Ethical Case Analysis: Eating Disorder and Compentence



Ethical Case Analysis: Eating Disorder and CompetenceCathy McCormickThe Chicago School of Professional PsychologyEthical Case Analysis: Eating Disorder and CompetenceIntroductionCounselors often face dilemmas and challenges which the client presents. It is crucial that we have a working knowledge of the ACA Code of Ethics which we can refer in these cases. With additional assistance in supervision, education and sensitivity along with the awareness of our strengths and weakness. We then can achieve a better sense of client needs. The ACA Code of Ethics gives us a framework which to draw from when facing dilemmas. By following the guides presented in this code along with the principles of ethical decision making, we can utilize the codes in our making of professional decision making. Ethical Case: Forester-Miller and DavisIn addressing the case presented, I chose the Forester-Miller and Davis ethical decision making model because I felt that it could be used as a guide to examine this case of an eating disorder which the counselor had not previous experience. In approaching this case, I thought about the areas of expertise the counselor would have. There is much going on in the life of Felicia, so we will dissect the issues one by one. (Sheperis, Henning, & Kocet, 2016)Identify the problem: The first thing which noted was the mother was the one making first contact. Much information was given over the phone regarding the needs of the potential client Felicia. To start her parents are going through a tenacious divorce in which it is known that the father has had an extra-martial affair. Felicia has had a recent difficult break-up of her long-term boyfriend. Felicia is stating one reason for the breakup and the mother expressing that she has learned of other issues regarding the ending of the relationship. Expressively the eating disorder was the real problem, and this is third party information, so it needs to be noted but not currently considered. However, as reported by her mother, Felicia appears to be having difficulty accepting of changes or presumed failure. The mother reports that Felicia has been hoarding food, known to be vomiting, and obsessed with her weight. Her mother recognizes Felicia to have poor self-esteem often comparing herself to her high-achieving brother. Felicia is making plans to attend college next year. Mother also states, Felicia also is showing signs of possible depression due to the reduction of contact with close friends, making self-defeating comments and has had changes in her basic mood and personality.(Forester-Miller & Davis, 1996)Applying the ACA Code of Ethics: B.5.a. It is crucial to let the mother know that if you accept Felica as a client, the primary responsibility will that of Felica. (Autonomy) B.5.b. In explaining the role of the client/patient relationship, that since Felica is currently a minor, does not change the identity of the primary client. Which precludes that the parent will only be part of the collaborative work. A.7.b However confidentiality is a critical part of any counseling relationship. It will need to know which will be shared with the mother. Felica sessions will be held in confidence, and you will not be giving her report. A.7.b. If anything does come up which she needs to be informed, you will help Felica advocate for herself to share information. (Fidelity) B.3.b. and C.2.a. Since you have already explained you are not an expert in the field of eating disorders, it is important to let both the mother and Felica know you will be seeking consultation and supervision, as well as working within an interdisciplinary team to assist you in creating a treatment plan. (Nonmaleficence) C.2.b. As soon as you accept this client, education, additional training should begin. (Beneficence) A.6.a and A.6.c. Lastly, because all of you live in a rural area, clear and precise boundaries needs to be discussed with both the parent and client.(Justice) (American Counseling Association [ACA], 2014)(Forester-Miller & Davis, 1996)Determine the nature of the dilemma: The first concern was previously mention, as the Mother is reporting information and we are not getting information directly from the client at this point. The other issues are, although the counselor has no experience in eating disorders, it is just one of the highlighted symptoms of other problems the client is potentially experiencing. Therefore, requesting supervision or consultation from an eating disorder expert would be a good start for consultation. Looking for a seminar or education material would also supplement the needed knowledge of the underlining problem of the eating disorder. The family has confidence in the counselor's abilities; this makes for a possible good report with Felicia. I see no reason the counselor is unable to take this client. (Forester-Miller & Davis, 1996)Generate your potential course of action: Using a therapy which is person center along with a cognitive approach would prove effective in treatment. I would seek out training in dialectic behavioral therapy which has shown itself to be successful with personality issues. Many things appear to be happening to Felica all at one time, making for a sense of being overwhelmed. Making collaborative goals of treatment will offer Felica a sense of empowerment. Helping the client be their own personal ally in their treatment will help her with an underlying sense of lack of control in her personal life. Keeping a personal journal of how she feels emotionally and physically when she is going about her daily life will help her see a pattern when she then can alter using coping skills learned in therapy. By keeping a record, it should help her identify her eating habits as well. The suggestion of a support group may be an additional recommendation of treatment.(Forester-Miller & Davis, 1996)Consider potential consequences, determine the course of action: The most concerning consequence is that the eating disorder goes untreated. Although this is usually symptomatic of another stressor, it is often a compulsive response which is hard to manage. It may be suggested prior to acceptance to your practice; the client goes for inpatient treatment. Giving you some time for you continue to form a plan for treatment. Having a medical and psychological profile to assist you in a treatment plan could help the client and yourself in getting the best results from counseling. (Forester-Miller & Davis, 1996)Evaluate selected course of action: In this stage you want to apply the test of justice by asking yourself some perennate questions. Does your decision in this case which provides treatment, hold up under public scrutiny? Yes, this is the exact course I would take regarding any challenge I would have due to lack of expertise. Do I feel that I have recommended and or provided the same treatment to others in the same circumstance? Yes, I would follow the same course of action. Would I recommend the same course of therapy to other counselors? Yes, I believe that being honest with the client or potential client about your limitations, but desire to learn what you can to provide the best course of treatment. (Forester-Miller & Davis, 1996)Implement course of action: Since I as the counselor, am choosing to get further education and support, I believe that I can achive the goals I set for the client. With my other set of skills, address many of the underlining issues would be similar in scope to other clients. Going for certifaction in Dialectic Behavior Therapy will not only improve my resources for this client but also with smular issues. (Forester-Miller & Davis, 1996)ConclusionThe difficulty lies in; Felica was currently not the client. It was the mother reporting the situation and from her perspective. Certainly, I would have no problem taking this client, due to the confidence having worked with similar issues. Meanwhile, it would be essential to get additional training, supervision, and certification. In ethics and counseling, as well as in general, there are always multiple directions one can choose. Rarely there is only one course of action. Primarily I see the importance in transparency, remaining professional and empathic as the key components to the counseling profession. To act in the best interest of the client and be ethically responsible. ReferencesAmerican Counseling Association. (2014). 2014 ACA Code of Ethics. In (Ed.), 2014 ACA code of ethics. Retrieved fromCorey, G. (2005). In Theory and practice of counseling and psychotherapy (7th ed., ). Belmount, CA: Brooks/Cole.Forester-Miller, H., & Davis, T. (1996). A practitioner’s guide to ethical decision making. Retrieved from , D. S., Henning, S. L., & Kocet, M. M. (2016). Cultural competency and ethical decision making. In R. D. Parsons & N. Zhang (Eds.), Ethical decision making for the 21st century counselor. Los Angeles, CA: Sage. ................
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