1. Read the ACA and NAADAC Codes of Ethics and compare the positions that each takes on issues of dual relationships. Provide examples of dual relationships for which these codes do not give definitive guidance about the appropriateness of the relationship. How should a counselor make a decision to enter or not enter into a dual relationship?
2. How would you handle the following three situations? What would you do in each?
1. Your client expresses emotional or physical attraction toward you and you have similar feelings for your client.
2. You have feelings of attraction toward your client, but you do not know if your client has similar feelings toward you.
3. Your client expresses attraction to you, but you do not have any feelings of attraction toward your client.
3. You are a counselor working at a publicly funded alcohol and drug treatment program. Your client, Doug, attends one of your counseling groups. Although he has a previous conviction and is on probation for possession of an illegal substance, he entered treatment as a voluntary client. Doug’s probation officer recently learned from another probationer that Doug is in treatment, and the officer has sent you a letter requesting that you provide a progress report and an assessment of Doug’s likelihood of relapse. The probation officer will use this information, if favorable, to petition the court for Doug’s early release from probation.
Discuss your options for responding to the probation officer’s request and describe what you would do. Cite relevant legal issues, including federal confidentiality and privacy regulations in your discussion. Identify the specific circumstances under which you would provide the information requested by the probation officer. How would you handle this differently if Doug were involuntarily attending the group?
4. Judith is a licensed professional counselor (LPC) in private practice. She has a contract to facilitate psycho-educational groups for students in a local public high school. Many of the students in her groups are dealing with the divorce of their parents. Judith has decided to create a specific psychoeducational group for adolescents whose parents are divorcing or divorced. What should be covered in her pregroup screening interviews with the students?
5. You are the executive director of a small publicly funded behavioral health agency that serves indigent clients. After 10 years of being able to serve all clients seeking help, your agency has just received a 20% budget cut and must prioritize which services to discontinue and which clients to turn away. The community has many suggestions: stop serving undocumented immigrants and their children; stop serving substance abuse clients, limit all clients to six sessions, discontinue providing expensive services like psychiatry, lay off professional counselors and hire non-licensed paraprofessionals, stop providing counseling and instead simply offer peer self-help groups and parenting classes, serve only the most seriously ill (or the least seriously ill), and serve only children. How would you approach the difficult task of cutting services by 20% in a manner that reflects your ethical obligations as a community counselor? Would your plan differ if you were in a private sector? If yes, how? What criteria would you consider? What theoretical or standard of care practice will you follow to make a final decision about what to cut from your program? Reference the ACA and/or NAADAC Code of Ethics to support your answer.
6. A managed care clinician completed a utilization review and has just denied authorization for you to continue treating a client. You believe that the client could benefit from four additional sessions. At the same time, you understand that the managed care clinician must apply criteria of medical necessity to justify continued treatment, and you are aware that many of your agency’s clients have problems much more severe than your client’s. Make a list of all of the ways that you could try to ensure that the managed care system does not prevent you from giving your client the type and duration of treatment services that he or she needs. Categorize each of the items into two groups reflecting those that would be considered professionally appropriate and ethical, and those that would be considered to be a violation of professional ethical standards.
7. You are counseling in an agency setting in which your supervision consists of a weekly group staff meetings. At these meetings, agency policies, procedures, and other administrative issues are discussed. You are uneasy with this situation because you believe that true clinical supervision would help you improve your counseling skills and your current work with clients. You are also aware that you need a minimum number of documented hours of clinical supervision in order to obtain your independent counseling license, and you wonder if your supervisor’s brief notes about “staffing cases” as the activity in these staff meetings are sufficient documentation. Discuss the ethical issues involved in this situation, describe your options for how to proceed, and identify the option(s) you would choose. Explain your reasoning. Cite an ethical code in your response.
8. Darla is a Master’s of Arts in Professional Counseling student working at her practicum site. Mike is a practicum student assigned to the same practicum site as Darla. Both Darla and Mike report directly to the same site supervisor. About halfway through the practicum, Darla realizes that many of the clients assigned to Mike for counseling are coming to see her. Comments from Mike’s clients have led Darla to believe that Mike is acting unethically. How should Darla handle this situation? What are the ethical and legal implications?
If Darla tells her supervisor, and her supervisor does not act on her concerns, what are the ethical and legal implications?