Ethical Dilemmas in Counselling: Robin's Case Analysis Question and Answers

1) What are the main elements of the dilemma?

In the case study of Robin, the main elements of the dilemma lie in different aspects relevant to the aspect of counselling which needs significant consideration to understand the patient's mental and Physical health and provide solutions in the counselling aspect. The first dilemma element is found in clients due to their financial limitations. In the case study, it has been found that a Trans person Robin is experiencing poor mental health, an intense exercise regime and an eating disorder. Due to this, he seeks counselling. However, Robin’s inadequate mental health limited his working opportunities and for that, he is still jobless. He relies on his parent’s financial support, which makes him depressed. For that, he is seeking a low-cost counselling service. He comes for the first session of therapy at his parent's request (Referred to case study). His financial dependency severely affects his self-ego and creates a dilemma in his mind. This gets a big picture during her last session of therapy when she fails to bring payment for her last session due to which she did not attend her next booking session.

Additionally, another essential element in the dilemma is Robbin's autonomy. A person has the right to the freedom of being autonomous. Similarly, Robin is a young person who understands self-determination as well as understanding independence. During his therapy sessions, he has the right to make his own decisions (M.A & B.A, 2021). Robin was initiated by his parents to take counselling which made other complications in his mind. This is due to his parents' willingness to join the therapeutic session suppressing his independence principle. Maintaining both the client's and his parents' desires is another challenge full element for counsellors as this needs significant balance.

A counselor's ethics rely on maintaining they are duty of care for patients and professionalism they act in their client's best interest boosting clients' goals, safeguarding clients' rights, increasing goods and reducing harm (Researchgate, 2023). Overall working honestly as a counsellor is the main ethics code. In the case of Robin, the counsellor also experienced a dilemma due to her ethics. The counsellor has the responsibility to ensure Robin’s well-being however his last session absence made him really worry about himself. Besides that, he must know about Robin's financial condition and his non-payment reason due to this he has to navigate the financial stress that can be generated by his absence and the last session's non-payment. The ethics code and professionalism also create dilemmas in counsellors' minds.

2) Who is responsible for what in this ethical dilemma?

Before delving into understanding the ethical dilemma there is a need to know about actors' responsibility. It provides significant knowledge and makes it easy to understand ethical dilemmas. In this case study the whole incident revolves around Robin. As a therapeutic patient, Robin has the responsibility for understanding his parent's concerns about him. Additionally, he also has to understand that actively participating in those therapy sessions can be beneficial for him as this is heavily connected with openly talking about their dilemma and concerns and maintaining his autonomy. Additionally, he also has the responsibility to provide payment as per the payment schedule for the beauty session which hinders his self-determination.

In this case, the next primary actor is a counsellor who has maximum responsibility toward Robin as well as the therapy centre. Maintaining the ethics code and patient and service providers' long-term relationship integrity is the primary responsibility of the counsellor (LPC et al., 2021). When Robin goes through a phase of dilemma and autonomy restriction the counselor's responsibility is to maintain her autonomy by understanding her dilemma and providing the best solutions to ensure Robin's welfare within the boundaries of professionalism. In the financial aspect, the counsellor has the responsibility to the centre to enhance its productivity with its image. Additionally, they also have a need to identify financial issues and need to develop an informed decision on maintaining both the centre's service adequacy and client health (Wootton et al., 2019).

The parents of Robin play another main role in such a dilemma. They initiated Robins therapy as they have the responsibility for taking care of their child's well-being. In the financial aspect, they provide proper financial support to Robin for his session demonstrating their mental support to Robin. Robin's parent contribution and financial support for Robin's health check-up make complications for Robin, particularly in the aspect of challenging his autonomy. For that, Robin experiences a conflict between his expectations and his family's expectations. In this aspect, the counsellor also needs to focus on this dynamic to maintain a significant equilibrium between both parents' problems and Robin's autonomy. Overall the counsellor needs to address and determine any differentiation in their relationship (Luepker, 2022). Besides that, he also needs to focus more on Robin as needs the help of a counsellor for mental support that can enhance Robin's motivation and involvement in therapeutic sessions while eliminating his dilemma for his parent's introduction. They can significantly navigate this sensitive issue while maintaining all involved actors' values and interests.

3) What are all the available ethical principles and guidelines that should be considered?

In this case study several principles need to be considered as ethics helps to maintain professionalism as well as integrity of counselling services. This principle assists counsellors in developing an informed decision that helps them maintain transparency within providing care service and ensure client well-being.

• Being trustworthy or fidelity: It incorporates loyalty, honouring promises and faithful notions. Credibility is considered fundamental to interpretation and solving ethical problems. Practitioners who embrace this principle, function according to the beliefs placed upon them, Try to assure that Robin's expectations are reasonably likely to be met, observe their contracts and commitments, Consider confidentiality like obligation originating from the client's confidence, Limit confidential information disclosure about customers to further the objectives for that it was initially disclosed (Rogol, 2020).
• Autonomy: The significance of this principle is to give a particular selection and movement freedom. This principle highlights the growth of a client's capability to be self-directed in all aspects of therapy and life. In the case of Robin’s it manages the counsellor's responsibility to inspire clients, when applicable, to construct self-decisions and perform on self-values. Two significant considerations noticed that help in motivating clients to become autonomous (Jarden et al., 2021). The first consideration is assisting clients to acknowledge their value and help to develop decisions for their own sake that may not be accepted within the societal context in which they live and their influence on others rights. The second consideration is process relevance with clients' capability to develop rational decisions and sounds. The autonomy principle opposes clients' manipulation of their interests even in cases that are for their own benefit.
• Beneficence: The beneficence principle is demonstrated as action in the clients' best interest considering on professional judgment. In this case, beneficence demonstrated the responsibility of the counsellor towards ensuring client welfare. Simply put it suggests doing good, being proactive and preventing harm in case possible. It focuses on working rigorously within competence limits and furnishing services based on experience or satisfactory training. There is a responsibility to operate ongoing and regular supervision to improve service quality delivered and to dedicate to revising exercise through resuming professional development (McCullough, 2020). The obligation to operate in a client's best interests may evolve as most important during performing with customers whose power for autonomy is reduced by understanding limitedness, immaturity, severe disturbance, extreme distress, or other substantial personal limitations.
• BACP ethics: BACP (‘the British Association for Counseling and Psychotherapy’) supply a significant framework for maintaining ethics that highlights consent confidentiality and arrangement for the client. That is beneficial for maintaining long-term relationships and shows effectiveness in therapeutic procedures (BACP, 2019).

4) What are all the possible courses of action?

In this case study identifying ethical dilemmas provides valuable information that is beneficial for selecting appropriate action for mitigating challenges.

• Interaction with Robin: The counsellor needs to focus on taking proper action for interest and finding the reason behind its absence. In order to do this they can make a phone call, or do a face-to-face meeting with his parents to understand his absence concern (Del Giacco et al., 2020). The introduction also helps them to understand Robin's concerns and experience struggle during the session procedure.
• Therapeutic goals evaluation: In the aspect of Robin’s dilemma, the counsellor can evaluate the goal of the therapy and make a face-to-face meeting with Robin to provide clarity about those goals. They can incorporate a brief discussion on different actions of Robin from session attendance to missing the session and collaboratively identify the lake area that does not boost Robin’s morale. After discovering the lack area, they need to focus area with emphasizing on motivating Robins to participate in therapy sessions (Heath & Startup, 2020). Additionally, they also need to emphasize their initiative as the initiative needs to be developed to align with client expectations and specific requirements.
• Communication with Robin’s parents: In order to understand Robins’ dilemma and different aspects of his absence they can make communication with his parents. The counsellor needs to ensure confidentiality during the communication procedure. Besides that, they can also involve them during the session to support Robin’s morale. It can provide them with the opportunity to develop an informed decision on selecting an appropriate initiative that has high effectiveness toward Robin's recovery and is also beneficial for parents through eliminating concerns (Medendorp et al., 2020). It can also provide valuable information that helps the counsellor to understand Robin's autonomy.
• Adaptation of terminating therapy: In case it has been found that Robin still has no interest in taking part in therapy sessions and the failure to communicate with Robin then the counsellor can adopt terminating therapy. This is a final therapy session that can be noticed in multiple distinct methods relying on the style of the therapist and supplying treatment types. The session of termination incorporates monitoring clients' progress and treatment over the period and identifies the significant approach through which they can utilise the information and skills they gain going forward (Sutton, 2021). However, the judgement has been made on the basis of ethics while maintaining appropriate termination procedures and identifying any excellent financial aspects.

5) What is the best course of action?

• Universality: The universality test asks to assess whether a counsellor could suggest the same action course to another counsellor within the exact situation. This taste is based on a universal adaptation of the principle that poses alignment with ethics. In Robin’s case restructuring in the interaction is paramount for Robin to understand his dilemma. The counsellor needs to emphasise an introduction to understanding the cause behind his absence by discovering financial constraint issues that are beneficial for enhancing the effectiveness of counselling. Through this, the counsellor can help boost Robin’s motivation by providing value to his autonomy and self-determination (Sundet, 2021). Additionally, it is also beneficial for identifying his poor mental health eating disorder issue for successfully achieving therapy goals and making an initiative that aligns with Robin's specific preferences that can be a patient-centred care initiative.
• Publicity: In this publicity test, the counsellor needs to ask himself whether he would want his behaviour reported with in press or not. This highlights the confidential significance of maintaining the ethics integrity and autonomy of a patient. The aspect of Robin's counsellor's judgement on structuring their interaction to understand Robin's concerns and delivery needs to be carefully implemented. Any opinion in the aspect of finance the counsellor, as well as the centre, needs to maintain are security or protection regulations (van Lotringen et al., 2021). Privacy control privatisation can help to establish client trust in therapy by helping them to establish long-term relationships that can be significantly justified by another counsellor in the presence of media.
• Justice: The test application helps to evaluate a counsellor on fairness by evaluating whether he would treat other clients exactly the same as per the situation. In this case, the counsellor needs to evaluate if case similar step would be beneficial or not for Robin as well as others in exactly the same situation. Additionally, they also need a thorough assessment of their decision development before selecting a suitable accent whether it cannot be altered by different factors such as gender, race, economic status, age and many more (Forester-Miller & Davis, 2020). After determining the appropriate initiative that goes based on exactly the same situation for others, the selected action needs to be aligned with the justice principle as it emphasises consistency and fairness maintenance.

After analysing all three actions, it can be stated that the best suitable test action is universality as it focuses on ethics and provides effective solutions for Robin as well as Robin like others in exactly the same situation. It helps to provide value to Robin's self-determination and autonomy and it is universally accepted for its nature. Additionally, the counsellor can supply effective care through this test adaptation while maintaining integrity in their service provision.

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