Scenarios

Please take time to read each of the following scenarios. Based upon your own experience with situations that presented ethical concerns, try to identify the most important components of the ethical decision making process for each scenario, and give some thought to how the ethical questions might be addressed. Then, on a piece of paper, write your answers to the questions at the end of the scenario. You can then compare your answers and your understanding of the ethical decision making process with the answers from a panel of experts that yourceus.com has asked to help with this process. You should expect to spend about 5-10 minutes on each scenario.


Scenario One

Jim P. is a licensed clinician, specializing in work with adolescents who have Attention Deficit Disorder. He works in a small town where there are few counselors and therefore few treatment options. He receives a call from Rhonda M., who is requesting services for her oldest son. Several minutes into the conversation, Jim realizes that his own son is in the same school class as is Rhonda's younger son. He also realizes that he has served as a sports coach for Rhonda's younger son, and has met Rhonda numerous times in that capacity. Are there any ethical concerns with Jim providing services to this family? Upon what principles related to ethics in counseling do you base your opinion? What options does Jim have to find the best ethical solution for this scenario?

Scenario Two

Julie R. is a licensed clinician. She has been seeing Gloria K. in counseling for about a year. Among other issues, Gloria has been discussing her relationship with Bob O., a local real estate developer. Gloria has reported to Julie that her boyfriend is unscrupulous, and has been bragging about the shoddy construction he has been using to build units cheaply in a new development, while still selling the units for a high price. Quite coincidentally, Julie has another client who is thinking of purchasing a unit in this development. Would it be ethical for Julie to warn her client about making a purchase in this development? Upon what principles related to ethics in counseling do you base your opinion?

Scenario Three

Jessica P. is a licensed clinician. At a party one night, she meets a former client, Edward G. She saw this client for a single assessment session ten years prior, when she was working as a counselor for the Employee Assistance Program offered by the client's company. Due to the public nature of the party, Jessica is not at liberty to notify Edward of this prior client/counselor relationship, and he appears not to remember their session together. At the time of this session, the client was seeking help for grief issues related to the death of his father. During the single session, the client reported that he had had a very good relationship with a counselor when he had been fifteen, and had resolved most other emotional issues during that treatment. Towards the end of the party, Edward asks Jessica if she would like to go out on a date with him. Is it ethical for Jessica to accept a date with this former client? Upon what principles related to ethics in counseling do you base your opinion?

Scenario Four

Ron B. is a clinical social worker who specializes in Attention Deficit Disorders. He has seen Arthur M., a 10 year old with ADD with hyperactivity, for two assessment sessions. At both sessions, Arthur’s mother and father have been present. During these assessment sessions, both parents have made it very clear to Ron that they expect that individual counseling for Arthur will be the approach taken. Ron has explained very gently and diplomatically that individual therapy is not usually recommended for children with ADD, as it has been shown to be not particularly useful in creating change, as opposed to a combination of family therapy, support, and education. At the start of the third session, Arthur’s father shows up with Arthur and tells Ron to see Arthur individually, saying that the family would drop out of therapy if Ron “couldn’t do his job and fix Arthur’s problems”. What is the most ethical course of action in this situation, and what ethical and leadership principles are at stake?

Scenario Five

Ellen P. is a social worker specializing in chronic medical problems. For several years she has been running a support/therapy group for people with chronic medical problems. The group often receives new members from people Ellen has seen first in individual counseling. Her group has instituted a rule that prohibits members from having romantic relationships with other people in the group, a rule that Ellen has championed for a number of important clinical and boundary reasons. Recently, a member of the group, Gary G., has stopped attending without providing the group or Ellen with any reason for his departure. Shortly after this, another member of the group, Jill C., also drops out of the group and asks to start seeing Ellen again in individual counseling for some “urgent things that have come up.” In the first individual session, Jill reports to Ellen that Gary had dropped out of the group because he wanted to begin a romantic relationship with Jill. Jill has since begun to date him, and they have gone out on a couple of occasions. Ellen is concerned, because, although Gary has acknowledged to the group that he has Hepatitis C, he did not disclose that he also has HIV. Ellen, however, is aware of his HIV status, since the information was disclosed in Gary’s individual sessions. Ellen is aware that, if the couple becomes sexually active, Gary’s HIV status holds serious risks for Jill. What are the leadership and ethical responsibilities here, and how should Ellen address them?

Scenario Six

Alan C. is a social worker who specializes in issues related to sex and sexuality. He has just agreed to meet with a new client, Jared M., who provided only sketchy information on the phone, saying the nature of the sexual concern was so personal he needed to discuss it in person. In the first meeting, Jared reports that his sexual concern is this: he is a devoutly religious person, and he has been fighting his impulses to engage in a ‘homosexual lifestyle’. His impulses run deeply contrary to his strongly felt religious beliefs, and he wants Alan to help him become straight. Alan’s very thorough study and research in this area has led him to a belief that efforts to “convert” homosexuals away from their sexual orientation are largely unsuccessful and can lead to additional emotional damage and disappointment, and such attempts are therefore inimical to Alan’s ethical obligations to promote more healthy approaches to sexuality and self-acceptance. What are the leadership and ethical considerations here? What issues related to values and diversity are at stake? What recommendations might you make to Alan regarding his handling of this situation?

Scenario Seven

Janet P. is a licensed clinician who specializes in Christian counseling. She has been seeing Marjorie B. for counseling. Marjorie has been having marital problems. As the counseling progresses, Janet's assessment is that Marjorie's goals for counseling would be better reached if the counseling were to move to couple counseling. Marjorie requests that Janet do the counseling, particularly because one of the primary problems between the couple is the refusal of Marjorie's husband to raise her children in a Christian environment. Is it ethical for Janet to agree to provide Christian based counseling for this couple? Upon what principles related to ethics in counseling do you base your opinion?

Scenario Eight

Steven is a psychotherapist who works in a group private practice in a small town. The practice has existed for almost twenty years. The group has plenty of word of mouth business and has decided that they do not need to set up a website in order to generate more client traffic. One day, when Steven had some time between appointments, he decided to Google his practice and found several websites that listed the practice, its contact information and counseling services available. These websites also encouraged visitors to “Add a Review,” and much to Steven’s surprise, several former clients had submitted testimonials about the practice, some positive, and others not so positive. Steven recognized the name of one of the reviewers as a client he’d worked with and terminated several months ago. What are the ethical concerns presented here and how might you recommend that he proceed?

Scenario Nine

Laura Y. is a mental health clinician specializing in work with adolescent girls. For the past year, she has been working with Natalie M., a fourteen year old with a history of acting out behaviors, self-mutilation and dramatic, but not life threatening, suicidal gestures. Natalie is currently living with her aunt, after a history of domestic violence between her mother and her father escalated to the point where her mother feared for her life and went into hiding, keeping her location hidden from everyone and not having contact with Natalie. Her father also went into hiding to avoid prosecution, but has been seen from time to time by Natalie at her school, where he comes to try to force Natalie to tell her  where her mother is living. One afternoon, Natalie calls Laura to tell her that she is pregnant, and she thinks she has been for about a month. In order to avoid the potential repercussions within her family, she has run away with the future father, a seventeen year old boy from her school. Natalie asks for Laura's help in handling the situation, but says it is going to have to be done via phone, since her family could find her if she showed up at Laura’s office. What are the legal and ethical considerations at stake here, and how would you suggest that Laura proceed forward?

This completes the first presentation of our scenarios. For now, please put your answers aside. Before we discuss the scenarios in detail, we will take some time to look at the ethical decision making process. This will help to explain the reasons why our panel of experts made the ethical decisions that they made.

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