COUN 5225 Week 9 Discussion_ Ethical Dilemma
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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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