Please include Christian worldview and/or bible scriptures, APA format, cited and referenced. Discussion must be approximately 350–400 words and demonstrate course-related knowledge. Make sure to justify and support your answer. Where appropriate, use in-text citations to support your assertions.
Reference Book: Young, M. (2017). Learning the Art of Helping. Boston, MA: Pearson. ISBN: 9780134165783.
Main Discussion Topic: Ethics & Informed Consent
Discussion Board Forum #1
You have an intake session with a client (16-year-old Native American female) and her mother. During intake you ask about her friend’s support, and she shares that she has been very “down” lately because of rumors spreading at school. She denies being suicidal at this time but has had “sad” thoughts. She has “cut in the past” but shared, “I won’t do it again; I learned my lesson.” The client also shared that she has always had difficulty expressing her feelings. In the interview she presents as quiet, guarded, and initially quite reluctant to talk.
Based on your reading, please address following points in your discussion board:
· Explore what your state requires(my state requirements will be based off of the STATE OF VIRGINIA) with regards to informed consent, age of consent for treatment, and if you as a counselor have a Duty to Warn, Duty to Care, or not. Write a brief description of how you will verbally explain confidentiality to the client in language that they will understand.
· Please discuss how you will handle assessing for suicide, next steps after disclosure, what are points to be aware of, and how would you word questions when working with a teenager? What are future elements that you need to be aware when working with a teenager? What cultural considerations are needed in this case? What would be the balance look like having the mother and daughter in the room at the time of this discussion? Is there any additional information needed in exploring the client’s “down” thoughts.
Reply Ghezal Zekrya
Reply to 1 classmate for each forum. Each reply must be 200–250 words with a minimum of 1 scholarly source. The scholarly source used for your thread and response should be in addition to the class textbooks.
According to the state of Virginia law informed consent must be obtained from client prior to initiating therapeutic services. Informed consent should include purposes, goals, techniques, procedure, limitations, potential risks, and benefits of services (18VAC115-20-130). Virginia law reveals that a minor is considered anyone under the age of 18 in which consent is required from the parent or legal guardian (12VAC35-115-80). However, the age limitations can be different with minors in different situations. It will be the counselor’s responsibility to pay close attention to the state laws related to the minor’s situation. Virginia counselors have a duty to protect third parties. During therapeutic services if a client discloses any intentions to cause serious bodily injury or death to an identifiable individual(s), it is the counselor’s duty to take precautions to protect the potential victim(s) (54.1-2400.1). In explaining confidentiality to the client, it is important to make sure they are paying attention and that they have a clear understanding of the stipulations. Since this is critical information for the client and her parent to understand it is important that the counselor uses language that is clear and presents carefully and not rushed.
“I want to go over some very important information about confidentiality and make sure you both (client and parent) understand. This is a place where I want you to feel safe and comfortable to share anything and everything and to know that whatever you share, or we discuss is confidential. However, there are three conditions in which confidentiality can be broken. First, if you express any intent of harm towards self or others as a mandated reporter, I must report it. Second, if I’m subpoenaed by court to disclose your records and third if you are a witness or involved in harm towards minors, elderly or physically handicapped. Do you have any questions?”
According to Young (2017), “a history of self-inflicted injury or harm to others can cue to examine the client’s situation more thoroughly and take precautions” (p.179). Though client expresses she is not suicidal at this time she has inflicted harm to herself in the past. Based on her history of self-harm, feeling down, and having sad thoughts it is important to evaluate her for suicidal risk utilizing the acronym IS PATH WARM and the SAFE-T assessment. The client shares that she has cut in the past, which research reveals that nonsuicidal self-injury (NSSI) can be associated with emotional and psychiatric distress (Klonsky, Victor & Saffer, 2014). It is important to explore past emotional and psychological difficulties in upcoming sessions. But since it’s the intake session it is important for counselor to use this time to understand the client and create a setting that encourages trust and honesty (Young, 2017, p. 183). Assessment questions can be used to collect important information and to distinguish important areas of client’s issues (Young, 2017, p.183). Knowing that the client is Native American it is critical to ask questions that can assist in a better understanding the extent of her cultural identity and its influence on the therapeutic treatment. It can be helpful to have the mother present when going over the consent, confidentiality, assessment questions, cultural background questions and other information the mother can answer better than the client that will be prudent in working with client. The parent of a minor should be aware of what happens in counseling and what counseling involves. Once the counselor starts the therapeutic treatment it will be best for the mother not to be present as counseling in this situation is for the 16-year-old and the issues she is struggling with. In addressing the down thoughts once the counselor assesses suicidal risks, questions related to onset of the thoughts and severity can be addressed and exploring these thoughts on a deeper level can be addressed in upcoming sessions without the mother.
Commonwealth of Virginia. (2020). Administrative code. Virginia Law. Retrieved from https://law.lis.virginia.gov/admincode/title12/agency35/chapter115/section80/ .
Commonwealth of Virginia. (2020). Administrative code. Virginia Law. Retrieved from https://law.lis.virginia.gov/vacode/title54.1/chapter24/section54.1-2400.1/
Young, M. (2017). Learning the Art of Helping: Building Block and Techniques. New York, NY: Pearson.
Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 565–568. https://doi.org/10.1177/070674371405901101