Identifying the Problem
A code of ethics is very important in the professional lives of people in different professions. However, a code of ethics cannot replace human minds that have the ability to question, judge, experience emotions, and even act depending on different situations. Ethical codes cannot replace the struggles that people in helping professions like counseling go through with simple quick solutions.
The ethical struggles are sometimes unique situations, puzzling questions and demanding personal responsibilities that call for practical solutions not clearly stated in the codes of ethics. Sometimes conflicts arise between unclear codes of ethics and the need for practical solutions thereby presenting dilemmas.
The case of Wilma, a counselor in a community agency, and Donna who is a client suffering from an anxiety disorder and panic attack is a real dilemma. Wilma discusses information that is considered private by Donna in a public place. The right to privacy implies that the decision of information such as opinions, emotions and personal data that someone is willing to share with other people is at an individual’s discretion. There is also a problem of breach of confidentiality on Wilma’s side.
The code of professional ethics requires Wilma to keep the information she has on Donna a secret (American Counseling Association, 2005). The code of ethics applies even if the information seems harmless. There is a moral obligation by Wilma to ensure that Donna adheres to her treatment plan and gets better from her current situation hence the dilemma as stated in article 7.B.1 (South Carolina Department of Labor Licensing and Regulation, 2006).
The simple fact that Wilma makes an inquiry on Donna’s progress in the presence of another person is a breach of privacy. Wilma’s frustration with Donna’s laxity with the homework she is given during the therapy session causes her to ask Donna about the homework. The context in which the confrontation occurs is wrong as both are in a public place. Furthermore, Wilma is not alone since she is in the company of a friend.
Perhaps Donna’s visits to the community agency counseling center are a secret and the information divulged to anyone else may lead to further complications especially now that she is being helped overcome her condition of panic and anxiety. There is a possibility that Wilma is the reason Donna is not able to complete all her homework. They may be having problems such as a personality clash or a situation where Wilma is not competent enough to handle Donna’s case.
A case of fidelity presents itself in this situation. The situation is a combination of an ethical and a clinical issue. An ethical issue arises due to the breach of the right to privacy and confidentiality. A clinical issue, on the other hand, comes about as the context in which the confrontation occurs may be a precipitating factor in a panic attack episode. Donna may get a panic attack as a result of the counselor’s indiscriminate behavior.
Applying the ACA Code of Ethics
Wilma’s conduct is evidently inappropriate according to the American Counselors’ Association (ACA) Code of Ethics. Section B.I.b code of ethics on respect for privacy states that, “Counselors respect client rights to privacy. Counselors solicit private information from clients only when it is beneficial to the counseling process” (ACA, 2005, p. 8). At the specific moment, there is no therapeutic process in play hence a breach of ethics.
In section B subsection 1.c, there is a code concerning respect for confidentiality, which requires “counselors do not share confidential information without client consent or without sound legal or ethical justification” (American Counseling Association, 2005, p. 8). Wilma shares Donna’s issues from a personal perspective. The concern does not appear therapeutic since it is out of frustration that she chooses to check on her client’s progress and not as part of the therapy sessions requirements (American Counseling Association, 2005, p.8).
According to section B in subsection 3.c., the code is clear on the setting in which to divulge confidential information. It is in a public setting that Wilma makes her inquiry from Donna. Donna is a waitress in an eatery that is obviously a public place. The sessions are meant to take place in a private place where the client does not feel intimidated or have feelings of insecurity with regard to personal information in possession of the therapist.
The code states that “counselors discuss confidential information only in settings in which they can reasonably ensure client privacy” (American Counseling Association, 2005, p. 8). ACA code of ethics in section C subsection 2.a requires that therapists practice according to their limits of competence. Their competence is established by things such as the counselors’ education levels, supervised experience and necessary credentials.
Nature and Dimensions of the Dilemma
As mentioned earlier, the situation between Wilma and Donna is an ethical dilemma. This is a pure dilemma as the ACA codes of ethics require that Wilma maintains confidentiality unless otherwise stated.
Nevertheless, an obligation stated in the principle of beneficence binds Wilma to ensure that Donna gets well. The fact that Wilma is a counselor in a community agency also presents a possible challenge that she may not be competent enough to handle cases of anxiety and panic attack disorders yet Donna needs help to overcome her current condition.
Potential Courses of Action
There is a need for Wilma as a professional counselor to follow strict guidelines as required by the ethical decision making model. At this stage, she must identify potential action plans to solve the ethical issue presented. There may be a need to be very strict with Donna, therefore, undermining her right to autonomy. She may also choose to let Donna go if Donna is not willing to accomplish her therapeutic tasks since Donna’s well-being is largely dependent on how well she accomplishes her tasks.
Therefore, failing to accomplish these tasks is synonymous to time wasting. A possible alternative is following Donna to her place of work and checking on her progress in private. This is likely to help her accomplish the therapeutic tasks required to make Donna get well. Wilma also has a choice of changing the therapeutic approach she uses on Donna as a new approach may yield better results.
There is a chance to refer the client as Wilma may consider Donna’s case as that which is beyond her competence level. This is in accordance to chapter 36 article 7 section B.10 of South Carolina Department of Labor Licensing and Regulations (2006, p. 21), which states “when a professional counselor determines an inability to be of professional assistance to a potential or existing client, the counselor must, respectively, not initiate the counseling relationship or immediately terminate the relationship.
In either event, the counselor must suggest appropriate alternatives and be knowledgeable about referral resources so that a satisfactory referral can be initiated. If the client declines the referral, the counselor shall not be obligated to continue the relationship.”
Evaluating Potential Courses of Action
There are possible repercussions that may arise due to the course of action taken. The repercussions should be considered in detail for the best course of action to be applied. Since Donna has a legal right to autonomy, her freedom of choice should at all times be respected even by her therapist.
The respect holds even when the choices she makes have little or no sense, for instance, the choice of not completing her therapeutic homework. There is a possibility that Donna may take actions against Wilma if her autonomy is undermined. The actions may include reporting Wilma to her seniors or even taking legal action.
Wilma’s plan to release Donna from her therapeutic care may also have consequences. The consequence of this action is failure to maintain the client’s welfare to the highest possible level that is a legal duty of the counselor.
Following Donna to her place of work may present a legal issue. This action can be interpreted as stalking. The final possible plan of action is referring the client. However, this action may also have its shortcomings. The suggestion may not go well with Donna for reasons such as fear of the unknown.
She can also interpret her case as so hopeless that she cannot get help elsewhere having failed in the first instance. Donna may also experience feelings of rejection since she may not consider the referral objectively and might take it personally. In such a case, it is important to let Donna know that she is special and unique and that she needs someone who understands her better.
Implementing the Course of Action
The most appropriate course of action in the Donna and Wilma case is to refer the client (Donna). Perhaps there are reasonable explanations why Donna fails to do her homework. These reasons may be beyond Wilma as a professional counselor. This then requires Wilma to accept that her competence is limited.
Therefore, she should allow Donna to seek help elsewhere. The referral is in line with the ethical principle of veracity. The principle of veracity is the counselors’ honesty in accepting their limitations as professionals. Wilma should be careful to consider all consequences the situation may bring to her as a professional (Akfert, 2013).
There is a need to explore all options carefully as referring Donna might bring up additional ethical issues. Wilma needs to do a critical evaluation of the decision to refer Donna and check if it is fair to do so. Wilma must consider how comfortable she can be with the decision if the same is suggested for her.
She should be comfortable recommending this solution to another counselor in a similar dilemma. She should also consider the universality test, which is a necessary condition for approval of the course of action taken (Akfert, 2013). The universality test entails how well the issue goes down with the press and the community at large. The action should receive positive publicity should the information leak out to the press.
Making a Follow-up
The final stage in the ethical decision making model is making a follow- up. Wilma should follow up Donna’s case to check whether her referral yields the anticipated outcome. Counselors handle an array of diverse of circumstances and each clinician has his own distinct style of handling the different situations. Therefore, Wilma should accept her shortcomings in handling Donna’s case and resolving the dilemma.
References
Akfert, S. K. (2013). Ethical dilemmas experienced by psychological counselors working at different institutions and their attitudes and behaviors s a response to these dilemmas. Educational Sciences: Theory & Practice, 12(3), 1806-1812.
American Counseling Association. (2005). ACA Code of Ethics. Web.
South Carolina Department of Labor Licensing and Regulation. (2006). Code of regulation and code of ethics, chapter 36. Web.