How would you prioritize these issues, most important to address, 2nd, etc.

Case 1

A. You are counseling a 17-year-old who states he sometimes thinks about ending it all. Upon questioning the student more carefully, he says he thinks about it sometimes but only has a vague idea of how he would do it and his way does not seem very probable. (Maybe drive into a brick wall or off a bridge.) He does not have access to a vehicle currently. He states he is also considering dropping out of school and hasnt told his parents. He casually mentions his 16-year-old girl friend might be pregnant.

a. Identify the ethical/legal issues involved.
b. How would you prioritize these issues, most important to address, 2nd, etc.

B. What would you do if the student above said he would use a gun and his dad kept guns and ammunition in the house? Would this change your plan of priorities and plan of action?

Case 2
Susan called a community counseling center seeking counseling for her daughter Leah, a 15-year-old 10th grader. Susan’s concerns about Leah included poor academic achievement during the current school year and defiant behavior at home. Leah lives with her mother, her father, and one younger brother who is 11 years old. Until the current school year, Leah had been an above average student.

An appointment was made for Susan and Leah, who were both present during the intake session with Carmen, the counselor. Carmen presented the standard “declaration of practices and procedures” document used by the counseling center. Because Leah is a minor, Carmen explained the benefits of maintaining Leah’s confidentiality while also explaining Susan’s right as the parent to know about the counseling process. Susan and Leah both agreed that the counselor would share only general information with Susan, and that Leah was free to discuss any aspects of the counseling process with her mother. Carmen explained the limitations to confidentiality, including (in general terms) potential harm to self or others. Carmen asked Susan and Leah if they had any questions, and then asked them both to verify that they understood the provisions of the informed consent document. Carmen asked them each to sign the document, and she gave them a copy to take with them for future reference.

Carmen began seeing Leah on a weekly basis. As counseling progressed, Leah disclosed that she felt as if her mother was trying to control her, and she resented what she considered to be her mother’s excessive involvement in her life. In today’s session, Leah revealed that she is secretly dating a boy named John who is 18 years old, and that her mother is not aware of her relationship with John. She stated that her mother does not approve of her dating. Leah added that she was considering having sex with John. In further exploring this issue, Carmen explained that counselors have a legal obligation to report situations that involve a minor having a sexual relationship with a legal adult, and that John, at age 18, was considered an adult. Leah was adamant in insisting that Carmen not tell her mother about anything she had revealed about her relationship with John. She thought for a minute and then told Carmen she had a solution to the problem. She stated, Well, if I do decide to have sex with John, I just won’t tell you about it. Then you won’t have to talk to my mother.”

a. Keep the daughters confidence
b. Counselor could facilitate the daughters discussion with mother by securing the daughters permission to invite the mom to the sessions
c. Tell the mother immediately
d. Have joint session with the daughter and boyfriend

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