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Identify the Problem
The receptionist violated the ACA code of ethics (2014) confidentiality by releasing the
client’s identity. She also violated the client’s right to privacy through unauthorized disclosure.
Even though she never directly stated the name of the client, because of the husband’s coy
verbiage, the counselor was under the impression that she was able to confirm the wife’s
location. Unfortunately, she was mistaken. The receptionist should have consulted records to see
to whom she may release information. At my current employer, I was informed that “I cannot
confirm or deny” when asked about the status of the client. Unless there is a release of
information signed in the client’s file, there is to be no information disclosed or exchanged. The
receptionist thought she was being helpful by relaying the information to the husband, but she
was mistaken in her assumption, as seen clearly on the lady’s face when she received the news of
the recent discourse. Therefore, this is an ethical problem and could become a matter of law. The
ethical problem is client confidentiality and privacy. The receptionist revealed the client’s
identity by confirming her appointment. Even though the “helpful receptionist” did not state her
name, the woman’s identity and involvement with counseling at this establishment were
revealed. This could become legal if the client files a grievance against the facility and/or the
counselor. It could get even uglier if the husband uses this information against said client in their
pending divorce.
Apply the ACA Code of Ethics
B.1.c in the ACA Code of Ethics (2014) directly relates to the respect of confidentiality
as well as the information that can only be released with appropriate consent or via ethical/legal
justification. Even section B.4.b “Couples and Family Counseling” of the ACA Code of Ethics
(2014) speaks to the role of the “client” and states there must be an agreement and a document in
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writing with the involved parties that states the agreed-upon parameters. The trust of the client
was shattered, as seen on her face in the video. She was shocked and taken aback that the
receptionist would confirm she was at the counseling center and now her soon-to-be ex-
husband’s suspicions were confirmed. Now the receptionist has also violated A.1.a (ACA Code
of Ethics, 2014) client welfare as the primary responsibility. As a result, the counselor who is
responsible for knowing and understanding the law and the code of ethics must attempt an
informal resolution as listed under (ACA Code of Ethics, 2014) I.2 Suspected Violations or
directly report the ethical violation as referenced in section I.2.b. in the Code (2014) “Reporting
Ethical Violations”. I.3 “The Cooperation with Ethics Committee” in the Code of Ethics (2014)
also states that the counselor will cooperate and assist in enforcing the code of ethics and will
comply with the proceedings and requirements of the investigation.
Applicable State Codes/Laws and Federal Mental Health Laws
Tennessee Code Title 33, Mental Health, and Substance Abuse and Intellectual and
Developmental Disabilities (2021) states that the department must develop and maintain a
system to guarantee the most appropriate services for service recipients. TN Code Title 33 also
states that adults with mental health needs may express preferences and instructions concerning
their participation in mental health treatment. The client may also provide consent or refusal of
those mental health services as well as any other instructions or information the client wishes to
provide to the service providers. In this case with the receptionist, the obvious is that there would
be a definitive electronic record or paper statement in the client's file that would clearly explain
her wishes. Not to mention the above ethical violations already revealed.
Determine the Nature and Dimensions of the Dilemma
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To clarify the issues of the situation and the presented problem, we turn to the
foundations of ethical reasoning: autonomy, justice, beneficence, nonmaleficence, and fidelity.
The American Counseling Association, the center for counseling practice, policy, and research
understands that practitioners in the counseling field are often faced with the need to make sound
decisions where ethics are involved. Therefore, they have developed these underpinnings to help
the profession. These cornerstones serve as the foundational guidelines and are vital to healthy
counseling relationships. Upon reflection, I feel this situation falls into nonmaleficence. This
cornerstone addresses both not inflicting intentional harm but furthermore also addresses “not
engaging in actions that risk harming others” according to ACA Center for Counseling Practice,
Policy, and Research (2014). Even though the counselor did not inflict any harm, it is their
responsibility to act accordingly with the receptionist since the client has encountered both a
legal and ethical injustice in which a critical concept of “cause no harm” has been breached.
According to research by Burns (2020), ethical boundary crossing has risen over recent years and
these complaints account for almost half of liability claims in the years 2013-2017. Burns (2020)
finds that even when using the code of ethics as a model for ethical decision-making, both
students and counselors were not impacted when it came time to cross boundaries.
Generate Potential course of Action
Counselors must act responsibly in matters such as these and ensure that confidentiality is
protected. Federal and state laws are specific in these scenarios and applicable ethical standards
will apply as well as federal and state regulations. Since the breach has occurred the counselor
may be liable. The Code of Ethics (2014) addresses confidentiality and privacy specifically. The
counselor must investigate and gather evidence from the receptionist and the client. The
counselor must notify the client in writing of the breach of confidence and determine the
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damages. If it is not appropriate to resolve these issues informally between the client and the
counselor, legal action may follow. However, to rebuild the relationship, if possible, the
counselor must connect with the client as this is essential to the relationship. As an aspiring
counselor, I know the importance of the therapeutic relationship and would hope this
circumstance would have a firm foundation beforehand. The desire to understand, including
active listening, would be needed to understand her perspective. Counselors must remain
professional, and this case is no exception. If this informal approach does not meet client
standards as learned from client feedback, changes will need to be made. As the Code of Ethics
reveals, the counselor may have to report this situation. However, if an informal meeting with the
parties involved can be resolved in-house, then it is important that the client and counselor work
on rebuilding that trust and further strengthening their alliance.
Perhaps this will work together for the good of all involved. Perhaps the husband will not
be malicious. Perhaps the client will be understanding of the receptionist's helpful demeanor that
resulted in the accidental yet ethical violation. I will consult with my Clinical Supervisor
Caroline Scantland and my Director, Anastasia Schinbeckler with Health Connect America. I
will also consult with TLPA, the Tennessee Licensed Professional Counselors Association, and
Tennessee American Mental Health Counselors for further insight regarding the resolution of
this matter. “The ethics codes, more than any other definitional component of a profession,
define and contextualize this relationship for the helping professions, Burkholder, D., &
Burkholder, J. (2014). Hopefully. Not all is lost with this client and with time, progressive
reform will prevail.
In conclusion, the counselor must now correct the wrong to the best of her ability. The
client must be willing to rebuild trust. The counselor must speak to the receptionist, and she
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should apologize to the client for her mistake. We are all human and make mistakes, but this
ethical mistake could become a legal mistake for the counselor and receptionist. Client-counselor
confidentiality is ethically mandatory. This event is very unfortunate for all involved.
References
American Counseling Association. (2014). 2014 ACA code of ethics. Retrieved from
https://www.counseling.org/docs/default-source/ethics/2014-code-of-
ethics.pdf?sfvrsn=2d58522c_4
Forester-Miller, H., & Davis, T. E. (2016). Practitioner’s guide to ethical decision making (Rev.
ed.). Retrieved from http://www.counseling.org/docs/default-source/ethics/practioner’s-
guide-to ethical-decision-making.pdf
StephanieGBurnsG|GJody S.GPiroG(Reviewing editor)G(2020)GImpact of ethical information resources
on counselor education students,GCogent
Education,G7:1,GDOI:G10.1080/2331186X.2020.1757182
Burkholder, D., & Burkholder, J. (2014). Reasons for Ethical Misconduct of Counseling
