Case Studies
Case 1:
Juanita is a counseling intern in an outpatient unit of a psychiatric hospital. Juanita has completed all requirements for her doctorate except internship. The first client to whom she is assigned at the hospital is a man with a diagnosis of manic-depression, a history of suicidal attempts, and episodes of violent behavior towards his family. Juanita has little experience with clients with such significant problems and asks that the case be transferred to a more experienced professional or that she be an observer or co-therapist for this client.
Her supervisor insists that she tackle this case independently because Juanita has completed all her courses on psychopathology and shown good counseling skills with less disturbed clients. The supervisor assures Juanita that she will have all the supervision she needs. Juanita is skeptical about the supervisor’s capacity to meet that commitment because interns from prior years have warned Juanita that this supervisor is often unavailable outside of the regularly scheduled supervision hour. Still, Juanita elects not to try to change her supervisor’s mind about the assignment and goes forward with the sessions. Over the course of the semester, the client makes little progress, and Juanita believes she has gained more from her work with the client than he has gained from her.
Case 2:
Ramonna is employed at a shelter for battered women while she is earning a graduate degree in counseling. She wants to use her clients at the shelter as part of the internship experience, but no staff member at the shelter has the proper credentials to provide supervision. So, Ramonna asks a psychologist she knows to provide supervision. She offers to pay him $20 per hour for supervision. The psychologist agrees and the supervision sessions begin the first week of the semester.
Case 3:
Sheena is a licensed clinical counselor who has been a strong advocate for the professionalization of counseling in her state. In fact, she helped to write the legislation that first established counselor licensure. Still, there are too few licensed clinical counselors available in her area to provide the supervision required for trainees to obtain licenses. Concerned about this problem and committed to help advance her profession, Sheena has agreed to supervise 5 trainees – the maximum allowed by law. Her demanding practice, family responsibilities, and community activities make it difficult for Sheena to give face-to-face time to each supervisee. Instead, she has each supervisee record comments and questions about cases on a cassette tape. Sheena listens to these tapes while commuting and then tapes her answers to the supervisee. She also gives each supervisee a phone number and meets with them in person a few times during the semester.
Case 4:
Philip is a school counseling intern at an elementary school. One of his clients has a number of bruises on her arms and legs. When asked, the child cannot account for the bruises – she just shrugs her shoulders and says, I don’t know.” Philip reports this child’s injuries to his supervisor, Vivian, and tells her he plans to call the child abuse hotline. Vivian suggests that no report is necessary because her case is already under investigation for an injury that was reported to them by the child’s teacher two weeks ago. At first, Philip is surprised by his supervisor’s advice, but then decides that she must be correct and does not report this new incident.
Case 5:
Rosemary supervises three interns at a psychiatric hospital. Rosemary’s philosophy of supervision places great emphasis on the role of the supervisee’s personal reactions to clients. She is especially interested in helping students to understand the impact of countertransference on the counseling process. Towards this end, she spends a good deal of the time in individual and group supervision on the interns’ emotional reactions to clients and the ways clients may trigger the interns’ unresolved psychological issues. Samuel, a doctoral intern, is uncomfortable with Rosemary’s style and emphasis in supervision. He believes that he can separate his personal issues from those of his clients most of the time and that when clients trigger inappropriate reactions from him, he can monitor his behavior and act responsibly.
To date, Samuel’s clinical evaluations have been strong – past supervisors have commented on his extraordinary potential as a therapist. Rosemary finds his attitude toward intense focus on countertransference as an important limitation, even though she acknowledges that his work with clients has been entirely satisfactory thus far. Because she believes so strongly in her philosophy of supervision and counseling, she gives Samuel a “marginally satisfactory” rating for his internship.
Explore each of the case studies in the Case Study document. Discuss how each scenario “feels” to you.
Examine material from your text and the ethics codes to determine what would be the ethical dilemma and how to resolve it for each case.
Reference the book
Welfel, E. (2016). Ethics in counseling and psychotherapy. (6th ed.), Belmont, CA. Cengage Learning. ISBN 9781305089723
Websites
American Counseling Associations Code of Ethics Website: www.counseling.org
American Association of Christian Counselors Code of Ethics Website: www.aacc.net
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