Ethical Decision Making
Ben is cutting himself regularly. The school counselor has spoken with his parents for several weeks and has explained the severity of this child's problem. Ben desperately needs help for a mental health professional. The parents refuse to take him for treatment and say they just want him to continue seeing the school counselor.
Ben is nine years old. He is in the third grade at Children’s Nation Elementary School, a quality school with rigorous curriculum and high academic achievement. Ben is from a poor neighborhood. His parents are both working extra time to pay for his tuition. Ben is one of the top students at school. He started to cut himself two months ago. I intern at the school, supervised by Dr. Brown. I have been counseling Ben for a month, twice a week. There are two more school counselors at the school.
Step One: Define the problem emotionally and intellectually
Emotionally, I feel bad and painful about Ben hurting himself. I'm also angry and critical of Ben's parents refusing a better treatment for him and not caring enough for his problem. At the same time, I am concerned with Ben's situation and the severity of him mental problem. Intellectually, the fact is that Ben's parents won't take him for professional mental health counseling, which Ben desperately needs, and want him to continue seeing me. I understand that time and money can be the possible reasons for their decision.
Step Two: Apply the ASCA and ACA Ethical Codes and the Law
According to the ASCA Ethical Standards for School Counselors, the following standards could be helpful in Ben’s case. A.5.b. Professional school counselors help educate about and prevent personal and social concerns for all students within the school counselor’s scope of education and competence and make necessary referrals when the counseling needs are beyond the individual school counselor’s education and training. Every attempt is made to find appropriate specialized resources for clinical therapeutic topics that are difficult or inappropriate to address in a school setting such as eating disorders, sexual trauma, chemical dependency and other addictions needing sustained clinical duration or assistance. A.5.d. Professional school counselors Develop a reasonable method of termination of counseling when it becomes apparent that counseling assistance is no longer needed or a referral is necessary to better meet the student’s needs. A.7.b. Report risk assessments to parents when they underscore the need to act on behalf of a child at risk; never negate a risk of harm as students sometimes deceive in order to avoid further scrutiny and/or parental notification. B.1.f. Work to establish, as appropriate, collaborative relationships with parents/guardians to best serve student. C.2.e. Professional school counselors recognize the powerful role of ally that faculty and administration who function high in personal/social development skills can play in supporting students in stress, and carefully filter confidential information to give these allies what they “need to know” in order to advantage the student. Consultation with other members of the school counseling profession is helpful in determining need-to-know information. The primary focus and obligation is always on the student when it comes to sharing confidential information. As for the American Counseling Association (ACA) Code of Ethics, the following standards may offer possible solutions to the problem. A.11.b. Inability to Assist Clients
If counselors determine an inability to be of professional assistance to clients, they avoid entering or continuing counseling relationships. Counselors are knowledgeable about culturally and clinically appropriate referral resources and suggest these alternatives. If clients decline the suggested referrals, counselors should discontinue the relationship. C.2.e. Consultation on Ethical Obligations
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