2 -pages per vignette. 750 words each
10 pages total in addition to a title and reference page.
For each of the four vignettes presented below:
- What are the ethical issues in the case? Identify the issue in the ethics code.
- Did the professional act in a manner consistent with current standards and principles? If not, what other courses of action would be more ethical? Support your decision by identifying the standards and principles relevant to this case.
- Are there any indications of bias, stereotyping or marginalization present?
- If relevant did the professional advocate for the client?
- How can colleagues and supervisors help the professional to act ethically in this situation? Please be specific.
Vignette 1
Beatrice is an eager client who has survived a traumatic youth and is committed to maintaining her mental and emotional stability despite her troubled past. She has been in counseling with Diego, a licensed professional counselor, for many months through services paid by a community program. Beatrice was recently hired by a retail store, and for the first time, has health insurance that will cover the cost of her counseling sessions, provided she is diagnosed with a mental and emotional disorder. Because she no longer qualifies for free service, Diego wants to help Beatrice take advantage of her health insurance benefits. At the moment, however, Diego does not believe Beatrice meets any of the criteria for a mental or emotional disorder. Nevertheless, because Beatrice has a history of depression, Diego uses the diagnostic code for depression in the insurance paperwork in order to relieve Beatrice of the burden of paying for counseling at a time when she has many other expenses.
Vignette 2
Gella, is a significantly underweight 15-year-old adolescent, who self-identifies as a lesbian. She has come out to her family and friends. Her parents have permanently grounded her except for school and church activities and she feels isolated at school. She met with her school counselor and showed signs of an eating disorder, serious depression with a moderately high risk of suicide. Gella admitted to the counselor that she knows where her father hides his guns, but that her religious beliefs stop her from killing herself. The school counselor believes that immediate treatment is essential, but her parents refuse and say they will bring her to the pastor at their conservative church to pray. The counselor is unsure of what to do next.
Vignette 3
Darcy is a psychologist in a group practice. He refers to himself as a non-traditional therapist who seeks to integrate non-Western philosophies into therapy and describes his approach as holistic. Darcy believes strongly that the most important factor in psychotherapy is the relationship between counselor and client. He encourages his clients to attend yoga and meditation to resolve emotional issues before considering medication, though he will refer them to a psychiatrist if they prefer traditional methods. He views the use of written records of psychotherapy sessions as incompatible with holistic approach. Consequently, he keeps no records of counseling sessions other than a listing of the clients name, and the date and length of the session. Not believing in diagnosis, Darcy does not accept insurance and requires that all his clients are self-pay. He explains this process to all clients at the initiation of counseling and obtains their consent prior to beginning therapy.
Vignette 4
Juanita, a 25-year-old Latina, is a counseling intern in an outpatient unit of a psychiatric hospital. Juanita has completed all requirements for her doctorate except internship. The first client to whom she is assigned at the hospital is a man with a diagnosis of Bipolar I Disorder, a history of suicide attempts, and episodes of violent behavior towards his family. Juanita has little experience with clients with such significant problems and asks that the case be transferred to a more experienced professional or that she be an observer or co-therapist for this client. Her supervisor insists that she tackle this case independently because Juanita has completed all her courses on psychopathology and shown good counseling skills with less disturbed clients. The supervisor assures Juanita that she will have all the supervision she needs. Juanita is skeptical about the supervisors capacity to meet that commitment because interns from prior years have warned Juanita that this supervisor is often unavailable outside of the regularly scheduled supervision hour. Still, Juanita elects not to try to change her supervisors mind about the assignment and goes forward with the sessions. Over the course of the semester, the client makes little progress, and Juanita believes she has gained more from her work with the client than he has gained from her.
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