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1 Ethical Decision-Making Model in Counseling Yorkville University PSYC 6203 – Ethical Standards for Mental Health Service Providers

2 Ethical Decision-Making Model in Counseling Counselors usually experience various ethical issues requiring them to use the CCPA code of ethics to make the right decision. The CCPA has a set of ethical principles that guide counselors during their practice, especially when they face an ethical dilemma. Therapists are responsible for protecting the client and ensuring their rights are protected. Thus, violating any of the ethical or legal principles and standards of practice can attract harm to the client and even lead to lawsuits. The CCPA ethical decision-making model utilizes a principle-based approach, requiring the counselor to identify the ethical problem and relevant CCPA code of ethics that are applicable and evaluate the six ethical principles. This model can lead to a more effective way to handle ethical dilemmas and provide maximum client assistance. Step One What are the key ethical issues in this situation? The primary ethical issue in this case relates to privacy and confidentiality, respect for autonomy, and responsibility to prevent harm to the client. Tammy's habit of excessive drinking, yet she has type 1 diabetes, could harm her health. Tammy is unwilling to speak on the subject, yet this habit threatens her medical safety. While the counselor is responsible for working in the client's best interest and ascertaining their safety, they are bound by ethical guidelines such as respect for the client's autonomy and maintaining confidentiality. According to CCPA (2020), the therapeutic relationship and the information obtained must be kept confidential. There is a need for the counselor to share Tammy's drinking habit with the parents, but this will violate section B2 of the CCPA code of ethics on confidentiality, leading to an ethical dilemma. Besides, keeping this information confidential could result in adverse health outcomes for Tammy. The principle of autonomy also applies to this case, as Tammy has a right to self-determination, and

3 the counselor must respect her decision not to talk about the issue of drinking. Despite being bound by the confidentiality rule, there are exceptions, including when the disclosure is necessary to prevent imminent harm or when there is a need to protect the child. Step Two What ethical articles from the CCPA Code of Ethics are relevant to this situation? The first article relevant to this case is B2 on confidentiality. According to CCPA (2020), therapists have an ethical responsibility to respect and safeguard the client's right to confidentiality. With this regard, the counselor should not inappropriately disclose the counseling information to any third party, as this violates the right to confidentiality (Sinclair, 2020). However, in the case of Tammy, there are exceptions, including an imminent danger that must be prevented. A second applicable CCPA article is B4 on informed consent. While the therapist must share with Tammy's parents about her drinking habit, she must be informed of the purpose, risks, and benefits. It would be an ethical violation to inform Tammy's parents without first getting informed consent from her. Another CCPA article relevant to the case scenario is section B5 on children and persons with diminished capacity. Tammy is a child, requiring the counselor to conduct informed consent with persons legally entitled to do so or parents who can do it on her behalf. In all these scenarios, the therapist must act professionally and maintain the highest competence while protecting the client's welfare. Are policies, case law, statutes, regulations, bylaws, or other related articles relevant? During the therapeutic relationship, the counselor remains guided by several related articles within the CCPA. The first relates to honoring the client's self-determination, which forms part of autonomy. The CCPA section I11 requires that the therapist respect the client's autonomy and independence to make personal choices (CCPA, 2020). It is important to

4 demonstrate respect for rights, diversity, and privacy and maintain effective therapeutic boundaries throughout the session (CRPO, 2020). Concerns about confidentiality and privacy, as discussed in article B2 of CCPA, must also be considered during the therapeutic relationship. Another legislation that applies to this scenario is the Child Protection Act and Privacy Act, listed in the general responsibility (A1). Because Tammy has yet to attain majority age, the therapist should understand legislation regarding the Child Protection Act and the required responsibilities. Besides, the Privacy Act must be observed in this case, as the therapist must ensure that the client's personal information remains protected. Adherence to some of these legislations could lead to malpractice, which is more of a legal than an ethical issue. Step Three Which of the six ethical principles is of significant importance in this situation? Ethical decision-making requires one to consider all six principles. In Tammy's case, the most important and applicable principles are autonomy, nonmaleficence, and beneficence. Autonomy relates to respecting the client's rights and allowing for self-determination (Varkey, 2021). Tammy is engaged in a dangerous drinking habit that poses a great risk to her health, yet she is reluctant to talk about it. To assist the client, the therapist needs to get more information about Tammy's partying and drinking lifestyle, as this will inform the counseling approach chosen. The counselor needs to respect Tammy's decision not to talk about her alcohol-drinking habit because she is uncomfortable with the topic, and she chooses not to talk about it. The nonmaleficence principle addresses the need not to harm the client ( Clark & Virani, 2021). Even though the therapist needs to share some sensitive information about Tammy with her parents, this could negatively impact the client's emotions and cause psychological harm.

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