Scenario One
Question One
It is vital for a counselor working with victims of interpersonal or domestic violence to set the “frame of treatment” during the informed consent process. This involves letting the client know the limits of the treatment process, setting the rules of conduct as well as specifying the consequences of failing to follow the set rules of conduct ( Pettifor, 2001 ) . Barbara needs to consider the scope of her license given that domestic violence group s are unique . As a result, there is n eed to ensure that she has undergone specialized training before offering her services to them. Lastly, she needs to remember th at the issue of confidentiality needs to be addressed verbally and in writing .
Question Two
Barbara should ensure that she educates members of the group about the importance of treating the information shared during the sessions with utmost confidentiality. During these sessions , she should assure the participants of confidentiality on her part. Secondly, she should encourage the participants to be mindful of the sensitive nature of domestic violence hence the need for confidentiality . The possible consequences of failing to be confidential should also be discussed during these sessions. She should also address the limits of confidentiality with the group participants. Unlike individual therapy sessions, the likelihood of a breach of confidentiality in a group setting is significantly higher. A contract should be signed by all the members of the group to reinforce the legal implications of confidentiality (Lasky & Riva, 2006) .
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Question Three
If breaches of confidentiality occur, Barbara should begin by terminating treatment of the group member who has breached confidentiality . This is because her actions may aggravate the psychological well-being of the other group members. Secondly, she should inform the group participants about the incident and tell them about the measures she has taken to address the issue. Further, s he should pursue the legal channels of reinforc ing the confidentiality contract that had been signed by the members of the group.
Scenario Two
Question One
In marriage therapy , the American Psychological Association ( APA ) Code of Conduct dictates that the counselor must take steps to determine who his or her client is and what relationship to establish with him or her. A marriage therapy involves two individuals who have different thoughts, emotions, and needs ( Pukay- Martin, 2008) . Therefore, David must establish a balanced relationship with both Steve and his wife as they work on improving the relationship. Secondly, David must discuss confidentiality with the couple . In some cases, one partner may want to disclose information that he/she does not want to be shared with the other partner. David must, therefore, develop guidelines concerning such issues.
Question Two
One special issue of confidentiality that may arise while David is counseling the couple pertains to secrets. In this case, either Steve or his wife may share information that they prefer David to treat as a secret. David has three options for addressing this issues. The first choice is to declare that there are no secrets , and hence all parties must share all the information with each other during sessions. This may create fear and tension thus leading to either party withholding vital information ( Pukay- Martin, 2008) . Secondly, David can withhold information shared in secret by any of the partners. However, this may be difficult if the information has implications for the relationship. Thirdly, David can withhold particular details . Nevertheless, d etermining what to withhold and what to share may not be easy for David.
Question Three
Personal values and cultural issues may create ethical dilemmas for David as he seeks to handle secrets during the therapy sessions. If David values honesty, then it may be difficult for him to keep secrets from one of the parties during the sessions. In this case, it is important for him to have an addendum in his informed consent form highlighting how he will treat the secrets shared by the couple.
Scenario Three
Question One
To smoothly transition into private practice, Stephanie needs to understand the laws and regulations regarding therapy fees. This is important because it is common for counselors to keep their prices low due to fear of being viewed as unethical. The se laws are designed to protect clients from being overcharged . S tephanie should understand that she has a business to run and thus should work on building it in spite of the limited resources. Secondly, Stephanie should work towards offering her services to local charity organizations pro bono. This will help her bring the change she desires to see in her community. In the process, she will build a name for her private practice and acquire more clients. Further, Stephanie should avoid relationships that will negatively affect her professional performance or harm her clients or employees. This is not only important for her reputation but also for the sake of both her clients and employees.
Question Two
Stephanie needs to know that most insurance companies require that the patients get a referral from a physician before seeing a counselor . Thus, i t is crucial that she insists on getting a written referral before embarking on counseling a ny patient. Secondly, she needs to be familiar with the Mental Health Parity and Addiction Act of 2008 . Through this Act, insurance companies are expected to provide coverage for mental health conditions . This is as generous as the benefits offered for general and physical care. This will be critical when charging for co-payment because the Act dictates that a health insurance provider cannot charge more than two-thirds of medical services in the treatment of mental health conditions (American Counselling Association, 2014) .
Question Three
When counseling victims of injustice , poverty, discrimination or lack of access to behavioral health services , Stephanie is ethically obliged to handle them fairly . The care that she extends to all her other patients should similarly be extended to su ch patient s . Secondly, she is obliged to ensure that such victim s are informed of all their rights while receiving treatment. Due to the nature of the misfortune experienced, the victim s may feel left out in some ways hence the need to offer assurance by explaining t he nature of treatment, the process, the limits and the expected outcome. Stephanie may also refer such client s to a community based legal organization where they may receive advice on whether to sue over the injustice or discrimination experienced. In doing so, Stephanie will contribute to a long-term solution by assisting the victims to speak out concerning the ir experiences.
Scenario Four
Question One
Amari should consider having procedures for screening clients before counseling them. This will enable her to sift through the genuine cases and impostors. Secondly, she needs to put measures in place to safeguard the virtual conversations that she is having with her clients. This is because confidentiality is still important even when doing distance counseling ( McAdams & Wyatt , 2010) . Finally, she should consider how she will manage expectations of her clients while maintain ing a professional relationship.
References
American Counselling Association (2014). Transitioning into private practice. Counselling today, 57 (6)
Lasky, G. B., & Riva, M. T. (2006). Confidentiality and privileged communication in group psychotherapy. International Journal of Group Psychotherapy , 56 (4), 455-476.
McAdams, C. R., & Wyatt, K. L. (2010). The regulation of technology ‐ assisted distance counseling and supervision in the United States: An analysis of current extent, trends, and implications. Counselor Education and Supervision , 49 (3), 179-192.
Pettifor, J. L. (2001). Are Professional Codes of Ethics Relevant for Multicultural Counselling ?. Canadian Journal of Counselling , 35 (1), 26-35.
Pukay- Martin, N. ( 2008 ). Ethical Considerations in Working with Couples: Confidentiality Within the Couple. Retrieved from https://www.nationalregister.org/pub/the-national-register-report-pub/the-register-report-fall-2008/ethical-considerations-in-working-with-couples-confidentiality-within-the-couple/
