Kitchener’s Ethical Principles decision-making model

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For counselors, the ability to make sound ethical decisions in the client’s best interest is paramount and can be challenging, especially in a dilemma situation. However, counselors are expected to respond in a way that reflects the best ethical fit and practice. Based on principles such as autonomy, justice, fidelity, nonmaleficence, and beneficence, the ethical codes that counselors espouse play a pivotal role in the therapeutic process. For this case study, there are elements of ethical implications; you will describe the key elements of the case that must be addressed and identify how ethical codes apply. Using this information, you will formulate and justify a plan of action based on the application of an ethical decision-making model and historical precedents.
Case Study
You are assigned a new client at your agency. Dave is a 39-year-old middle-class Caucasian man who has been mandated to attend counseling. Upon intake, Dave states that he is angry about being made to attend counseling. Four months before that, he and his wife had an altercation in which law enforcement was called. He was subsequently arrested for domestic violence, and the Department of Children and Family Services intervened because his two children (a seven-year-old boy and a ten-year-old girl) were present at the time of the fight. He has been ordered to successfully complete substance abuse counseling because he was under the influence. When prompted about his anger, Dave tells you that he is angry that he had to leave his home and attend treatment. He states that his wife had equal blame. Further, he states that he never wanted children in the first place and feels trapped because of them. Now, he feels as though his freedom has been taken away because he lost his job, his house, and his ability to enjoy a few drinks because he will lose the children he never wanted. Over the next month, Dave is compliant with attending counseling, but he seemed resistant and guarded during his sessions.
Over the weekend, you go to a local bar with your friends and notice your client is drinking at the bar. You proceed with your plans and do not acknowledge him. Over the next hour or so, you watch him become increasingly intoxicated. What do you do?

Specifically, the following critical elements must be addressed:
• Identify and explain the ethical codes that relate to what bearing of information a counselor has the ability to share in a public event. Relate your response to the case of Dave in a local bar.
• Using historical precedence, consider the court case of Jaffee v Redmond and relate it to your plan of action in the case of Dave.
• Evaluate the current situation at the bar and consider the logic that if you are not calling the police as an option, would his threat meet the criteria to call the spouse, or would you do one without the other?

 

Sample Solution

The ethical codes that relate to what bearing of information a counselor has the ability to share in a public event are the American Counseling Association (ACA) Code of Ethics and the National Association of Social Workers (NASW) Code of Ethics.

The ACA Code of Ethics states that counselors have a responsibility to protect the confidentiality of their clients’ information. However, there are some exceptions to this rule, such as when the counselor believes that the client is in danger of harming themselves or others.

In the case of Dave, the counselor would need to weigh the risks and benefits of sharing the information that he saw Dave drinking at the bar. On the one hand, sharing the information could help to protect Dave from harming himself or others. On the other hand, sharing the information could violate Dave’s confidentiality and damage the therapeutic relationship.

Ultimately, the decision of whether or not to share the information would be up to the counselor. However, the counselor would need to carefully consider all of the factors involved before making a decision.

Using historical precedence, consider the court case of Jaffee v Redmond and relate it to your plan of action in the case of Dave.

The court case of Jaffee v. Redmond is a landmark case that established the right of psychotherapists to keep their clients’ communications confidential. In this case, a police officer sued her therapist for disclosing information about her therapy sessions. The Supreme Court ruled that the therapist had a qualified privilege to keep the information confidential, even though the information was relevant to a criminal case.

The Jaffee v. Redmond decision has important implications for the case of Dave. If the counselor were to disclose the information that he saw Dave drinking at the bar, he could be sued by Dave for violating his confidentiality. However, the counselor could also argue that he had a qualified privilege to disclose the information, because he believed that Dave was in danger of harming himself or others.

The decision of whether or not to disclose the information would be a difficult one, and the counselor would need to carefully consider all of the factors involved before making a decision.

Evaluate the current situation at the bar and consider the logic that if you are not calling the police as an option, would his threat meet the criteria to call the spouse, or would you do one without the other?

The counselor is faced with a difficult situation. On the one hand, he does not want to violate Dave’s confidentiality. On the other hand, he is concerned about Dave’s safety and the safety of others.

If the counselor decides not to call the police, he could try to contact Dave’s spouse or another trusted friend or family member. He could also try to talk to Dave directly about his drinking and his threats.

The counselor would need to carefully assess the situation and make the decision that he believes is in Dave’s best interest. There is no easy answer, and the counselor may need to consult with a supervisor or another professional to get advice.

Ultimately, the decision of whether or not to disclose the information and whether or not to contact the police is up to the counselor. The counselor would need to weigh the risks and benefits of each option and make the decision that he believes is in Dave’s best interest.

 

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