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    Boundary Issues in Marriage and Family Counseling

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    Case study# 1
    A Marriage and Family Counselor Learns a secret

    Diana, a private practitioner, began working with Mrs. Cole, who was referred for counseling by her family doctor. Her doctor had not been able to find any physiological basis for her complaint that on several occasions she had felt as though she were choking and could not breathe. After several sessions, it became apparent to both Diana and the client that these choking symptoms occurred when Mrs. Cole husband came home from work. Through further explanation, Mrs. Cole came to realize that she felt a great deal of anger that she has not been able to express, and that her relationship with her husband was directly related to her choking. With Mrs. Coleâ??s permission, Mr. Cole was invited to conjoint the therapy.
    During the first conjoint session, Diana noted that Mr. Cole was not been congruent when he discussed his relationship with his wife. He said that he loved her, but his non verbal communications and tone of voice indicated otherwise. When Diana asked him if he had any feeling other than love for his wife, he became defensive and said â??noâ?. at this point, Diana told Mr. and Mrs. Cole that she wanted to see each of them separately. Concerned that Mr. Cole might become hostile and uncooperative, she neglected to discuss issues pertaining to secrets and how they are handled.
    Mr. Cole did come for an individual session, during which, he admitted that he had been having an affair for 8 months. He was adamant in stating that he would never reveal the affair to his wife. He also stated that he would deny if the counselor brought it up in a conjoint session. He urged Diana not to bring up the affair during the sessions with Mrs. Cole. He felt certain that his wife would leave him if she knew. He became very emotional when he spoke of their four young children saying that he was good father and did not was their lives disrupted. When Diana asked he was committed to the marriage he said that he was, but he wanted very much to have this other relationship. He stated that his goal in counseling was to adjust to balancing to relationships and to reduce his stress, and he requested additional sessions to help him with these goals.

    Give a brief description of an ethical dilemma related to boundary issues from this case study.
    Analyze how you would address each of these dilemmas, citing the appropriate ethical codes.
    Describe the ethical decision-making model you utilized in this process and explain why.

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    Solution Preview

    (1) Give a brief description of an ethical dilemma related to boundary issues from this case study.

    A key ethical consideration in this case study is the issue of limits to confidentiality (Standard 4.02, American Psychological Association, 4.02a2, which states that counselors discuss, "the relevant limits of confidentially" with clients whom they work. In addition, under Section II of the International Association of Marriage and Family counselor (IAMFC) Ethics codes, it is mandated that counselors must not disclose confidential information, except when mandated by law. However, the IMAFC cites the exception, that disclosure can be made to prevent clearly evidence of harm to client or some other clearly identified person. In addition, in its Preamble, the IMAFC encourages the healthy growth of families. Thus, in some instances, disclosure, which is at the discretion of the counselor, may have the potential for harm. As it applies to the current case, the therapist' position on disclosure can have important implications for how marital therapy is conducted. For instance, on one hand, the therapist has been provided information that may limit her capabilities when counseling from a couples' therapeutic perspective. On the other hand, disclosing the information may put her client at risk for harm (i.e., the dissolving of his marriage and potential loss of his children). Mr. Cole's decision to remain in the relationship outside of his marriage further complicates the ...

    Solution Summary

    This solution describes ethical dilemmas related to boundary issues in marriage and family counseling.