COUN 5225 Week 9 Discussion_ Ethical Dilemma

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Jan 9, 2024

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Week 9 Discussion: Ethical Dilemma Write a one-paragraph counseling session describing an ethical dilemma involving sexuality. Write a three-paragraph description detailing how a counselor could handle this ethical dilemma. Include the need for multicultural awareness, knowledge, and skills in order to address the situation correctly. Be sure to cite the 2014 ACA Code of Ethics Counselor: Good morning (Clients Name), what brings you back into the psychiatric unit today? Client: Well to be honest, it is because I feel most close with you and I can trust you. Since you are the first person I have told about wanting to transition. Counselor: It is great that you feel you can trust me, I know being able to trust counselors in the past has been an issue. Client: Well I have been having these sexual fantasies about you and wanted to be near you. Counselor: As we have discussed before, clients-counselors do not engage in relationships such as you speak. I want to remind you that inpatient care is for those who are in crisis. Tell me about what is going on in your life since your last visit and the transition process. Client: Nothing has changed, I was finally approved to started hormone injections, I just wanted to see you and was hoping we could further our relationship and fulfill these fantasies. Counselor: We will go over the roles and responsibilities again to remind you of the Code of Ethics I abide by. II want to encourage you to utilize your services outside the psychiatric unit unless you are a danger to yourself or others, or in crisis. The counselor could have acknowledged that the client's feelings are normal as a person, considering the circumstances that the client has only shared information with the counselor. The counselor could appreciate the clients courage but further discuss the type of relationship they do have within the counseling relationship. At any point the counselor should not reject or shame the client. I personally would help the client navigate through those feelings and fantasies and let the client know that they are not alone. It is important that counseling professionals are willing to examine the concerns to promote open and honest discussion rather than shame or silence (Jacob et al, 2022). I would take this opportunity to help the client understand what they are missing in their other relationships and navigate what is needed to connect with others. As a counselor, I personally would want to go over the ethical codes, such as: A2.a. Informed Consent- Counselors have an obligation to review in writing and verbally with the client the rights and responsibilities of both the counselor and clients. A.5.a. Sexual and/or romantic relationships prohibited- These types of relationships are prohibited in person and electronically.
A.5.c. Sexual and/or romantic relationships with former clients- There is a 5 year prohibition period before a counselor could have this type of relationship with a client (ACA, 2014). I personally would want to keep the relationship professional and bring the awareness and boundaries to light again. I would also consult a supervisor on how to approach this situation without causing harm to the client. If it came to the point that the counseling relationship had to be ended, I would consult supervision first. This type of scenario happened in the psychiatric unit and the actual psychiatrist was no longer able to provide direct care with the client because the client's delusions of them being together were so severe that he began stalking her and her family outside of the facility. Other providers had to have direct care and the psychiatrist oversaw their work and the treatment. The treatment team also added on services the client could utilize outside of the psychiatric unit. References American Counseling Association. (2014). 2014 ACA code of ethics [PDF] . https://www.counseling.org/docs/default-source/ethics/2014-code-of-ethics.pdf? sfvrsn=2d58522c_4 Jacob, C. J., Byrd, R., Donald, E. J., Milner, R. J., & Flowers, T. (2022). Avoiding Boundary Violations: Recommendations for Managing Attraction to and From Clients in Response to the Healthcare Providers Service Organization's 2019 Report. Journal of Mental Health Counseling, 44 (1), 6-17. https://doi.org/10.17744/mehc.44.1.02 Jess Foxe Friday Dec 8 at 1:59am Manage Discussion Entry Alex is 31 years old. Alex and their partner have been together for 5 years and an last week, Alex was diagnosed with HIV. Alex hasn't told their partner, Dylan because their partner doesn't know they had cheated on her 10 months ago after a night out partying with friends. Alex had sex with a mutual friend of theirs while at the out of town party. Alex stated that they do not plan on telling their partner because they heard that some treatments can make it so that the viral load is undetectable, thus they might be able to
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