Question

Scenario

           Imagine that you are on a team of counselors who have been called in to provide consultation. You begin your work by interviewing trainees at the site. Your first interview is with Kara, a master's level student at her local university who is doing an internship at the agency. Kara states that her most puzzling client is an Eastern European male named Dominik; he has been in the United States for about a year on a work visa and is working hard to "blend in." Dominik sought counseling because his employer suggested that it might help him be less distracted at work improve his ability to complete tasks. Kara states that she diagnosed Dominik with ADHD because he was having difficulty sitting still and focusing, but she did not refer him for a medical evaluation. Kara expresses confidence that things are going well because when Dominik arrives for his appointment, he says, "Hey Doc!" and gives her a kiss on the cheek. Dominik schedules appointments over his lunch hour so he will not miss work, and he brings Kara lunch so she can eat too. Kara wants Dominik to feel welcome and comfortable, so she accepts what he brings. Sometimes they sit outside if the weather is nice. Kara says she believes that fresh air is good for the wellbeing of her client. Kara confides to you that yesterday, Dominik asked if they could meet at a restaurant instead of eating at the office. Kara says she felt a little funny about this but she said, "Yes." Kara also discloses that recently Dominik "friend-requested" her on Facebook and LinkedIn, both of which she accepted. Kara enjoys talking to Dominik and finds him to be good company. He has only four more sessions of counseling left at the agency and she hopes they can still be friends after he completes treatment. When you ask to review Kara's case notes, you do not see a supervisor's signature. Kara says she told her internship supervisor that things are going well so she does not feel the need to staff this case; she states that they agreed that Kara could exercise her own professional judgment. On the treatment plan, you see that Kara states that she is using a directive approach and supplementing it with humor therapy, which she read about on the Internet. She describes this approach as "common sense counseling," but she is not able to articulate why it will be helpful for Dominik or discuss the evidence that this approach helps clients get better. When you ask Kara how she knows her counseling sessions are benefitting Dominik, she says, "Well, he keeps coming back, so it must be worth his while, right?"

          Using the Web sites for the ACA and AMHCA ethics codes, the ACA Ethical Decision-Making Model, and the Calmes, Piazza, and Laux (2013) DOI: 10.1002/j.2161-007X.2013.00025.x article assigned in this unit's studies, prepare a draft of your conclusions regarding this case that you will review with your consulting team.

1) Prepare a multi-step plan for the agency to follow in re-aligning its interns' and superiors' clinical work with professional standards.

Answer 1

The review of the case study in terms of ACA codes, AMHCA ethics codes and Decision Making Model

While interviewing the Kara the following ethical issues are violated by her:

1. She daigonosed him with ADHD but didnt send him for medical evaluations.

2. According to her the progess is going on well because he turns up for appointments - Her notion is completely wrong. THe progress has to be reviewed in terms of improvement in the client, how far as he reached his goal and change when needed for maximizing welfare of the client.

3. She gives preference to him by arranging a meeting at lunch time and eat lunch with him- To accept things from the clients is not allowed. A strict professional relationship should be followed on this point. No gifts to be taken.

5. She agreed to meet him outside for lunch - The counselors are suggested to avoid any non-professional relationship with the client. If, the counselor decides to engage in any activity outside counseling session there is a need to official document the meeting, rationale behind it, the impact on the client and positive outcomes expected from it. A casual meeting is not appreciated.

6. Accepted his Facebook Request - the counselor are not allowed to have virtual relationship with the current clients.

7. She wants to have a friendly contact with him after the sessions are over - According to ACA ethics, a counselor and client are not allowed to have any relationship after the sessions are over, till 5 years.

8. The agency let the counselor practice without any review of case notes - It is totally unethical to practice if education, experience , supervision training is not followed or completed. The documenation of each case has to be reviewed and signed by the qualified counselors.

9. She didnt file a case note beacuse she thought everything is going on well - According to ACA ethics a counselor has to document the case that provides information about the progress and services provided. Any amendements made should be in accordance to the institutional policies.

10. Cant provide reasons on how the therapy is helping - The therapy provided is not discussed with the agency and is not helping the client solve his purpose. As a result the therapy provided is no at all valid as no good reasons are there of it being effective. The therapy is not reviewed and discussed with the client and not modified in accordance to progess. THis is against the welfare of the client

The Plan for the agency that can be in used in order to re-align its interns and superiors' clinical work with professional standards are:

1. A document can be formulated by the agency that provides information on the Do's and Dont's during the counseling sessions. American Consueling Association ethical guidelines can be reffered to while preparing the document. For example, in the above case study, Touching and relationship with the client can be a issue. According to ACA Codes of Ethics, the Counselor is not allowed to have a sexual relationship with his/her clients. Though the Ethical Guidelines doesnt attend to non-sexual contact between Counselor and cli

ent. But through the document the interns or superior can be made aware about the 5-typical touch- related- counseling experience, given by Mc Neil- Haber (2004). The touch used by the counselor above is cotroversial and so different case studies can be provided in the document , to clarify what is appropriate and inappropriate.

2. A supervisor should talk to the each counselor in detail about there relationship with there clients. A questionnaire can also be provided to them which doesnt make it apparent about what are they assessed for. This ensure any lying factor.

3. A seminar must be held every 6 months that discuss about the positive and the negative impacts of certain practices in counseling and provide information about any recent developemt on those areas. For example, touch as a counseling practice.

4. A group of seniors counselors should be invited to discuss there case studies and certain challenges faced by them and how to deal with it.

5. Role-play technique should be used with a group of counselors. THey should be given a stiuations where the ethical guidelines are violated or going to be violated and through role play they should show how they would resolve it. They should always ask the interns and superiors to be frank in there angency, by creating an environment where communication and honesty is given importance.

by following the steps and implementing these activities they are making the interns aware about the professional ethics and how to deal with them when they are being violated.