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Posted: October 4th, 2024

Ethical Decision-Making in Counseling: A Case Study Approach

Benchmark Ethical Dilemma Presentation Assignment Instructions

Ethical Dilemmas in Counseling: A Case Study Approach
Ethical dilemmas are an inherent part of the counseling profession. Counselors often face complex situations where their values and professional obligations clash, requiring careful consideration and a structured approach to decision-making. This paper will explore a hypothetical ethical dilemma in counseling, applying the American Counseling Association's (ACA) Ethical Decision-Making Model to guide the process.

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The case involves a counselor working with a client who discloses a plan to harm a third party. This presents a significant ethical challenge, as counselors are obligated to protect both their clients and the potential victims of harm. The ACA Code of Ethics (2014) emphasizes the paramount importance of client welfare while also acknowledging the duty to prevent foreseeable harm.

Step 1: Identify the Ethical Dilemma

The core dilemma lies in balancing the client's right to confidentiality with the responsibility to prevent potential harm. While confidentiality is a cornerstone of the therapeutic relationship, it is not absolute. The ACA Code of Ethics (2014) permits breaches of confidentiality in situations where there is a clear and imminent danger to oneself or others.

Step 2: Review Relevant Ethical Principles and Guidelines

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The ACA Code of Ethics (2014) provides guidance on this dilemma, outlining the counselor's responsibilities to both client and potential victim. Specifically, Principle A (Beneficence) and Principle B (Nonmaleficence) are central to this case. Beneficence requires counselors to act in the best interests of their clients, while nonmaleficence mandates avoiding harm.

Step 3: Identify Potential Courses of Action

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Several options are available to the counselor:

Maintain Confidentiality: This option prioritizes client confidentiality but risks potential harm to the third party.
Warn the Potential Victim: This option prioritizes safety but may violate client confidentiality and damage the therapeutic relationship.
Contact Law Enforcement: This option may be necessary if the threat is serious and immediate, but it can have legal and ethical ramifications.
Step 4: Analyze the Potential Consequences of Each Course of Action

Each option carries significant consequences:

Maintaining confidentiality: While upholding client trust, this could result in harm to the potential victim.
Warning the potential victim: This may prevent harm but could damage the therapeutic relationship and lead to legal repercussions.
Contacting law enforcement: This may be necessary to ensure safety but could violate client confidentiality and lead to legal challenges.
Step 5: Determine a Course of Action

The chosen course of action depends on the specific details of the case, including the severity of the threat, the client's mental state, and relevant legal requirements.

Step 6: Evaluate the Chosen Course of Action

The chosen action should be evaluated based on its ethical implications, potential benefits, and risks. Applying the three tests of ethical decision-making – justice, publicity, and universality – can provide a framework for this evaluation.

Step 7: Implement the Selected Course of Action

Once a course of action is determined, it should be implemented carefully and ethically. This may involve documenting the decision-making process, communicating with relevant parties, and seeking consultation from colleagues or supervisors.

Conclusion

Navigating ethical dilemmas in counseling requires a thoughtful and systematic approach. The ACA's Ethical Decision-Making Model provides a valuable framework for counselors to analyze complex situations, weigh ethical principles, and make informed decisions that prioritize client welfare and societal safety.

References

American Counseling Association. (2014). 2014 ACA code of ethics: As approved by the ACA governing council. [Electronic version]. https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=55ab73d0_1

Hansson, K. M., Romøren, M., Weimand, B., Heiervang, K. S., Hestmark, L., Landeweer, E. G. M., & Pedersen, R. (2022). The duty of confidentiality during family involvement: ethical challenges and possible solutions in the treatment of persons with psychotic disorders. BMC psychiatry, 22(1), 812. https://doi.org/10.1186/s12888-022-04461-6

Rustad, J. K., Schlozman, S. C., Hendler, R. A., Rasmussen, M. J., Rader III, G. L., & Stern, T. A. (2022). Developing, losing, and regaining trust in the doctor-patient relationship. The Primary Care Companion for CNS Disorders, 24(3), 41531. https://www.psychiatrist.com/pcc/developing-losing-regaining-trust-doctor-patient-relationship/

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

Benchmark Ethical Dilemma Presentation Assignment Instructions

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The purpose of this assignment is to demonstrate the ability to apply the values, ethical standards, and the ethical decision-making model provided by the American Counseling Association to a case scenario. This assignment will also encourage the development of professional presentation skills.

Instructions

Your will use the information written on your Ethical Vignette Paper Assignment to continue with the Ethical Decision-Making Model outlined in the Practitioners Guide for Ethical Decision Making and apply the content to the Ethical Dilemma Presentation PowerPoint template. Once complete, you will record a 10-15 min video (approximately 11-15 slides, including the title and references slides) presenting your ethical dilemma as you work through the Ethical Decision-Making Model. Follow the steps below:

Step 1:Review the feedback received from the instructor on the Ethical Vignette PaperAssignment and make anycorrections noted. Make sure you incorporate all feedback provided.

Step 2:Once you have applied the feedback from your instructor, use the information from your corrected Ethical Vignette Paper assignment to complete steps 1-4 in the Ethical Dilemma Presentation PowerPoint template. Do not just copy and paste the content. Make sure you reduce the contentinto bullet points. The slide content should be minimal. Summarize the information and make sure the required information is addressed within steps 1-4. See the Ethical Vignette Assignment Instructions for more information. Use the Ethical Dilemma Presentation Student Example Guide for additional support.

Step 3. Continue working through the remaining steps (steps 5-7) of the Ethical Decision-Making model. Add the information listed below to the Ethical Dilemma Presentation PowerPoint template to complete the remaining slides on your document:

Potential Consequences of Each Option and Determine a Course of Action

• This step has multiple sub steps. Briefly list the consequences for each potential course of action addressed in step 4. Answer the question, “If I take this course of action, what will be the consequences for all parties involved (the counselor, the client, others)?

• Eliminate the actions that will not work based on the consequences identified. Make sure you state what actions will not work and why.

• State which action or combination of actions you decided to take to fix the problem and explain why. Make sure you have scholarly sources that support your chosen course of action.

Evaluate Chosen Course of Action

• Restate your chosen action and clearly state if any ethical dilemmas still exist (the answer should be no).

• Evaluate the chosen action by applying the three tests (Justice, Publicity, and Universality). Make sure you have scholarly sources that support your position.

Implement Selected Course of Action

• Provide a step-by-step plan for how you will implement the chosen course of action.

• This may include information not stated in previous steps to effectively implement the plan (for example, calling the client is a step needed to implement informing a client of a mistake).

Your final presentation document must include:

• Approximately 11-15 slides, including the title and references slides.

• The following 7-8 references are required and must be cited verbally, intext, and included on the reference slides:

• The 2014 ACA Code of Ethics, your State Ethical Codes/Mental Health Laws, the two course textbooks, and the Practitioner’s Guide for Ethical Decision Making.

• 2-3 additional scholarly sources (scholarly journal articles published within the last 5 years) related to the identified problem and moral principle specific to the counseling profession. Materials must be outside of course materials, and materials from other classes.

Step 4. Saveyour Microsoft PowerPoint Presentation file under your name and assignment title (Example: Doe_J_EthicalDilemma_Presentation).

Step 5: Record a 10-15-minute video presentation applying the Ethical Decision-Making Model to the chosen case scenario.You may record the video on any device where screen sharing is allowed. The instructor must see you and the slide presentation in the video.

Step 6: Once the video is recorded, upload the video to Kaltura. Make sure the video is marked unlisted and save it. Grab the share link.

Step 7. Paste the video link on slide 2 of your PowerPointpresentation and save it again.

Step 8: Submitthe PowerPoint presentation file via the assignment submission link in Canvas.

Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
References
American Counseling Association. (2014). 2014 ACA code of ethics: As approved by the ACA governing council. [Electronic version]. https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=55ab73d0_1
Hansson, K. M., Romøren, M., Weimand, B., Heiervang, K. S., Hestmark, L., Landeweer, E. G. M., & Pedersen, R. (2022). The duty of confidentiality during family involvement: ethical challenges and possible solutions in the treatment of persons with psychotic disorders. BMC psychiatry, 22(1), 812. https://doi.org/10.1186/s12888-022-04461-6
FL Stat § 491.0147 (2023). 2023 Florida Statutes Title XXXII - Regulation of Professions and Occupations Chapter 491 - Clinical, Counseling, and Psychotherapy Services 491.0147 - Confidentiality and Privileged Communications.
Rustad, J. K., Schlozman, S. C., Hendler, R. A., Rasmussen, M. J., Rader III, G. L., & Stern, T. A. (2022). Developing, losing, and regaining trust in the doctor-patient relationship. The Primary Care Companion for CNS Disorders, 24(3), 41531. https://www.psychiatrist.com/pcc/developing-losing-regaining-trust-doctor-patient-relationship/
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

Tags: Ethical Dilemmas, Ethical Decision-Making Model, Duty to Warn, Counseling, Confidentiality, ACA Code of Ethics

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