Discussion 1

Sheila came to your office about 8 months ago seeking counseling. She stated that she, “hoped to save her marriage.” After a few sessions with Sheila, you suggested that couples counseling might be helpful, but her husband, Roy, refused to participate. Three months ago, Sheila and Roy went through a very nasty breakup of their marriage, and now you have been subpoenaed to produce all of your records pertaining to Sheila’s treatment. Sheila has told you not to comply with the subpoena.

What should you do? Why?

Describe the specific steps you would take in responding to the subpoena.

This discussion question meets the following NASAC Standards:

20) Understand the addiction professional’s obligation to adhere to generally accepted ethical and behavioral standards of conduct in the helping relationship.

21) Understand the importance of ongoing supervision and continuing education in the delivery of client services.

35) Seek appropriate supervision and consultation.

47) Inform the client of his/her confidentiality rights, program procedures that safeguard them, and the exceptions imposed by statute.

65) Apply confidentiality-related legal restrictions appropriately.

66) Demonstrate respect and nonjudgmental attitudes toward the client in all contacts with other professionals or agencies.

110) Protect client rights to privacy and confidentiality in the preparation and handling of records, especially in relation to the communication of client information with third parties.

112) Prepare and record treatment and continuing care plans that are consistent with agency standards and comply with applicable administrative rules.

116) Demonstrate ethical behaviors by adhering to established professional codes of ethics that define the professional context within which the counselor works, in order to maintain professional standards and safeguard the client.

118) Adhere to federal and state laws, and agency regulations, regarding addictions treatment.

120) Utilize a range of supervisory options to process personal feelings and concerns about clients.

122) Obtain appropriate continuing professional education.

123) Assess and participate in regular supervision and consultation sessions.

Discussion 2

Marcie is a new client and a 22-year-old female who works as a receptionist in a doctor’s office. She has just revealed to you during the intake session that she has recently lost interest in most activities, has been sleeping a great deal yet feels tired all the time, and sometimes wishes she could cease to exist. She mentioned feeling as though she has been “on an emotional roller coaster” during the past year, throughout her on-again/off-again relationship with a 35-year-old married man. The last breakup with him seemed final, and Marcie has felt herself sinking deeper and deeper into depression ever since. When probed further about suicidal ideations, Marcie admitted that she has considered killing herself, although she is uncertain whether or not she would actually do it. She said that she is currently in possession of a gun that her friend allowed her to keep in her home following a rash of burglaries in the neighborhood, but she does not know whether she would actually use it.

You have consulted with your supervisor, who has agreed that Marcie should be referred immediately for a psychiatric evaluation and has instructed you to arrange for Marcie to go directly from your office to a nearby hospital. Marcie told you that her mother accompanied her and is in the waiting room, but she has emphatically stated that she does not want her mother to know what is going on with her. How should this delicate situation be handled? Why? What are three ethical and/or legal concerns about this case?

This discussion question meets the following NASAC Standards:

20) Understand the addiction professional’s obligation to adhere to generally accepted ethical and behavioral standards of conduct in the helping relationship.

35) Seek appropriate supervision and consultation.

47) Inform the client of his/her confidentiality rights, program procedures that safeguard them, and the exceptions imposed by statute.

65) Apply confidentiality-related legal restrictions appropriately.

66) Demonstrate respect and nonjudgmental attitudes toward the client in all contacts with other professionals or agencies.

110) Protect client rights to privacy and confidentiality in the preparation and handling of records, especially in relation to the communication of client information with third parties.

112) Prepare and record treatment and continuing care plans that are consistent with agency standards and comply with applicable administrative rules.

116) Demonstrate ethical behaviors by adhering to established professional codes of ethics that define the professional context within which the counselor works, in order to maintain professional standards and safeguard the client.

118) Adhere to federal and state laws, and agency regulations, regarding addictions treatment.