Joe and Jill Case Study on Code of Ethics Violations
Joe, a thirty-five-year-old, male mental health counselor, received a client referral, thirty-five-year-old Jill,
from a community counseling clinic. He began providing counseling services to her. Jill’s complaint was that she was unsatisfied with her current job as a bank teller and was experiencing mild anxiety and depression. Joe had been providing services to Jill for three weeks when she disclosed that she was confused about her sexuality because she experienced sexual attraction toward some women. Joe immediately responded to Jill with wide eyes and a shocked look. He told Jill that he was a traditional Catholic, who felt that this type of feeling was immoral and wrong. He informed her that she should avoid thinking about this and pray for forgiveness. He also told her that he felt uncomfortable talking about the issue any further. Jill continued to talk to Joe about dealing with her family issues.
Joe had recently read about a new technique and immediately became excited about trying it. He explained to her that he had read an article in a magazine about a new technique called rebirthing. The new technique was being used in Europe to help people change their views about their relationships with their family. Joe said, “It is supposed to be really effective in almost wiping out your memory of your family; it is like hypnosis.” “I would really like to try it on you today, what do you think?” Jill declined his offer and continued to talk about her family. Joe thought to himself that even though Jill said no, he was still going to try to hypnotize her as they talked because he thought she could benefit from the technique.
Jill disclosed that she was raised in a traditional Asian American home with many cultural influences and
culture-specific rules and behavior. Jill was struggling with balancing her individualism and her cultural
heritage. Joe explained to her that because he was living and working in a rural community, mostly
consisting of people of East European descent, he could not relate to Jill’s culture and the issues with which she was struggling. He apologized and explained that he was not required to study these cultural issues because of his geographical location.
Jill moved on to talk about her depression. She began talking about feeling lonely and how it contributed to her depression. During a counseling session several months later, she revealed that she was attracted to
Joe and would like a closer, intimate relationship with him. Joe, aware that he was also attracted to Jill,
talked about his feelings toward her but explained that engaging in a relationship outside the established
counseling relationship was unethical. He informed her that because of the mutual feelings of attraction, the counseling relationship would be ineffective and that he would refer her to another counselor for continued services. Jill agreed, and they terminated the counseling relationship. Later, she contacted him to continue counseling and to discuss the referral. Joe agreed to meet her that evening at a restaurant and bring her the referral information. That night they began an intimate sexual relationship.
Joe never got around to providing the referral for Jill even though he was aware of her ongoing state of
depression and anxiety. Joe stopped seeing Jill after a month of intimate sexual encounters. Joe enjoyed
the relationship but felt guilty due to the unethical nature of the relationship. Because of his continued
concern about Jill’s depression, Joe considered going to his current clinical supervisor to discuss the case
but decided against it. This was because he and his supervisor were good friends and he suspected his
supervisor would be hurt by knowing the real reason he had been cancelling get-togethers.
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Joe decided to call Jill’s boss at the bank to check on her and see how she was doing. He called her boss
and explained that he had been counseling her for anxiety and depression and wanted to check if she was
feeling fine. Her boss informed Joe that Jill had quit her job and was in the county hospital undergoing
treatment for severe depression. Joe quickly hung up and decided not to call or visit the bank again. After
thinking it over, Joe decided that general counseling might not be for him. He decided to begin marriage
and family therapy. He ordered some business cards and advertised in the yellow pages. He thought, “After all, I am a mental health counselor, and it can’t be hard to counsel a couple. You don’t need anything special. I already have one degree, and that’s enough!”
Summary and Analysis of Joe the Counselor’s Questionable Behavior
The case study above provides a detailed overview of a general counselor’s interaction with one of their clients and the manner in which events unfolded from the initial meeting. Joe (the general counselor) has just started providing counseling services to a female client identified as Jill who currently works at a local bank as a teller. She is disillusioned by her current job posting and also reveals she frequently experiences mild anxiety and depression. Although general counselors are typically expected to observe a strict code of ethics governing their behavior in the contemporary clinical environment, Joe displays a series of questionable unethical and unprofessional behavior patterns. Jill begins to formally confide in Joe three weeks after the official start of the counseling session. During this period, she discloses private and personal issues about her sexual attraction to women with the hope of gaining important insight on how to address this new development. However, Joe is immediately dismissive and critical of her sexual disposition and immediately responds in shock. He continues to point out that he is a staunch traditional Catholic and regarded such feelings as immoral and utterly wrong. Joe halts any further discussion on this matter and concludes the session by urging Jill to avoid such thoughts and pray for forgiveness. Another questionable pattern of behavior was in Joe’s attempt to recommend a new therapy technique referred to as “re-birthing”after reading about it from a magazine article.
Joe would later proceed to elaborate that the “re-birth” technique is a form of hypnosis capable of transforming a patient’s worldview and any inherent biases regarding its safety and applicability while ultimately improving their interpersonal and familial relationship. Jill is skeptical about this suggestion and declines the counselor’s request for integrating the counseling session with the re-birthing technique. Nevertheless, Joe still contemplates applying this technique and hatches a scheme to secretly hypnotize his client as he rationalized that this would be in the client’s best interest. Jill later reveals that she was starting to feel physically attracted to Joe and suggested that they get closer and start an intimate relationship. Surprisingly, Joe was also attracted to Jill and openly discussed his attraction to her but states that it is unethical for him as a general counselor to engage in intimate relationships with his clients outside a clinical setting. Joe soon terminates the counseling sessions and promises to subsequently refer her to another counselor as he believed that counseling sessions held under such circumstances would ultimately prove to be inefficient. He later engages in a month-long passionate relation with Jill; full of unbridled romance and an intimate sexual relationships. Joe then ends the relationship after feeling guilty and aware of the unethical nature of this particular arrangement while also failing to Jill to a new general counselor. While discreetly checking up Jill at her workplace, Joe is promptly informed that Jill had since quit her job and was being treated for severe depression at a local county hospital.
The Counselor ACA Code of Ethics Violations
The American Counseling Association (ACA) Code of Ethics sets an obligatory standard for all members to adhere to when providing guidance in an individual capacity as a professional counselor. It also identifies some of the most crucial ethical considerations typically relevant to professional counselors with the express aim of introducing a degree of clarity and perspective to all relevant parties. The ACA Code of Ethics, therefore, plays the critical role of ensuring that members are fully aware of their ethical responsibilities and obligations to their clients at all times (Kocet, 2016). Moreover, the code serves as an extension of the commission’s role to science and education as it attempts to guarantee the broad inclusion of ethics in counseling. In the above-mentioned case scenario, Joe was expected to maintain a professional relationship with his patient as per ACA standards given that it has typically resulted in a wide range of potential benefits for both parties. General counselors who follow this specification to the letter typically enjoy success while providing the aforementioned services to a diverse client base. Patients are, eventually, able to tune in to the guidance provided, which ultimately improves their outcome while allowing them to achieve set mental health and wellness goals. Nevertheless, it is worth noting that Joe failed to achieve the treatment goals set for Jill mainly due to the fact that his pattern of behavior was in clear violation of the ACA Code of Ethics. He seems quite unaware of its provisions and some of the main stipulations embodying its application given that he contiguously flouted a sizable cross-section of universally agreed ethical standards.
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Joe begins his counseling session by dismissing Jill and seemingly displaying a degree of hostility and criticism when the client reveals personal information about her sexual orientation. He makes it immediately clear to the client that he is not quite ready to listen to her talking about her attraction to women. Joe claims to be a staunch Catholic and continues to claim that same-sex relationship go against his religion, and he would actually appreciate if she did not bring it up again. He then proceeds to admonish her and implores her to pray so as to keep such thoughts out of her mind. This goes against the professional responsibility clause given that one of his obligations is to serve patients regardless of their personal views towards or their stand on various pertinent issues. Joe’s violation of this clause is further evident in his decision to fail to follow standard counseling procedures by suggesting that the patient consider hypnosis in the form of “re-birthing” as a potential therapeutic option. This type of treatment is not approved for use in the United States by the ACA, yet Joe proceeds to recommend it to the patient and even goes as far as using it secretly on the patient during treatment. Moreover, Joe is also in clear violation of his professional relationship as a general counselor by blurring the line between their relationship. He opens up to Jill about his feelings towards her and even proceeds to initiate an intimate relationship. This may have prevented Jill from fully participating in treatment and may be among one of the main reasons why she quit her job eventually and was hospitalized for severe depression.
APA and ACA Ethical Codes
Both APA and ACA Ethical Codes share some key similarities given that they are both designed to promote the integration of ethical standards within a clinical setting. Both codes underscore the importance of maintaining confidentially as a core tenet of ethical behavior among counselors. Confidentially fosters trust between both parties, especially given that patients can now consider the counselor as an individual capable of protecting their personal information while also being open about any limits from the onset. Additionally, both codes are committed to improving the integration of professional knowledge into the healthcare environment through Evidence-Based Practice (EBP) and scientific research (Scrivner, 2019). Each of the above codes are also particular about the importance of consent within a clinical setting; especially before suggesting a potential treatment option. Both codes are also similar in the manner in which they advise and direct the termination of services previously offered to a client (Harris, 2021). They specify that the resident counselor would only be required to terminate the services in the event that the client no longer requires the service or in a scenario where the existing evidence proves that they are not benefiting from the current treatment module.
Distinct differences are also present in the use and application of APA and ACA Ethical Codes. These differences are mainly in relation to the therapeutic relationship shared by both parties in the treatment dynamic and in client protection. For instance, ACA is definitive in its description of its prohibitions with regard to the therapeutic relationship and with the primary aim of guaranteeing patient safety and well-being (Jones, 2016). On the other hand, APA only provides a general overview of this relationship and only seems to focus on a principle-driven approach. This is further expressed by a limited focus on the possibility of multiple relationships emerging during routine counseling sessions and an overall failure to set and identify any emerging boundary changes. Additionally, the ethical code provided by ACA offers a guideline that is more detailed while APA only focuses on providing a general outlook on ethical behavior within a clinical environment and ultimately fails to explore fundamental issues associated with the therapeutic relationship.
The Alaine Congress ETHIC Decision-Making Model
Based on the information provided within this case scenario, Joe’s ethical dilemma would have been averted if he had applied the Alaine Congress ETHIC Decision-Making Model. This model is systematic and chooses to always prioritize the patient’s needs and requirements while also expecting psychologists and counselors to strictly adhere to professional values. It stresses the importance of observing relevant laws and standards when dealing with patients in addition to also hypothesizing about relevant consequences associated with non-compliance (Logan, 2013). This model requires healthcare professionals to only proceed with patient’s scheduled treatment after a thorough review of relevant professional and personal values. Besides, counselors are also expected to update their personal knowledge of existing code of ethics to ensure their practice falls squarely under acceptable care parameters. Thy should also strive to always identify the potential benefits of approved therapeutic options and consult relevant colleagues or supervisors when faced with an ethical dilemma.