ETHICAL VIGNETTE PAPER
Abstract
Protecting clients’ information is essential to their safety and comfort. It not only protects them,
but it also protects me as a service provider. Someone walks into an office and asks the
receptionist to leave a note for his wife regarding picking up their children. The receptionist
agreed to do so. When the client came out of her session, the receptionist gave her the message,
and the client stated that she is in the middle of a divorce and her soon-to-be ex-husband will
likely use her seeing a counselor to say that she is mentally unstable and incapable of providing
care for their children. She was worried. What the receptionist did by providing that seemingly
small piece of information violates the client’s ethical rights. If reported, the counselor could be
reprimanded. This work focuses on what moral rights were violated and what I would do if I
were the counselor whose receptionist violated a client’s ethical rights.
Keywords: ethical violations, counselors, HIPAA, Texas State Codes, ACA moral Principles,
ACA Code of Ethics.
ETHICAL VIGNETTE PAPER
Ethical Vignette Paper
Introduction
The ACA Code of Ethics (2014) was implemented to protect clients and counselors and
help guide them in their profession. At some point, all counselors will be put in a position where
they must refer back to the ACA Code of Ethics (2014) for reassurance that they have not
violated any ethical rules. Everyone in the office should know ethical standards, what they mean,
and how to follow them, even receptionists. Working in the front office, the receptionist sees
who is coming into the office for visits on that day, they will help clients schedule appointments,
and greet them when they come in. The client is not obligated to discuss with the receptionist
what is happening in their lives or what is being discussed in counseling sessions. In the video
about ‘The Helpful Receptionist,’ the receptionist made a potentially damaging mistake. The clip
started with the receptionist speaking with a client’s husband. He wanted to be sure that he had
the right office. The receptionist did not cause any harm by confirming the name of the office;
however, once she acknowledged that his wife was in a session there, she broke a necessary
ethical code. She also compromised multiple foundational principles. The receptionist failed to
protect the client’s privacy, which could lead to a dangerous situation for her and could get the
counselor in trouble with her state counseling board. The receptionist thought that she was
helping by agreeing to pass information to a client in a session, yet, that piece of information that
she thought was inconsequential could be dangerous and cause harm to the client and her well-
being.
Identifying The Problem
In the video, I watched the receptionist talking to what appeared to be the client’s
husband. He wanted to give information about a change of plans and needed the receptionist to
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relay a message. The receptionist did not wholly say that his wife was being seen there, but she
did not protect the client’s confidentiality because she agreed to give her a message confirming
that she was a client. This is an ethical and professional issue. The ACA Code of Ethics (2014)
speaks about respecting clients' confidentiality, and we should only disclose information when
necessary. In this situation, it was not obligatory for her husband to know she was a client at that
office. Releasing that information puts the counselor at risk of being reported to the board of
ethics. But most importantly, that little information could cause the client emotional, physical,
and mental harm. The
Apply the ACA Code of Ethics
I noticed four applicable standards from the 2014 ACA Code of Ethics when processing
the situation. According to ethical code A.1.a, the receptionist failed to protect the client’s
welfare. Ethical code A.1.a states that counselors are responsible for respecting and promoting
the clients' welfare (2014, Section A.1.a.). The scenario in the video could easily happen. Still,
the repercussions of not respecting the client’s welfare could have led to a dangerous situation
for that particular client, other clients, and the staff working there. It was a complete disregard
for the well-being of everyone in the building. The second code is American Counseling
Association Code B.1.b and B.1.c. (2014, Section B.1.b and B.1.c.). Both of those codes are
about respect for privacy and confidentiality. As previously stated, disclosing that information to
a ‘stranger’ was extremely careless. I am referring to the husband as a stranger because he first
said he wanted to ensure he had the right place. Someone who had been there would not say that.
Counselors must always respect the privacy of their clients. The only time that information
should be distributed is with appropriate consent or if there is a justification. In this situation, the
receptionist not saying anything; she said a great deal and then agreed to pass the information on,
ETHICAL VIGNETTE PAPER
acknowledging that the client was present. The last code that is applicable is C.6.b. This code is
about reporting to third parties (2014, Section C.6.b.). The code refers to counselors being
objective in reporting to a list of third parties, but at the end, it states the word ‘other.’ I also read
anyone not listed previously when I read the word other. He may be her legal husband, but when
she came out of her session, she explained why she did not want that information disclosed to
him. As someone with a background in Criminal Justice and who has worked for the Department
of Children and Family Services, watching the receptionist give that information out and seeing
the client’s reaction was deplorable. I can understand the mistake, but it should not have
happened. The ACA Code of Ethics (2014) also says that counselors are responsible for those
who work for them. This would mean the counselor could be held responsible for what this
receptionist did.
Applicable State Code/Laws and Federal Mental Health Laws
In Texas, the Texas Administrative Code from chapter 681 Rule 681.45 says that a
licensee should not disclose any client information except what is necessary. This means that the
data needs to be highly protected unless the information is imperative to treatment, payment, or
the safety of the client or others. This applies to everyone working in the office. This applies to
this scenario because providing that information was unnecessary, and the receptionist did not
have consent. Protecting clients’ data will always ensure them of the professionalism and
integrity of the counselor and the practice. HIPAA is the federal law regarding the Health
Insurance Portability Act of 1996, and sharing protected information with the family members of
a client or patient is prohibited without consent unless it is beneficial to their wellbeing.
Determine the Nature and Dimensions of the Dilemma
The receptionist broke this situation's autonomy, beneficence, and nonmaleficence
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principle. The receptionist did not have respect for the client’s freedom to choose. If she wanted
her husband to know that she was seeing a counselor, she would have told him. The receptionist
is also causing harm to the client by not protecting her confidentiality. Thus, the moral principle
of nonmaleficence applies to this scenario. The office must ensure that clients are safe and
protected as service providers. Releasing that information went against the beneficence principle
because this could show the client that she cannot trust her counselor. The most crucial principle
is beneficence. She is not concerned with the client's welfare by agreeing to pass on information
to the client and acknowledging that she is being seen there. The client believes that her husband
will use this against her, which could cause the client to stop receiving services she may need.
Two counselors I am confident abide by the ACA Code of Ethics are Dr. Deena Bohn,
PsyD of Oakdale, Minnesota. She was my counselor for many years throughout various life
changes and stages. She was very open and upfront regarding things I would ask or confide in
her during our sessions. I also watched her lock and unlock her files at the beginning and end of
every session, so my medical records were safe. Another counselor I am sure who abides by the
ACA Code of Ethics is Essica Pullam of As I am Counseling LLC in Arlington, Texas. She is
very professional and upfront with how she provides services. If I need to consult someone
regarding the Code of Ethics, I would be comfortable contacting Dr. Bohn or Essica Pullam for
assistance. I would also get the Code of Ethics Hotline for a consultation or the legal team for the
practice I work with. The Code of Ethics Hotline is affiliated with the American Counseling
Association. They have a Professional Standards Department that counselors can contact to ask
questions regarding ethical codes. I could also get the Texas Counseling Association. You can
fill out a form on their website or call them.
Generate Potential Course of Action
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If this happens to me while practicing, I would first contact my client to see if she is safe.
I think it’s essential to maintain an open line of communication and show my clients that I care
about them. I would then reach out to Essica Pullam and ask for advice. I would then ensure that
everyone at my practice will retake the HIPAA training and reread the ACA Code of Ethics.
Another option that I would have would be to consult with the ACA Code of Ethics Hotline for
guidance. This hotline offers consultations about how to proceed when one code is violated. I
would instead tell them how to rectify the situation. I would call a staff meeting with all staff
members to discuss ethical professionalism and the importance of protecting our clients. The
final option I would attempt would be to pray for the client’s safety and guidance. I would then
find another professional counselor to supervise myself to ensure I follow the code of ethics
guidelines. By practicing under supervision or having a colleague critique my work, I can be
aware of when I am not following the code appropriately.
Conclusion
Each of us is human, just like the receptionist. In life, mistakes will happen. The best way
to prevent an error is to be vigilant about following codes, laws, and guidelines. Be sure I am
aware of possible violations within my practice and correct them immediately. I am learning why
having a good relationship with my colleagues is essential because I will need people willing to
assist me when I make mistakes. Proverbs 11:2 ESV says, when pride comes, then comes
disgrace, but with the humble is wisdom. I never want to get to where I don’t need anyone. God
did not create me to live my life alone. Having those I can relate to is the best way to ensure I
provide the best care for those who come to me for help.
ETHICAL VIGNETTE PAPER
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