Reference no: EM133458105

Case Example #1

Dr. G has been supervising a practicum student, Blair for six months. Blair is in her final year of earning her Master's degree in counseling at a local university. Dr. G and Blair have a strong rapport and mutual respect for each other. Blair is experiencing the usual demands of a busy graduate student in the midst of practicum and preparing for gradua- tion. Additionally, Blair is also the mother of two adolescents and in the process of getting a divorce from a verbally abusive husband. Besides experiencing her own struggles surrounding the divorce, such as finan- cial concerns, emotional loss, and starting to date again, her children are also in need of more attention from their mother. Blair has demon- strated some adequate beginner-level skills as a counselor. She establishes a working alliance with her clients and is able to identify appropriate treatments. In supervision, Blair addresses some client issues, but has also used it as a time to talk about her divorce and vent her frustrations toward her daughters. Dr. G feels that given Blair's personal struggles, it is appropriate to allow some venting about personal issues so that Blair can consider how her personal experiences might be affecting her role counselor. However, recently, Blair has begun to use supervision to talk about her personal issues more often, and even used one whole ses- sion to talk about herself. Blair has also gotten behind in her paperwork and some session notes appear to be missing altogether. Additionally, on several occasions during working hours, Dr. G has walked into the office when Blair has been talking on the phone, e-mailing, or text messaging with one of her children, lawyers, or new boyfriend. Dr. G is sure that Blair's personal life is hindering her ability to develop fully as a coun- selor. When Dr. G recommended that Blair seek out her own counseling, Blair acknowledged the need for it but stated that there was no time or money for such counseling. As Blair is approaching her graduation, she frequently expresses hope for her quality of life to improve, including fewer financial concerns (assuming a full-time job is secured), and more time. She has frequently stated that doing counseling is one of the few things that is rewarding in her life right now, and she does not know what she would do without the support of her coworkers at the practicum. In spite of some of Blair's professional shortcomings, Dr. G is hopeful that Blair has demonstrated enough strengths as a counselor that she will be able to do strong work in the future. However, Dr. G also recognizes that practicum is a key aspect of training and is concerned that Blair is simply not getting all that she can from the experience. Dr. G is compelled to provide an accurate evaluation of Blair, but is concerned about how some negative feedback might affect Blair.

Discussion Questions

1. Which ethical guidelines should be considered in this vignette?

2. How would you approach Blair's subpar professional behavior?

3. What recommendations would you make for Blair's future practice?

Case Example #2

Mr. O, a high school counselor, had provided supervision to a new counselor, April, for one year. Throughout that year, April frequently sought supervi- sion for one client, Michelle, a first-year student who maintained suicidal ideations, major mood swings, and poor boundaries with others. Michelle frequently referred to April as her only friend and requested to remain in contact after April left the school for a new counseling position in a to Mr. O that it felt cruel to disconnect from Michelle completely, and felt different school the following school year. In supervision, April expressed guilty for "abandoning" her client. Mr. O firmly advised April to terminate completely with Michelle and used supervision to discuss how termination might take place. He also helped April to explore her feelings of guilt surrounding the termination. April appeared to have understood the reasons for the professional boundary and agreed to proceed as advised. tion in a different school district, April e-mailed Mr. O stating that she had continued to remain in contact though e-mail with her client, Michelle. In the most recent e-mail to April, Michelle had written that she was f terribly alone, was having serious thoughts about hurting herself, and did not want to tell anyone at her school for fear that they would hospitalize her. April was concerned for Michelle's safety and hoped that Mr. O would meet with Michelle for counseling.

Discussion Questions

1. What is Mr. O's ethical responsibility to April? to Michelle?

2. How should Mr. O respond to Michelle?

3. Who is responsible for the boundary violations that have occurred?

4. What ethical decision-making steps should be taken?

Case Example #3

Counselor L is the only licensed counselors in a small rural town. Her practice and training has generally centered on working with adult populations. She is supervising a new counselor, Tom, who is providing therapy to a teenage girl named Ellen. Ellen struggles with anorexia, bulimia, and frequently makes superficial cuts on her arm when feeling anxious. Tom has acknowledged, to both Counselor L and to Ellen that he has had no training or experience in the treatment of eating disorders or self-injurious behaviors and would like to refer Ellen to a more expe- rienced practitioner. Ellen only wants to work with Tom, however, and has flat-out refused to see another counselor. Additionally, the closest counselor is one hour away by car, a trip that Ellen's parents would not be able to make on a regular basis, even if Ellen was willing. Counselor L's experience with eating disorders and self-injurious behaviors is also limited, although the treatment of eating disorders was addressed in some of her graduate-level coursework and she did read a few books on the topic.

Discussion Questions

1. What are the ethical considerations of supervising Tom and treat-Ing Ellen?

2. What role does ambiguity play in this case?

3. How should Counselor L proceed?