A counseling intern at a community agency has six new clients assigned to her caseload.
Per her supervisor’s instruction, the student schedules to see the clients one time a
week for 55 minutes. The student also works a full-time job, taking two additional
courses and is a single mother of two children under the age of five. In the first two
months, the student cancelled around 30% of her client’s appointments due to other
obligations and a general sense of being overwhelmed.
Selected
Answer: The professional values violated are fidelity and veracity.
She overwhelmed herself with many commitments and left some obligations
unfulfilled. She did not honor her commitments which will affect the trust and
the therapeutic relationship with her clients. Furthermore, it will affect herself
and her children below the age of five.
Response
Feedback:
Fidelity is the professional value violated.+
Fidelity – the student has not followed through with her promise to see clients
as scheduled
Question 2
9 out of 10 points
A counselor at a community mental health center has been seeing a client for 4
months. The client initially presented with substance abuse concerns but has not
been complying with treatment goals for reducing substance abuse. The counselor’s
supervisor suggests to the counselor that the client needs enter a structured
treatment program. At the client’s next appointment, the counselor tells the client
that arrangements for the client to participate in the agency’s intensive outpatient
program have been made for “her own good.” The client is upset and states she does
not want to be in the program. The counselor tells the client, “Too bad, you’re already
enrolled.”
Selected
Answer: The professional values violated are autonomy, fidelity, and veracity.
The counselor is doubting the client’s ability to make rational decisions while
following the suggestion of his supervisor. However, he should have explained
the process to the client before enrolling him instead of shaking the client’s
faith in the therapeutic relationship.
Response
Feedback:
Autonomy is the professional value that is violated.+
Autonomy – the counselor is attempting to force the client to do something she does
not want to do
Question 3
9 out of 10 points
An experienced career counselor works for a community agency that covers a broad
range of services to clients. Two clients come in to the see the counselor. The first
client is a respected member of the community and is a department head in the local
government. The second client is a part time employee at a factory who has had
several arrests and is well known in the community for being intoxicated in public.
The counselor recommends a full career assessment for the first client, believing the
client will take full advantage of the new information in making a career choice. The
counselor encourages the second client to focus on substance abuse treatment
instead of career services, even though the client came in specifically to address
career concerns.
Selected
Answer: The professional value violated is autonomy. However, justice was supported.
Justice is “treating unequals unequally but in proportion to their relevant
Response
Feedback
:
Both justice and autonomy are violated.
Justice – the counselor has no documented reason to treat the two client’s
differently
Autonomy – the counselor does not give the second client full information
so the client can make an informed choice based on his own goals
Question 4
8.5 out of 10 points
A counselor works at a rural community mental health clinic.+ A client diagnosed with
borderline personality disorder requests specialized treatment to help her learn how
to regulate her emotions.+ The counselor agrees to start a four-month training
program in this specific treatment and informs the client and her supervisor.+ Six
weeks into treatment the client reports feeling better because of the sessions.+ The
counselor is not enjoying the specialized training, does not see the need in the
specialized interventions and believes the eight hours a month should be spent on
activities that are more important.+ Since the client is reporting improvement, the
counselor discontinues the training without telling anyone.
Selected
Answer: The professional values violated are autonomy, fidelity, and veracity.
Because the counselor works jointly with the client, he should have respected
the client’s freedom of choice and honored the prearranged plan. He could
have reviewed and revised the counseling plan after the four months.
Response
Feedback:
Professional values violated are fidelity and veracity for the following
reasons.
Fidelity – not following through with her word in completing a training
program
Veracity - is not being truthful with the client about stopping
the+ongoing+training
Question 5
9.5 out of 10 points
A counselor completes an assessment with a 17 year old who was brought in by her
mother.+ At the start of the assessment, the counselor explains confidentiality to the
client and discusses the role the client wants her mother to play in the counseling.+
The counselor discusses informed consent, reasons she would breach confidentially
and her general rights as a client.+ She then lets the client know that as counseling
progresses they will revisit these topics, including the role she wishes her mother to
have in counseling.+ The last 10 minutes of the assessment, with the client’s
permission, the counselor invites the mother into the session and reviews the same
information with the mother, setting clear boundaries and letting the mother know
what kind of information she can expect to be shared with her.
Selected
Answer: The professional values supported are autonomy, fidelity, and veracity.
The counselor acted professionally, protected the confidential information, and
informed the mother about the nature of the counseling relationship. Moreover,
he respected the right of the mother regarding the client’s welfare. However, he
helped the client to have faith in the therapeutic relationship.
Response
Feedback
:
Autonomy and veracity were supported in this vignette.
Autonomy - gives client+information+about her rights to make choices for
herself that best meet her goals+
Veracity – being transparent and truthful with both client and guardian
Question 6
9.5 out of 10 points
A counselor at a community agency decides to start a group for women recovering
from sexual abuse. On the first group meeting, the counselor hands out the informed
consent form for each participant to sign. The consent form reviews the possible
benefits to participating in the group but leave out the possible risks of participating
in group. The counselor reviewing risks will cause the members feel anxious or
frightened and drop out of group before they experience the benefits.+ She plans to
review the risks on the third session.
Selected
Answer: The professional values violated are autonomy, fidelity, and veracity.
The counselor should not hide information from his/her clients. The counselor
should ask the clients to sign both the possible benefits and risks of
participating. The counselor should give his/her clients the freedom of choice
because the growth occurs jointly.
Response
Feedback
:
Veracity and autonomy were violated for the following reasons.
Veracity – the counselor was not completely truthful with informed consent
and the possible risks
Autonomy – the counselor did not give enough
information for the clients to make an informed choice that aligns with
their goals and desire
Question 7
9.5 out of 10 points
Two clients have been referred to a counselor who only has one available spot.+ The
counselor looks over the referral information and decides to take the client with
insurance that is known for paying without detailed documentation.+ The second client
is informed that the counselor will have an opening in four weeks and an appointment
is scheduled.+
Selected
Answer: The professional values violated are justice and veracity.
In this case the counselor has chosen his own benefit and(treated the client
differently and untruthfully without basis on his/her referral information,
assessment results or the(welfare of the client. The counselor should
create detailed documentation for both clients.
Response
Feedback:
Justice is violated in this vignette.
Justice – the counselor has no justifiable reason to be treating the two clients so
differently
Question 8
8.5 out of 10 points
A client initially comes into counseling worried that she might be bipolar like her
mother. The client has she has stated several times that, “If I am bipolar, I would kill
myself!” The client agrees to complete a battery of assessments to diagnose bipolar
disorder. The client meets the criteria for bipolar. The counselor decides to keep the
result from the client. Four weeks later, the client requests to see the results of her
assessment. The counselor refuses to release them telling the client that the results
were not conclusive.
Selected
Answer: The professional values violated are autonomy and veracity.
The counselor did not disclose the results to protect the client. He weighed the
risks for harm and considered that the client might make an irrational decision.
Moreover, he contributed to the welfare of the client and acted professionally.
Response
Feedback
:
The counselor violated both autonomy and veracity.+ The counselor should
have assessed the client before giving the assessment to determine her
risk of self-harm. If she was suicidal the counselor should not have
continued to give her the assessment for bipolar.
Autonomy - restricts+information+therefor+restricting her ability to make a
personal choice+
Veracity – the counselor is not being truthful with the client about the
assessment results
Question 9
9.5 out of 10 points
A college student comes in with an eating disorder. None of the staff has expertise in
working with eating disorders and the client is assigned to a counselor who has
experience working with college students. The counselor is aware that she lacks the
knowledge and skills to work effectively with the client so she seeks consultation and
supervision from a private practitioner who specializes in eating disorders. She
informs the client of her lack of experience and her participation in supervisor and
intention to engage in additional training. She then shares other professionals in the
community that specialize in eating disorders.
Selected
Answer: The professional value supported is veracity.
The counselor was professional and truthful because she did not practice in a
new area of specialty without appropriate education, training, and supervised
experience. Since she lacks the competence to give help, she avoided entering
the counseling relationship. Furthermore, she suggested the referral.
Response
Feedback
:
Veracity and autonomy are supported.+
Veracity – being truthful with the client about the lack of training
Autonomy –+telling the client about the lack of training and giving her
the+choice+to go somewhere else
Question 10
9.5 out of 10 points
A marriage counselor has been working with a couple for the past six months. The
couple started counseling to decide whether they wanted to continue in the marriage
or divorce. The counselor believes that marriage should be for life. He has helped the
couple see the roots of their unhappiness in the marriage as well as the benefits and
consequences of remaining married or divorcing. One day the couple walks in and
tells the counselor they have decided to move forward with a divorce. The counselor
states that their reasons do not justify a divorce and he will no longer see them even
though they have requested to see him separately to work through the divorce.
Selected
Answer: The professional values violated are autonomy and veracity.
The counselor should have respected the values that are different from his own
and avoided imposing his own personal values on the clients. Furthermore, he
should have given them the freedom of choice and courses of action while
acting in a professional manner.
Response
Feedback
:
Autonomy and fidelity were violated.
Autonomy – the counselor is not allowing the couple to make a choice they
desire, continuing separately
Fidelity+– the+counselor agreed to work with the couple, to stop based
on+their+decisions+to divorce is not keeping his promise
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