Case Vignette1: Jessica
Jessica is sixteen years old, and is sent to the school counselor following concerns from her year level coordinator. Jessica is finding it difficult to concentrate in class, is continuously late to school, and often arrives to school disheveled and unkempt. The coordinator is concerned about what may be happening at home with Jessica, and that she may be getting involved in a notoriously bad circle of friends in the area known for drug taking and other delinquent activities. Although reluctant during the first few sessions to disclose anything much, Jessica begins to trust the counselor and opens up about her frequent drug use. She says she used to only smoke marijuana, but that now this had increased to weekly party hits of Cocaine and speed. She tells the counselor that the effects of these drugs is beginning to diminish and that she feels like she has to try something harder like heroin, to gain the same effect. That week the counselor receives a call from Jessica’s parents wanting to know what is going on with their daughter. What should she do? Ethical standard involved:
The issue here is of sharing confidential information divulged by a minor during therapy with the parents. The following points from the Singapore Association for Counselling, Australian Counselling Association and American Counseling Association pertain to this issue: Singapore Association for Counselling (SAC)’s Code of Ethics: Section B point number 3, which states ‘Members discuss with clients as early as feasible in the therapeutic relationship appropriate issues such as the nature and anticipated course of counseling, fees and confidentiality’.
Australian Counselling Association (ACA)’s Code of Conduct: Code of Ethics section, point number five which states, ‘as members of the ACA we will: offer a promise of confidentiality and explain the limits of duty of care’. Also the following points in the Code of Practice section:
2.1 Issues of Responsibility
184.108.40.206 Counsellors must take all reasonable steps to be aware of current law as it applies to their counselling practice. 2.3 Confidentiality
2.3.4 Exceptional Circumstances
220.127.116.11 Any disclosure of confidential information should be restricted to relevant information, conveyed only to appropriate people and for appropriate reasons likely to alleviate the exceptional circumstances. The ethical considerations include achieving a balance between acting in the best interests of the client and the counsellor’s responsibilities to the wider community. 18.104.22.168 Counsellors hold different views about the grounds for breaking confidentiality, such as potential self-harm, suicide, and harm to others. Counsellors must consider their own views, as they will affect their practice and communicate them to clients and significant others e.g. supervisor, agency. American Counseling Association (ACA)’s Code of Ethics:
Section A: The Counseling relationship
A.1 Welfare of Those Served by Counselors
A.1.d. Support Network Involvement
Counselors recognize that support networks hold various meanings in the lives of clients and consider enlisting the support, understanding, and involvement of others (for e.g., religious/ spiritual/ community leaders, family members, and friends) as positive resources, when appropriate, with client consent. A.2. Informed Consent in the Counseling Relationship
A.2.d. Inability to Give Consent
When counseling minors or persons unable to give voluntary consent, counselors seek the assent of clients to services and include them in decision making as appropriate. Counselors recognize the need to balance the ethical rights of clients to make choices, their capacity to give consent or assent to receive services, and parental or familial legal rights and responsibilities to protect these clients and make decisions on their behalf. Section B: Confidentiality, Privileged Communication and Privacy B.5. Clients Lacking Capacity to Give Informed...
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