Choose three of the seven ethical case scenarios.
Answer the following questions for each scenario in 75 to 100 words each.
What is the ethical issue described in the scenario? Why is this an ethical issue?
Scenario 20: The counselor has a client who is currently going through a divorce. The client provides the counselor his journal to hold on to, as it is helping him through his treatment. Upon further discussion, a referral is made to a different counselor to better assist the client.
In the transition, the counselor gives the new counselor records for the client, along with his journal. This poses an ethical dilemma as there was no informed consent or open communication with the client about what information would be transferred, in particular, his journal.
Scenario 22: A minor, 17-year-old has been receiving anger management therapy from a counselor in a private practice setting. During treatment, the minor turns 18. The mother requests the clinical records as she feels the behavior of her son is odd.
The counselor denies the request to release the records, as the client is now an adult. This poses an ethical dilemma as it needs to be determined if the mother has the right to have access to the minor records or not, and does the odd behavior constitute a need to break confidentiality to discuss the clients potential mental health risk with the parent.
Scenario 27: The counselor in this scenario is part of a treatment team at a local mental health center.
Each week, the team gathers to discuss their individual caseloads. Although the counselor did discuss the parameters of confidentiality with her clients, she did not inform her clients that their cases would be further discussed with a treatment team at the mental health center. This is an ethical dilemma as the clients were not informed that the team even existed and that their cases would be consulted on by a treatment team.
Which state laws apply to this scenario? Why are these laws applicable?
Scenario 20: Informed consent is applicable in both state law and the ACA Code of Ethics. There is a whole section under Article 11: Standards of Practice in the Arizona Administrative Code that covers the parameters of informed consent, ranging from benefits and limitations of treatment to confidentiality of clients records (R4-6-1101, 2018). There also is a section on client records and states that you must obtain written permission from the client to release any confidential information or record (R4-6-1103, 2018).
Scenario 22: Under Arizona Law, there is a Parents Bill of Rights that favor parental rights over the childs rights. The Parents Bill of Rights covers areas such as education, consent for mental health care, immunizations, and general upbringing and protects against government intervention (A.R.S. § 1-602, 2019). However, as the State of Arizona does not have a specific law that outlines confidentiality about a minors records and parental access to these records, counselors are left to use discretion (Birkholz, MD et al., 2018).
Scenario 27: According to Article 11: Standards of Practice, in the Arizona Administrative Code, the client must be notified by the counselor if there is any involvement with a treatment team (RA-6-1101, 2018). This coincides with the ACA guidelines surrounding treatment teams as well. It is pertinent that the client understands the limits and expectations of privacy and confidentiality. Article 11 also covers confidentiality and privacy for the clients information. Counselors are not only ethically bound to uphold these guidelines but legally bound as well.
Which ACA ethical codes apply to this scenario? Why are these codes applicable?
Scenario 20: In the ACA Code of Ethics section A.2.a, it states that informed consent needs to be a continual part of the counseling process (American Counseling Association, 2014). Section A.11.d of the ACA Code of Ethics also states there needs to be open communication between the client, the current counselor, and the new counselor when there is a referral (American Counseling Association, 2014). As the counselor did not openly communicate with their client about the records and information that would be transferred to the new counselor, it did not provide the client the opportunity to ask for the journal back, before the referral.
Scenario 22: In the case of minors, counselors are to protect the confidentiality of information received during treatment (American Counseling Association, 2014). While Section B.5.b. does state that counselors do need to inform parents about confidentiality surrounding the treatment and records, it does not state that counselors must disclose the information or records to the parents, as confidentiality is crucial in a counseling relationship (American Counseling Association, 2014).
Scenario 27: Section B.3.b of the ACA Code of Ethics discusses that all clients must be informed of a treatment teams existence and the purpose behind the treatment team as well as the information that will be shared (American Counseling Association, 2014). Section B.7.b also discusses the importance of disclosing confidential information. The counselor must ensure the utmost confidentiality when discussing cases with other professionals and cannot release identifiable and confidential information without receiving consent from the client themselves (American Counseling Association, 2014).
What is the proper ethical response for the counselor in this situation?
Scenario 20: The counselor in this scenario should have consulted with the client before releasing the journal to the new counselor. While the counselor may have thought it would be beneficial for the client, it is still his property and record that he did not provide consent to be released. This information should have been included in the referral process. The release of the journal may have caused undue harm to the client, which is what should be avoided in the helping profession. The release of the journal also broke the trust of the client, which may hinder his future counseling relationship and treatment.
Scenario 22: The counselors refusal to release records to the parent was an appropriate response to the situation. The client was no longer a minor at the time of the request and therefore has the right to have his records protected. Even as a minor, confidentiality is crucial, and the parents should be reminded throughout treatment about the role of the counselor and the importance and expectations of confidentiality. Of course, had the minor exhibited any alarming behavior that would have constituted being at risk to themselves or others, then the parents should have been notified.
Scenario 27: A consultation team is not a breach of confidentiality as long as the clients, whose cases will be discussed during the consultation, have been notified about the existence and purpose of the team. Confidentiality and privacy are of the utmost importance in the counseling profession. The counselor should have followed ethical and legal guidelines in this scenario and informed her clients that the team exists and what information would be discussed and disclosed in the weekly meetings.
Arizona Administrative Code, Consent for treatment R4-6-1101 (2018).
Arizona Administrative Code, Client record R4-6-1103 (2018).
American Counseling Association. (2014). ACA code of ethics. Alexandria, VA: Author.
Birkholz, MD, K., Chulani, MD, MSED, FSAHM, V., Murphy, MD, P., Quinn, MD, L., Ritzman, MBA, J. and Stookey, CRNP, K. (2018). Consent & confidentiality in adolescent health care. [ebook] Phoenix: Arizona Medical Association, pp.15-20. Available at: Oct. 2019].
Parents bill of rights, Arizona Revised Statute § 1-602 (2019).