, burnout, stress, practicing counselors. Dr. Crane feels ambivalent because of their therapeutic relationship, but also wants to help Dan because he appears to have limited options. He struggles with understanding concepts and his conversation becomes tangential during the next two sessions. "useRatesEcommerce": false The therapist has not worked with the patient for about two years. Next, most vignettes have more than one ethical issue that can be addressed. Does the therapist who hears this information have any legal obligations? The treatment notes indicate that she dropped out of therapy about one year ago. A therapist had an intake appointment with a new client. The treating therapist believes the options are: What are the possible emotional reactions to this situation? Dr. Tell agreed to contact someone to discuss whether Dr. Tell had to report this information to the police or Child Protective Services. He believed that the custody evaluator had made several significant errors in the report concerning the psychological health of his patient. In a therapy session in an outpatient substance abuse treatment facility, a patient reveals that an agency staff person another therapist in a different department has paid to have sex with another patient in the treatment facility Lyla, who is a prostitute. 6P*-45Denc \4RPG6mNruMK*glwuh]4 P. t;qH AhX`8Ng3a%[,M&;;CZ523m-CH#s?tJwzqJ@J(&,i]Kbvq"1hpuDq U9'&-|)*5Y%kP2kiT;3fz-t1#5?&mv>TDN'8kU^V3q8 At#8 dHM'IF Is Dr. While Chuck now lives in an apartment in town, she remembers him well. The client presents the therapist with information about a well-known, local therapist who released confidential information about him to an attorney without a signed release or court order. The therapist obtains the keys and title for the vehicle. Looking through his files, the therapist cannot find his file, so it must have been more than five or six years ago. <> Dr. Miller suggests that she meet with both Mr. and Mrs. Drapier to evaluate the marital situation. A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. His impairment is noticeable by Dr. Dilemma 6: Referral and Treatment Boundaries. As the conversation continues, the therapist is surprised to learn that the patients new friend is the ex-wife of the therapists husband. My company has developed a unique opportunity for you and your associates. She was pleased to find that by attending the seminar, she could earn 20 CEUs that would count towards maintaining her licensure, and also gain the knowledge needed to successfully treat her new clients. Dr. Smith also asked if it is ethical to bill the patients insurance company to review his impressions of a forensic report during a psychotherapy session. ), Psikolojik danmanlk alannda mevcut ve gelien etik sorunlar [Current and developing ethical problems in psyhological counseling field], Sources of conflict between primary school principals and school counselors in Turkey, I wanna tell you a story: Exploring the application of vignettes in qualitative research with children and young people, International journal of Social Research Methodology, Using an ethical decision-making model to address ethical dilemmas in school counseling, An examination of the ethical dilemmas of school counsellors: Opinions and solution recommendations. The group is for newly diagnosed schizophrenic clients, and is meant to help them cope specifically with their auditory or visual hallucinations. While confidentiality has been preserved, the dynamics of each case areisomorphicto a real clinical situation faced by a practicing psychologist. Standards of Practice, B. Counselling Relationships, Confidentiality. Dr. Tell reminded her about confidentiality and the laws in Pennsylvania that would override it. endobj Just as he is about to hang up, Buddy says, Thanks. The patient had been in treatment for about 10 months on a weekly basis. !!jdUR{YUbYUKg$Hu/krtu/_Y1>6..7199l< First, these vignettes are meant to be teaching tools. . The main therapeutic issues are depression and loneliness. A survey of ethical dilemmas based on salient ethical issues in counseling supervision (i.e., dual . Dr. Goodfriend is unclear whether Buddy is serious or joking. Mr. Biggy indicates that he wants to talk more about his feelings. Mr. Drapier acknowledges many cognitive, behavioral, and physical symptoms of serious depression. Would your answer differ if there were no advanced directives? The test usually takes approximately 40 to 60 minutes to administer. xZ[o~/@FPpt>(2]s$gfH]Q4!g8oX4^e^Xt]Qn}a.>_t]t[}y^_-/.&$]|!X KC2In_g?/a=1x9>n3b.O R|xyis.(gi_E`I>a("?MX\H&4-oX0~K1'I{GotYsvs!f5Xk\p)nolV5z/ZX\F^sH%Sv 2E[tO8=~?g[)R t,q$q< Q2 viA#UgMzewq(! ^wV[W\_Dv(rS6S2 R0y[w*Lw$d+_^#&mw[p;(>H{m #1nA Does Dr. Goodfriend need to phone his high school friend to clarify his last comment? Hopefully, the teacher will use the Acculturation Model to help blend professional, ethical obligations with personal values and beliefs. V;J/$"P)T)-nC6!;D-b0 *a #Xk%u %lFhZ@=Hr|y>wtrPuDd"Q=d0bs9>CQ?Rkf-U]BFJV9>g$d\3IH:$@eU-ASq 1K [i=2y#qIg3ibct x*apx>1@y#@/#x@ s ^R9,.6^ X T9,e64vKa8%#o-%=cpi %&)}Cd$fi4/6O.FSKA^iBd<2PTG :5=@0J=kM* When she asks about insurance, he indicates that he will pay in cash. ACE provider approval period: 3/21/2021-3/21/2024. The EAP service provides a solution-focused, three-session benefit for companies within Virginia. Dr. Smith politely explains that he feels uncomfortable with them discussing his more personal marital issues. What are other steps that the therapist may want to take in this situation? What factors make this situation potentially easy for you as a therapist? Buddy adds that he has had trouble sleeping, has stopped exercising, has little energy, and fleeting thoughts of hurting himself. ev}]=h}))-mv-K4a_5@rFBPnevW :X})8Bl;%1cw'=@rw6=V|}oYdhNTJ]gIXS0f319' T8L*(xp8w}?}UD endobj He revealed that she had been suffering greatly and, out of compassion for her, he gave her an excess dose of her sleeping and pain pills. A physician requests a psychological evaluation of a 46-year-old man who attempted suicide via overdose of prescription medications along with alcohol. Therefore, this article offers a brief description of the purpose and alleged benefits of supervision, and examines the current position of the law in regard to ethical dilemmas within supervision. However, the police report indicated she has made such verbal threats in the past but also, on several occasions, has damaged her neighbors property including scratching the paint on their car and throwing rocks at their house. One day, Dr. Bishop receives a phone call from his contact at the institution. What are the potential pitfalls in the scenario? Mr. Biggy pulls Dr. Smith aside and explains how he has become very attracted to a new sales representative. adapted and used used with consent from a state psychological association. stream Copyright Center for Ethical Practice, 977 Seminole Trail, #312, Charlottesville, Virginia 22901 Regulatory boards are the final authority on courses accepted for continuing education credit. Dr. Smith was treating Mrs. Simpson for depression precipitated, in part, by a separation and pending divorce. Sue schedules the appointment for early in the evening. They have dinner as couples several times per year. The therapist explains the fee structure for the initial appointment as well as ongoing psychotherapy sessions. I encourage you to review our web site. Kara then contacted the facility and let the supervisor know that she is not able to accept the position at this time, but that she plans to seek out the necessary training and supervision to work with substance abuse clients, and that she hopes the facility will consider her for the position once she has completed the necessary training. Unfortunately, many patients struggling with mental health issues in primary care settings are not properly identified or treated. This particular vignette, Swenson said, may well fail the two-prong test. Is the goal of therapy to help the client manage the situation or is the responsibility now on the psychologist to gather more information about the possible crimes committed with children? Part of her struggle is that she sees her husband as more depressed now than when he started treatment. How would you feel about receiving this request? The therapist who received this information does not know the other therapist well, but has provided some consultation for the therapist in the past. A therapist is treating a client who is involved in a legal proceeding. Does Dr. Goodfriend need to encourage Buddy to become involved in therapy if symptoms persist? At the end of the day, he listens to voicemail messages to learn that a former patient is reaching out to him for a request. iRE]7*ZG; K5|h{. What would you likely do with this email solicitation? Should Dr. Goodfriend call Buddy and offer a few referrals? Dr. Solomon, a psychologist on an inpatient psychiatric treatment team, is concerned about the pending discharge of a current inpatient. The contact is now requesting that Dr. Bishop begin to screen individuals for homosexual tendencies because, according to the doctrines of the denomination, such individuals are not eligible to become clergy. Dan asked a number of faculty members to be the faculty advisor of this group. Dr. Bishop calls you for a consult about this situation. Dan explained to Dr. Crane that this group would be student-led and meet on campus. Published by Cambridge University Press, Journal of Psychologists and Counsellors in Schools. However, she begins to feel uncomfortable as she feels like they are spending too much time together. The therapist screens the potential patient and believes that she can help him. 1 0 obj Results will be available to you and the patient online. 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. 4 Ethical Vignette "School counselors should acknowledge the vital role of parents/guardians and families." (American School Counselor Association, 2010, Section A.1.d.) . However, after the session, the therapist feels uneasy about what his patient revealed. Apparently, no one is. What are the ethical issues involved in this case? She stated that Dr. Jordan recommended that she write down her memories. Among other things, the report contained a psychological evaluation of the patient. How are the clients emotional and interpersonal issues related to the therapists dilemma? He is talking with a young man, most likely his cousin. My name is Dr. He drives the car to a local dealer who indicated that the Explorer is worth about $3,500. The attorney-patient indicates that he earns about 2.5 times what the psychologist asked. He confides that he would like to have an affair with her. The patient was in therapy for approximately one year. Are there additional considerations for how to approach the referring physician when calling back? Your browser either does not support scripting or you have turned scripting off. While he did complete his Legal and Ethical Issues in Counseling class while working on his masters degree, he feels that now that he working in the real world, he should review and discuss the Code of Ethics and the Standards of Practice with his peers. Mr. DiMencha doesnt appear to understand his legal rights or the settlement process. By Mrs. Drapiers report, he appears more stressed because of his job and is drinking alcohol more frequently. The client indicated that she was hesitant to speak about the issue for fear of a breach of confidentiality.

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