Ethical Vignette Paper 1
Benchmark Ethical Vignette Paper Assignment
Kati Bland
School of Behavioral Sciences, Liberty University
Ethical Vignette Paper 2
Abstract
Counseling is known for upholding the ACA code of ethics, which was designed to
protect the client from all forms of harm and maintain proper boundaries within the client-
counselor relationship. Sadly, there are many unique ethical dilemmas which require difficult
judgement calls from the counselor’s perspective. Most importantly, the responsibility to sustain
client confidentiality and privacy is one that cannot be overlooked by the counselor. This paper
reviews a scenario, in which a receptionist must decide on whether to protect the client’s privacy
or break protocol. Furthermore, the utilization of the ethical decision-making model will be
discussed, as well as the ACA code of ethics. Both state and federal laws/regulations for
counseling are referenced to enlighten the decision-making process during the ascension of
ethical dilemmas. To conclude, there will be a conversation about various debatable responses to
the following ethical scenario.
Keywords:
Ethical Vignette Paper 3
Introduction
Ethical dilemmas can be stressful and difficult to manage when they arise. Oftentimes,
these stumbling blocks occur when least expected and require guidance from the ACA code of
ethics and the help of trusted colleagues. There will be circumstances in which the line between
violating ethical boundaries and state/federal laws is blurred. The following paper addresses a
unique scenario, whereby, the ethical principle of protecting client confidentiality and privacy
will need to be reviewed in the case of the receptionist and the client’s family member.
Identify The Problem
In the following scenario, John, the husband of a current client receiving counseling
services, stopped by to ask the receptionist of that counseling office to pass along a message to
his wife, Amy. The receptionist responded agreeing that she would in fact pass along the message
to Amy. Once Amy’s counseling session was finished, the receptionist passed along the message.
Amy was upset that her husband was aware that she was receiving counseling. According to
Amy, she and her husband are in the middle of a divorce. Amy is under the impression that her
husband is pursuing charges that will deem Amy to be mentally unfit to raise her children. The
most apparent problem is that the receptionist agreed to pass along the husband’s message.
Although the receptionist did not verbally state that Amy was a client receiving counseling
services at that location, her willingness to pass along the message suggests that the husband’s
belief that Amy is undergoing counseling services was accurate. The following scenario is
perceived to be both ethically and potentially legally violating.
Apply The ACA Code of Ethics
Moreover, the privacy of the client has been violated and the ACA Code of Ethics section
B.1.d., which states “counselors must always protect the confidentiality of the client unless the
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client has provided consent or there are legal or ethical justifications (ACA Code of Ethics,
2014).” This ethical code requires that anyone not specified as being deemed the right to the
client’s information cannot receive such. The receptionist may not have intentionally given the
husband information that Amy was at the office; however, the counseling organization has a duty
to ensure that the client’s attendance is not shared with others. Another debatable ethical
violation is that of section B.2.e., which states, “when circumstances require confidential
information, the client must be part of the decision-making process before any information is
revealed, and the information must be deemed necessary (ACA Code of Ethics, 2014).” Amy did
not agree to have her husband aware of the mental health services she was receiving.
Furthermore, one can debate whether the release of such information is harmful to the client. The
reasoning behind the perceived harm is derived from Amy’s initial comment about her husband
pursuing charges that will ultimately regard her as unfit to raise and care for her children.
According to the Practitioner’s Guide to Ethical Decision-Making, one of the five foundational
principles to ethical decision-making is to practice nonmaleficence, which affirms that practicing
counselors act in a manner that does not bring harm to the client in any manner (Ethical
Decision-Making Model for Counselors, 2019). Unfortunately, the husband’s cognizance of
Amy’s counseling services may solidify his decision to pursue an investigation into her mental
stability. This result could lead to detrimental outcomes such as grounds for gaining custody over
Amy and John’s children.
Applicable State Codes/Laws and Federal Mental Health Laws
In addition to violating ethical guidelines, the following scenario may be perceived as
breaching legal requirements set by the Virginia Board of Counseling. According to § 32.1-
127.1:03 of the Code of Virginia, privacy of all mental health records is required to remain
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confidential (Code of Virginia, 2021). If a counselor releases information acknowledging that the
client is receiving mental health services and the client is somehow harmed as a result, then legal
action such as suing the counselor for emotional damages can deem the counselor liable.
Furthermore, federal laws instated by the Health Insurance Portability and Accountability Act
(HIPPA) state that patient consent and access to client information such as mental health records
are prohibited ( What takes precedence: HIPAA or state law?, n.d.). Moreover, counselors have a
duty to maintain confidentiality and privacy of clients on both a state and federal level.
Determine The Nature and Dimensions of The Dilemma
The ACA moral principle of nonmaleficence most closely applies to the scenario. There
will be many situations in which counselors must make quick judgement calls utilizing the facts
and all the skills and training that have equipped them. Furthermore, this scenario required the
receptionist to reflect on her duty to the client and determine the right course of action in only a
matter of seconds. Unfortunately, the receptionists’ choice of words may not have been the best
method for upholding Amy’s right to privacy. As a result, the client’s husband has the potential to
wield Amy’s use of counseling services as a weapon for obtaining child custody. In contrast,
some circumstances require breaking confidentiality for the sake of safety. According to one
article, action must be taken when the client is endangering themselves or others (Darby &
Weinstock, 2018). Fortunately, neither Amy nor her husband John were acting in physical
threats. However, as we settle further into the scenario regarding the receptionist’s failure to
create confidential boundaries with John, one can argue that the receptionist has not broken any
ethical codes of nonmaleficence. According to one article, maintaining confidentiality is entails
withholding verbal and written information about the client (Protecting Your Privacy:
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Understanding Confidentiality, 2022). The receptionist did not confirm to John that his wife,
Amy, was receiving counseling.
After consulting with multiple professionals in the field, I can confidently say that
Danielle Shigley, LPC, and Nicole Taylor, LPC, abide by the code of ethics by maintaining client
privacy and practicing confidential record keeping. Two organizations that I would like to join
include the American Counseling Organization and the Virginia Counselors Association. I
believe that these organizations can help inform me on my ethical dilemmas from both a federal
and state perspective.
Generate The Potential Course of Action
My first plan of action to combat an ethical dilemma such as the one in the scenario
would be to explain to the husband that his message can not be delivered and suggest that he call
or message his wife. My judgement of the situation stems from wanting to protect the client’s
privacy, not making the husband aware that I know his wife is receiving counseling and wanting
to stray from being dishonest. Confidentiality is possible to sustain while also maintaining an
integrity of honest behavior (Ethical Decision-Making Model for Counselors, 2019). Another
course of action would be to address the husband by letting him know that I cannot deliver the
message for privacy purposes. I believe that by agreeing to deliver the message is shifting the
counselor-client relationship to include a third-party, which can lead to consequences that
damage the relationship. The client-counselor relationship is important because of the trusting
connection that is built from establishing loyalty and fulfillment of promises (Ethical Decision-
Making Model for Counselors, 2019). My final course of action would be to apologize to the
husband, let him know that I cannot deliver the message and provide no further explanation. This
option is not the most ideal; however, for the sake of my client’s privacy, I have a duty to uphold
Ethical Vignette Paper 7
boundaries. The client’s privacy should always be placed as a priority when consulting the
client’s family members (Protecting Your Privacy: Understanding confidentiality, 2022).
Moreover, the following plans of action are ultimately left in the hands of the counselor’s best
judgement.
Conclusion
Counselors face many ethical dilemmas which may not be satisfied with a single, black
and white answer. More often, counselors will be using an approach far greyer than anything. In
the case of the receptionist and the client’s husband. One can argue that the receptionist could
have denied delivering the husbands’ message and been more cognizant about maintaining
privacy. On the other hand, the receptionist’s response could be perceived as being the best
possible option for upholding the ethical code. After contemplating alternative courses of action,
I have come to the realization that there will be circumstances where I will need to utilize my
best judgement in order to protect my client’s right to privacy.
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References
American Counseling Association (ACA). (2014). ACA Code of Ethics.
https://www.counseling.org/resources/aca-code-of-ethics.pdf
AMERICAN COUNSELING ASSOCIATION. (2019). Ethical Decision-Making Model for
Counselors. Counseling.org. https://www.counseling.org/knowledge-
center/ethics/ethical-decision-making
American psychological association. (2022). Protecting your privacy: Understanding
confidentiality. Apa.org. https://www.apa.org/topics/psychotherapy/confidentiality
Commonwealth of Virginia REGULATIONS GOVERNING THE PRACTICE OF
PROFESSIONAL COUNSELING VIRGINIA BOARD OF COUNSELING Title of
Regulations: 18 VAC 115-20-10 et seq. Statutory Authority: § § 54.1-2400 and Chapter
35 of Title 54.1 of the Code of Virginia. (2021).
https://www.dhp.virginia.gov/media/dhpweb/docs/counseling/leg/LPC.pdf
Darby, W. C., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent and
Psychotherapy. Focus (American Psychiatric Publishing), 16(4), 395–401.
https://doi.org/10.1176/appi.focus.20180020
What takes precedence: HIPAA or state law? (n.d.). Https://Www.apa.org.
https://www.apa.org/monitor/jan03/hipaa
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