Ethical Decision Making

Ethical violations tend to affect professional prestige across every profession. It is essential for frequent training to take place to increase professionals’ abilities in moral judgment and decision-making. However, activities are insufficient in informing counselors and paraprofessionals about the complexity of particular situations. Oramas (2017) claims that actions are not enough to tell most counsellors how they should handle current ethical issues. In my profession as a mental health paraprofessional, I expect to encounter specific challenges.

One of the significant challenges that I might face revolves around issues of confidentiality. In this context, I picture an ethical dilemma involving confidentiality. I am working with victims of trauma following sexual abuse. One of my clients discloses that she had been sexually abused by her cousin when she was around nine years old, but she insists on having this information remain confidential. This abuse has led to major intimate issues. Later, the cousin stays with her aunt, who has a 10-year-old daughter. The client has expressed worries over potential damage to the family if the information is disclosed, and even though she has taken time to heal and even experienced difficulties in her intimate relationship, she still believes that the information should remain private and confidential. It is my responsibility to act in the interest of the client. Still, at the same time, given that mandatory reporting for abuse is required by the law for incidents of abuse, I should care for the welfare of the child who might be under a similar threat of experiencing sexual abuse and the succeeding trauma.

Boundaries are essential for any effective relationship between a client and a counsellor. They set the structure for the association and offer a consistent framework in the counselling process. Therapeutic boundaries are founded on beneficence, nonmaleficence, fidelity, justice, and autonomy. The ethical boundaries relevant in this situation are nonmaleficence, charity, and freedom. It is the responsibility of the counsellor to do no harm and to avoid problems or activities that might cause damage or conflict of interest with the client. It is also the responsibility of the counsellor to promote what is suitable for the client with the expectation that the client will benefit from the counselling. It is essential to maintain these principles. The client might feel harmed or betrayed when information about the abuse is disclosed to the authorities, in this case, the Child Protective Services. One of the ways that the client might benefit from the counselling sessions will involve closure where either the perpetrator is charged for the abuse or the client takes part in preventing a similar incident from happening to someone else. This brings about issues of autonomy since failure to report would imply colluding with the client in keeping silent and allowing the perpetrator to have control over her, hence violating her independence. The law mandates reporting of any cases of child abuse. Therefore, it will be essential to report this incident to Child Protective Services while striving to maintain the boundaries. This will ensure that the client’s welfare is protected, and even though her trust might lessen, mandatory reporting will help curb any potential harm that might be caused by the perpetrator to other children.

Confidentiality is a counselor’s moral and legal obligation to refrain from disclosing information about the client or their treatment. This includes refraining from making comments with other staff members in the workplace. Confidentiality is critical to the effectiveness of therapeutic relationships because it builds trust. Clients are confident that they can share information since the counsellor cannot disclose the information to other people. Oramas (2017) claims that even though the protection of the client and others is the primary responsibility of the counsellor, counsellors fulfil their responsibility by being aware that sharing information might lessen or eliminate trust, besides affecting the therapeutic relationship with the client. In cases of abuse, there is usually the duty to warn and protect.

Ethical decision-making entails gathering facts, determining whether a dilemma or issue exists, and whether or not there is a moral, legal, clinical, professional, or ethical obligation to make decisions (Davies, 2019). It is also the process in which divergent courses of action and their consequences and implications for the client or counselor are considered. Ethical decision-making also involves consultations with colleagues, peers, or supervisors. In this context, ethical decision-making will include obtaining informed consent and written authorization from the client to authorize the counsellor to disclose information to relevant parties where needed. The second step is to make a clear explanation to the client regarding the rules or exceptions to confidentiality to avoid misunderstanding. The client needs to understand that confidentiality must be breached when mandated by the law, mainly when there are threats of one harming themselves, threats of harm to other people, or when it is learned or even suspected that an elder or child is a victim of neglect or abuse (Sori & Hecker, 2015). Some states mandate professionals to report any child abuse, and in most of the states, failure to do so might lead to criminal penalties. Most clinicians hesitate to say abuse because it could permanently damage the therapeutic alliance between the client and the counsellor, as well as the client and the parents. However, Sori and Hecker (2015) claim that failure to report the abuse could prevent a child from obtaining the proper intervention. The client must understand that saying, in this case, is mandatory. Before disclosing the information to anyone, the client’s file must be checked to ensure authorization and the limitations on the information to be shared. Generally, it is always better to inform the client of the limits of confidentiality at the beginning of the counselling session, as this will lessen the probability of reduced trust and a broken relationship in the process.

Resolving this dilemma might require supervisory consultation. In particular, reporting the probability of abuse by the perpetrator to Child Protective Services should be done with the help of the supervisor, who will be able to help with the required steps of reporting the abuse and raising concerns of probable abuse. Confidentiality in the process of reporting should also be maintained. The counselor needs to know that information that can be disclosed to the supervisor should be on a need-to-know basis, as this will help prevent a breach of confidentiality. There may also be a need for supervisory or collegial advice about whether reporting in the first place might be a good call, given that the client had stated emphatically that she did not want the information disclosed to anyone. The law requires all in all, given that mandatory reporting of abuse, and to avoid any legal repercussions, such a consultation might not be necessary.

References

Davies, M. Ethical Decision Making within the Counselling Professions. British Association for Counselling & Psychotherapy.

Oramas, J. E. (2017). Counselling ethics: Overview of challenges, responsibilities and recommended practices. Journal of Multidisciplinary Research, 9(3), 47-58.

Sori, C. F., & Hecker, L. L. (2015). Ethical and legal considerations when counselling children and families. Australian and New Zealand Journal of Family Therapy, 36(4), 450-464.

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Discuss what ethical boundaries are relevant in the situation and the importance of maintaining those boundaries.

Explain the ethical decision-making process. Frame the circle around your dilemma when discussing each of the moral decision-making steps that a paraprofessional must complete.

Address areas that may require collegial or supervisory consultation to resolve this dilemma.

Note: It is acceptable to get inspiration for this dilemma from the textbook if needed; you must create your spot, not simply revisit one from the text.

Substance Use and Disorders Program Students:

Create your ethical dilemma and ethical decision-making steps as it relates to substance use and addictions. Resources specific to substance use are included in the Topic 4 materials folder.

A minimum of three scholarly sources should be included in the paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the title before beginning the work to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

6.5: Examine ethical codes and organizational policies and procedures.