Lisa 1: Ethical Case Study Analysis
Counseling profession is very complex in nature. The people practicing this profession are usually faced by ethical dilemmas. The counselors who are responsible can make use of model of ethical decision making which guides a counselor in making ethical resolutions. The models are indispensible for those counselors with such problems. Virtuous counselor will be required to agree on uncertainties when it comes to making decisions (Cohen and Cohen, 1999).
The paper aims to evaluate a case of James, an intern in a counseling center. He realizes that his client Latina student of 21 years by the name Lisa led to the death of a man who was a partner to her mother. The man was physically abusing her at the age of 5 and half years and at 7 years, he started abusing her sexually. In such situations, the ACA Committee of Ethics suggests that counselors should be able to use the decision making models and select wisely the best model for the said case (Kocet, 2006). If one fails to practice this, an ethical problem occurs when the counselor uses his or her own intuitions (Welfel, 2010). In the case of James, we will make use of the ethical decision making model by Welfel (2010) as it contains ethical principals and standards in the profession, emphasize the reflection of counselor in the process of making decisions, and promotes analysis grounded in the professional moral vision. The reflections improve on the counselor’s skills in making decisions, and make him safe. Now that James was incompetent, the elements of Garcia et al (2003) will also be applied. The decision making model used to improve the culture awareness of the said counselor in making decisions has the following ethical dilemmas. The model for ethical decision making which has been used in this case was the model based on Forester-Miller and Davis. It has the following steps.
- Identifying the problem, which are the ethical dilemmas that are involved in the case study
- Application of APA and ACA code of ethics.
- Identifying the dimension and nature of the dilemma
- Determining the best action to be taken
- Analyze the advantages and limitations in every course of action,
- Assess the selected action and
- Implementing the action that was suggested.
The following were found to be the dilemmas that James experienced.
Clinical experience and diversity
It is not good for James to take a session in counseling when he does not have the necessary experience and exposure to deal with the client. According to the case study, it is evident that he did not have any experience or exposure to such cases. He pursued his studies near his home and had ambitions of starting his own clinic in his hometown. He wanted his father to boost the practice. James was not supposed to take up the counseling session with Lisa. This is because he did not have any experience. From the word go, he was late during their first session and just perused through the documents. He makes Lisa to sign documents that she is not aware of the content.
It is very difficult for James to handle the case of Lisa without the clinical experience especially now that she had admitted to have killed his step father using alcohol According to APA, standard 2.02, (2012), psychologists are supposed to only offer services which are within their competence. The competence is as a result of the education acquired, training as well as experience which should be supervised. The counselor should acquire knowledge by working in diverse environment so as to possess cultural diversity 9American counseling association, 2005). James did not have all these because he hasn’t finished education, has not had any supervised experience and is not diverse culturally and therefore should only handle Caucasians.
To solve this dilemma, James is supposed to be supervised while working. This enables the supervisor to identify his strengths and weaknesses so that he can be guided on how to improve on the weaknesses. For instance the lack of cultural diversity could have been noted while working with Lisa who would have made him improve and expand the diversity on clients. Because James is training, all decisions and actions he undertakes should pass through the supervisor. Though he could feel intimidated as his supervisor was his ex girlfriend, it is better for him so that he qualifies with the best knowledge (Jones, 2005).
This is another ethical dilemma that James faced. Lisa was able to admit that she was sexually and physically abused by the step father. She later admits having placed a certain substance on the alcohol being taken by her step father which led to his death. The situation at hand is difficult for James as it involves a criminal act even though Lisa was only seven. The dilemma is whether James should report the case to the authority or keep it for it was confidential. Confidentiality rights of a client are discussed at length in ACA, (2005) where a counselor is prohibited to share any confidential information provided by a client without an ethical justification. However there are some cases when a client could lose his/her rights for example when the client requires to be protected from any danger or any other foreseeable danger (ACA, 2005). On the other hand, the counselor could seek consent from the client before he or she divulges confidential information (APA, 2012). It is important for the counselor to note that there are limits to the confidentiality a client is able to enjoy. These limits are well defined by the law. The confidentiality increases trust between the counselor and the client though withholding certain information could lead to violating law.
The situation at hand was quite difficult for James. However, it is not necessary for James to break the confidentiality right for James. The crime happened when the lady was young and the step father was abusing her physically and sexually. This made Lisa be pushed too much and with no help coming on her side, she laced her step father alcohol with medicine. Now that a counselor should break confidentiality right only when the evidence is serious or could harm the client or people surrounding her (ACA, 2005), the case should just be forgotten and allow the young lady build her life as she is even aspiring to become a lawyer. James is supposed to review the previous records keenly to confirm that there is no harm or imminent danger.
The best way to rectify the dilemma is for James to keenly pay attention to what ACA and APA codes have stated. Now that Lisa was able to confide with an intern, he is supposed to breakdown the situation properly together with its effect on the client and people surrounding her. If he is certain that there is no harm, then there is no reason for breaking the confidentiality right.
Relationships and Supervisory responsibility.
This is the third ethical dilemma. James was supervised by his ex girlfriend. This should not have taken place from the word go. This is because their professional conduct would be affected by their past. However, James has a feeling that it will be smooth for him with her ex girlfriend being the one to supervise him. He even goes on to put the credentials off the supervisor ‘Licensed professional counselor’. This is not ethical because he is just an intern who has not finished studies and is yet to receive a license. The supervisor is very much lenient to the intern. She is very much aware that James is not experienced and goes ahead to give him a client by the name Lisa. This is against the law which stipulates that supervisors should make sure students acquire the necessary knowledge and experience (APA, 2012). The law also prohibits any sexual relationship between the intern and supervisor. This means that the supervisor was supposed to ask for a change when she noted that James was the one she was to supervise. According to ACA Sec F1.a (2005), the supervisor should access the services rendered by the interns and discuss them regularly. This did not happen for James and her supervisor.
To rectify the dilemma, the supervisor is supposed to read through the responsibilities of a supervisor. She was supposed to ensure James acquires enough experience and knowledge when in the internship program. She is also supposed to know the fact that she is answerable to all the actions undertaken by the intern (Jones, 2005). This means that she was supposed to inform the necessary authority that she is not able to supervise James and this would have benefitted James and herself. James could have become a better counselor.
In conclusion, the model for ethical decision making which has been used in this case was the model based on Forester-Miller and Davis. The first step involved identifying the problem, which is the ethical dilemmas that are involved in the case study, the second step was the application of APA and ACA code of ethics. Third step involved identifying the dimension and nature of the dilemma, fourth step was determining the best action to be taken then analyze the advantages and limitations in every course of action, assess the selected action and finally implementing the action that was suggested.
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