Assignment task:
Sarah work as a mental health/drug and alcohol social worker in a small community centre which offers a range of services to the local community. Other services include child and family counselling and sexual assault/domestic violence counselling.
Sarah has been providing services to Paul Jones, a local farmer aged 63 years, for the last 3 months. Paul presented with acute suicidal ideation, which has now resolved. At the time of referral, he had recently commenced anti-depressant medication and was subsequently diagnosed with depression by a visiting psychiatrist. Triggers for his low mood were identified as the prolonged drought and the recent death of his elderly father with whom he reported having a close relationship. Sarah, believe that she has developed a good therapeutic alliance and Paul has disclosed a problem with gambling and with your support and that of his GP has been able to dramatically reduce his gambling over the past 6 weeks. Paul would like to continue counselling but due to issues with recruitment and funding, your service can only offer a limited number of sessions. There are few options for ongoing psychological support in the local community. At the last two sessions Sarah and Paul have discussed completing counselling in a few weeks.
Today Sarah have been approached by Miranda Smith, the sexual assault/domestic violence counsellor who informs you that she commenced counselling with Louise Jones, Paul's wife approximately 6 weeks ago. Louise is aged 59 years and was a victim of sexual assault when she was a child. The recent Royal Commission has triggered her memories of the assault and she sought counselling in relation to the abuse. She has not told anyone else about the abuse and has not told her husband she is seeking support. Louise is aware that he has sought help from the community centre for depression.
In the last session, Louise disclosed to her counsellor that she is a victim of ongoing domestic violence by her husband Paul. The violence is psychological, physical and very occasionally, sexual. She has never sought medical help for her injuries, although she has threatened Paul that she could do this. Louise has stated clearly that she will not leave her marriage, she has too much invested in the property, having used her family inheritance to build a house on Paul's land. She states, "after all, I have put up with it for this long." Due to the drought the couple have very limited savings and are struggling financially.
Miranda is very worried for Louise's safety because Paul has access to weapons on the property and they continue to argue about Paul's gambling. Louise reports that things have been a fair bit better since Paul started going to counselling. She is adamant that the violence is Paul's problem, which he needs to address. Miranda pleads with Sarah to continue providing a counselling service to Paul.
Paul and Louise live on a farm near a small rural community. The town has very few services and, in fact, these are confined to those offered by the community health centre. However, the various services have separate managers and are operated very much as stand-alone services, maintaining their own records and other data.
Services at the centre do share a common code of ethics in which confidentiality and the importance of duty of care are paramount.
Analyse and discuss the ethical dilemmas in this scenario. Looking for Online Tutoring?
Use ethical decision making model- Reamer (2013) to come to conclusion