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Arianne Broadnax

CNS 780 EG - Crockett


Discussion 4.1- The Case of Sheila
November 5, 2015
Prompt:

Sheila came to your office about eight months ago, seeking counseling
and stating that she hoped to save her marriage. After a few sessions with
Sheila, you had suggested that couples counseling might be helpful, but her
husband, Roy, refused to participate. Three months ago, Sheila and Roy went
through a very nasty breakup of their marriage, and now you have been
subpoenaed to produce all of your records pertaining to Sheilas treatment.
Sheila has told you to comply with the subpoena, saying that she has nothing
to hide. Despite your suggestion to Sheila that it may not be in her best
interest to disclose those records, she has refused to assert the privilege.
What should you do?
1. What types of issues might be related to Sheilas decision to release
her records?
2. How might Sheila be disadvantaged by releasing her records?
3. Apply your ethical decision-making model of choice to this case and
describe the specific steps you would take in responding to the
subpoena.
1. Sheila may chose to release her records in efforts to state her case, in the
divorce proceedings due to her hopes to save her marriage, and to convey
husbands resistance to participate in counseling. Sheila also may be
confident if she is receiving legal support in order to use the information to
prepare for deposition.
2. On the other hand, Sheila may be disadvantaged by releasing her records if
she is not fully aware of the information within those records considering the
stipulations within the subpoena request for the production of all the
counselors records pertaining to treatment. Sheila may also be
disadvantaged in the uncertainties of how the information will be used
especially if the information in the records are used to undermine her
credibility. Her lack of knowledge may hinder her in this case.
3. Ethical Decision Making Model: Ethical Decision Making Model Adapted
from Welfel (2012):
Step 1: Be sensitive to the moral dimensions of counseling. Have
insight into how your own personal principles, values, and worldview
will impact your decision-making process.

Personally it would be vital to consider my limitations of insight into legal


matters. I would need to consider how my own believes/values (valuing the
sanctions of marriage) and how this could affect my decision making in terms
of how I conceptualized the case and the information submitted within
records. I value my clients rights to privacy and confidentiality and although I
am opposed to generating this information due to my concerns of the
information being detrimental to my client, she desires my compliance.
Step 2: Define dilemmas and options. What is the situation? Who is
your client? Who are the stakeholders? What are the cultural
considerations?
The dilemma is the mandate to submit information (counseling records)
although I foresee releasing this information to the courts is against my
clients best interest.
The options in this case are to respond to the subpoena and submit the
records following through or to refrain. Stakeholders include my client Sheila,
Sheilas husband Roy. Cultural considerations are difficult to explore due to
the limited amount of information regarding Sheila and Roys culture.
Step 3: Define the central issue and options. What is the ethical
issue(s) and what are the options?
The ethical dilemma at play here is the controversy between my duty to
uphold the confidentiality and privacy rights of my client, the duty to protect
clients privileged communications, and the duty to respond to the courts
subpoena for all records pertaining to Sheilas treatment after receiving
clients consent despite her best interest. Options include submitting the
information and adherence to the subpoena.
Step 4: Refer to the professional standards (e.g., ACA, ASCA, NBCC)
and examine relevant laws and regulations, if any.
According to ACAs Code of Ethics, the following standards have relevance to
this particular case.
B.1.b-Respect for Privacy
B.1.c-Respect for Confidentiality
B.2.a Serious and Foreseeable harm and legal requirements
B.2.d-Court Ordered Disclosure
B.2.e-Minimal Disclosure
C.6.b- Reports to Third Parties
It would be important to review any relevant laws and other regulations
contingent upon the state we live in (i.e. NC state law on authorization to
release confidential information).
Step 5: Search out ethical scholarship. What does the literature
provide regarding how other counselors have dealt with this type of
issue?
Conducting thorough research on literature on this issue would need to be
initiated. Considering my limitations of knowledge concerning the legal
system/issues, I would ask for where I could find information on how
counselors have responded to these issues.

Step 6: Consult with supervisors and colleagues. An option at any


point. Ensure consultation does not violate confidentiality.
I would consult with clinical supervisors, legal advisors (lawyers), health care
attorneys obtaining consents from client to speak with them about the case.
Step 7: Deliberate and decide. What are you going to do? Consider
your options. Identify competing values. Determine the best course
of action. It is often touch to make ethical decisions, remember to
engage in ethical courage!
Options include:
1. Seeking legal advice from my attorney to determine the
validity/nature of the subpoena 1st and legal manner in which to
respond.
2. Notification of my clinical/immediate supervisor.
3. Adhering to the subpoena as requested by both the lawyer and my
client.
4. Seeking consultation with legal advisors on the information within the
records that is potentially detrimental to my client.
5. Choosing not to comply with the subpoena against the court/client (a
valid subpoena) (could result in contempt of court, imprisonment,
fines.
I would seek to initiate # 1, 2, and 4 as my first steps.

Step 8: Inform supervisor and document. After deliberation, if you


have a supervisor, discuss your decision with your supervisor before
engaging in chosen action, and document, document, document!
I would keep documentation of all participation and information shared
supervisors, attorneys and my client concerning the case. This would be
helpful to refer to at a later time if issues arise similar to this scenario.
Step 9: Reflect on the experience.
Reflecting on individuals sought for advisement, reflection on feelings during
the course of the process are areas I would consider along with possible
questions listed below.
-

Experience without reflection is wasted (Welfel, 2012, p. 54).


Did I act timely?
Was I educated enough about the ethical codes?
What ethical resources should I have available to me?
Did I utilize consolation effectively?
Did I adequately identify my competing values?
Would I have done anything differently?
What did I do that I liked?
How can I pay it forward?

References
Ethical Decision Making Model:
http://www.sdcounseling.org/documents/Ethical_Decision_Making_Model.pdf
Remley, T.P., & Herlihy, B. (2015). Ethical, legal, and professional issues in
counseling. (5th ed.).
Upper Saddle River, NJ: Merrill.
Wheeler, A.M., & Bertram, B. (2015). The counselor and the law (7th ed.).
Alexandria, VA:
American Counseling Association.
American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA.

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