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Case Study: Lowndes Family Ethics Dilemma

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Case Study

Jan has received her couples and family counseling license and has opened a private practice. The Lowndes family (husband, Tom; wife, Lisa; children, Steven [12] and Daniel [10]) entered counseling with Jan because of continuous discord in the family.
Tom and Lisa have been married for 15 years. Tom is in upper management for a business and Lisa is a homemaker. Lisa indicated during the intake phone call that she believed the discord stemmed from her husband's absence from the family as he "is always working and even if he isn't in his office, he brings work home with him." She further asserted that this has caused problems with their children, who disrespect her, argue constantly with each other, and show poor performance academically. Over the past month, Steven had been sent to the principal's office six times for acting out at school. The school counselor, who is a friend of Jan's from graduate school, suggested family counseling to the Lowndeses and referred them to Jan. It took some coercing, but Lisa finally talked Tom into attending the family session.

In the initial session, Tom reported that he believed that the children's misbehavior, especially Steven's, was a result of Lisa's "coddling" the children and giving in to their every whim. Lisa, however, blamed Tom's absence from the family for the children's behavior problems. In front of the children, Tom yelled at Lisa, saying that if she wasn't such a "cold fish" he might want to be home more often. Lisa began to cry while the children scowled at their father. For the most part, the children were quiet as their parents argued over who was to blame for the family problems. Jan attempted to bring the children into the discussion and finally Steven grumbled, "This is what it is like all the time. They are always yelling at each other over everything." Daniel nodded his head and said he usually goes to his room and pulls the pillow over his head when his parents start arguing. In fact, the arguing in the session lasted so long that Jan was unable to do any assessment or family-of-origin history gathering.

Before the second session, Tom called Jan and said that he needed to tell her something. He explained that he was on the verge of having an affair, that he had not had any sexual contact yet, but that he felt strong emotions for a female colleague. He reported, "It is just so easy to be around her. Being with Lisa is like being in a war zone." He then asked Jan not to tell Lisa. He said that he would like to have a few sessions alone and asked if he could do this without Lisa finding out, "just to get my head straight."

Lisa also contacted Jan between sessions. She reported that she needed to tell Jan that she was six weeks pregnant. She stated that this was an unplanned pregnancy and that she had not told Tom. She said she was considering an abortion because "the way this family is right now, I don't want to bring another child into the picture." She further indicated that she sees the pregnancy as a way to hurt Tom for being so accusing with and unavailable to her. She said that he has always wanted a daughter and she thought that this baby would be a girl, and that she could "sting" him by having an abortion, especially if she was right about the baby being a girl.

Jan feels like she is in over her head with this case. She doesn't know where to begin with the family or what to do with all the secrets. She is uncertain as to whether she should keep these clients or refer them to another counselor.

Identify two potential ethical dilemmas presented in the above case.

Explain each of the possible ethical dilemmas, referencing specific ethical codes from either AAMFT or IAMFC.

Explain a potential resolution for each of the dilemmas you selected. Support your explanations using the ethical decision-making model in the Learning Resources.

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Solution Summary

This solution discusses issues of ethics related to a specific case study.

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Hi Student,

Note: I don't know what the ethical decision -making model that is being referenced here, but I included one that was published on behalf of the IMAFC.


Ethical decision making is important because therapeutic services carry significant potential harmful consequences. For example, sometimes confidentiality is violated just on the basis of careless or insufficient awareness of the extent that some disclosures can affect clients. In this specific case, because of the closeness of the relationship; it may be unclear which interactions are covered by rules of confidentiality (e.g., when information can be shared with another). Many clients who seek therapy experience conflicts regarding who they are or what the problem is that they are encountering. Therefore, the overriding concern for the therapist is to ensure that the client obtains a proper evaluation of his or her problem, but at the same time not subject the client (s) to harm.

Identify two potential ethical dilemmas presented in the above case.

The two potential ethical dilemmas presented in the current case study include: confidentiality and competency.

Explain each of the possible ethical dilemmas, referencing specific ethical codes from either AAMFT or IAMFC.

In the case of confidentiality, Tom has called and disclosed to the counselor that he may be in danger of having an affair, but does not want this information divulged to Lisa, his wife. On the other hand, Lisa has disclosed that she is pregnant, but does not want this information given to Tom. In each of the instances an ethical dilemma is involved related to confidentiality. When a couple or a family enter into a relationship information to the counselor , the counselor still have to treat persons in the relationship as individuals, and thus information provided by one member cannot be shared with another partner without the person's consent.

Based on the International Marriage and Family Counseling (IMAFC) Association, guidelines have been established for its members when counseling with families and/or couples. For instance, under Section II, "Nature of Confidentiality" (3), it is stated that unless alternate arrangements have been agreed upon by all participants. On this basis, statements made by a family member to a counselor during the course of therapy are to ...

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