Assignment task:
Scenario 1:
Sarah, a master's student who is a second-semester intern in a high school in a large southern city. The student population is diverse, academically talented, and college focused. Sarah has been doing good work with a 15-year-old client until the client reveals, in their fourth session, that she is sure she is lesbian and wants help in coming out to her classmates and her parents. The student's parents are conservative and while the school is diverse in population, very few LGBTQIA students are known.
Sarah is very conservative and was raised and continues to be active in a Christian denomination that teaches that homosexuality is a sin, and she sincerely believes that to be a biblical truth. She adds that she realizes "it's not about me" and has learned, through her previous coursework, that she must set aside her personal values. But where she is struggling now is that she is being asked to be LGBTQIA-affirmative as a counselor. She thinks that she can be values-neutral in her sessions, but she would be incongruent with her true self and would be actively encouraging sin if she were to be LGBTQIA-affirmative in working with the client. Sarah is feeling conflicted and has asked her supervisor to transfer the student to another counselor.
Scenario 2:
The case where the ethical dilemma arose involved a 17 year old Mexican-American male patient, Juan. Juan was being treated in an urban outpatient facility for anxiety and trauma (resulting from a gang incident when he was 14 and was jumped in the streets and nearly died).
Juan mentioned in the beginning of our work together that he did not trust doctors or counselors, especially those who identified as White. Therefore, he did not disclose important information regarding his mental health to his referring physician and me, as his counselor. I had had some negative experiences as well, so assured Juan that his apprehension was valid and accepted in our therapeutic space. We met once a week for two months to assist Juan with developing coping skills to manage his anxiety and to support his recovery from traumatic experiences. Our sessions included movement experientials that drew from Laban Movement Analysis (LMA) techniques, improvisational movement, and mindfulness-based activities, and were supplemented with verbal processing. Many of our sessions involved evocative verbal exploration into Juan's interpretation of his life experiences; this helped to strengthen our therapeutic relationship and build trust. During our seventh individual session, one of his deepest secrets was revealed. He stared me in the eyes and stated, "I have a spirit attached to my right shoulder. I can see him and feel him. He's talking to you. Can you hear him?" I was thunderstruck and became curious about his unexpected disclosure. The spirit had attached to Juan two months prior after he prayed to his God for companionship and guidance. What started out as a positive human-spirit friendship turned into daily negative comments from the spirit, which led the patient to share his experience with me, but not without hesitation.
Juan communicated that he would not return to counseling if the divulgence of his private information had to be revealed as he had his own codes that he lived by. Additionally, Juan closely identified with being spiritually gifted since childhood. He talked about seeing people's auras (even mine) and sightings of spiritual entities throughout his upbringing so far. This was the first time Juan had confided in anyone, aside from his mother, about seeing spirits.
Questions to answer:
For both scenarios, consider your bias. As you explore the case, consider what in your earlier development (parents, community, and more) taught you about individuals from these diverse groups (consider intersectionality as well)? How did this shape your understanding of cultural groups that might differ from your own background?
The concept of bracketing is important when working with clients that have world views and value systems that differ from your own. Share how you might use bracketing if you were the counselor in these situations.
What ethical codes (ASA & ASCA) and cultural competencies are relevant to resolving these dilemmas? As you explore the codes and competencies, also consider the moral principles - which two are most at odds with each other as you work through your decision making?
Finally, what is your resolution, what action would you take here?