Confidentiality

A counselor has been treating a client, Jay, who was recently in a bad accident that left him bedridden and partially paralyzed. With sustained physiotherapy and medication, the paralytic effect has gone, but motor movements are still affected.

Jay's steady girlfriend left him when she could not cope with the demands of a paralytic partner. Jay lost his job too. These left a heavy dent on his self-esteem, and he was slowly letting his life slip past. He began attending therapy at the insistence of friends.

One day, he discloses to his counselor that he is contemplating suicide because there is nothing he looks forward to in life. He announces that he has had enough of living and plans to shoot himself that evening. The counselor knows he has access to an old hunting rifle and that he has attempted suicide in the past. He has been under treatment for major clinical depression for the past three months.

• Discuss the ethical issues presented in this scenario; identify the ethical code number and definition.
• Describe the limits of confidentiality that must be considered.
• Justify whether or not the counselor would need to break confidentiality.
• Describe the steps the counselor should follow if he or she finds it necessary to break confidentiality.
• Compare the ethical issues presented in this scenario to the APA's ethical standards and describe the similarities or differences in the ethical codes using the following website: http://www.apa.org/ethics/code/index.aspx.