Ethical Issues in Counseling

Ethical Issues in Counseling

 Post an analysis of one of the three case scenarios in which you:

• Identify the substance-related issue the client is experiencing.
• Analyze the social worker–client interaction in the scenario.
• Analyze the specific biases or attitudes displayed by the social worker in the scenario and explain the effect of these on the therapeutic relationship.
• Identify at least one ethical issue arising from the scenario.

APA citation and references

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Ethical Issues in Counseling

Substance-Related Issue

In the selected case scenario, the client is experiencing an opioid use disorder (OUD) resulting from the misuse of prescribed painkillers after a surgery. Over time, the client developed a dependency and began seeking additional prescriptions from multiple providers, a behavior known as “doctor shopping.” This behavior is indicative of the client’s inability to control their use of opioids despite negative consequences, meeting the criteria for OUD as outlined in the DSM-5-TR.

Social Worker–Client Interaction

The social worker in this scenario approaches the client with a mixture of concern and judgment. While the worker expresses empathy for the client’s pain and struggle with addiction, their communication includes statements that imply blame, such as, “You should have known the risks of taking so many medications.” This interaction creates a tension between support and criticism, potentially undermining the client’s willingness to open up about their challenges.

Biases and Attitudes Displayed by the Social Worker

The social worker exhibits a moralistic bias by subtly suggesting that the client is at fault for their substance use. This attitude likely stems from a stigma associated with addiction, often perceived as a personal failing rather than a medical condition.

Effect on the Therapeutic Relationship:
This bias creates a barrier to trust and rapport, as the client may feel judged rather than supported. Consequently, the client might withhold information about their substance use, making it more difficult to develop an effective treatment plan. A nonjudgmental and strengths-based approach is crucial for fostering a collaborative and productive therapeutic relationship.

Ethical Issue

An ethical issue in this scenario is the potential violation of the NASW Code of Ethics Standard 1.01: Commitment to Clients. The social worker’s judgmental statements could be interpreted as prioritizing personal attitudes over the client’s well-being. Additionally, if the social worker fails to recognize the medical nature of addiction and refer the client to appropriate treatment (e.g., medication-assisted treatment or counseling), they risk failing to provide competent care as outlined in Standard 1.04: Competence.

Conclusion and Recommendations

To improve outcomes, the social worker must address their biases through self-reflection and education about addiction as a chronic illness. A nonjudgmental approach, paired with evidence-based interventions, will help rebuild trust with the client. Ethical practice demands prioritizing the client’s needs and fostering a safe, supportive therapeutic environment.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

National Association of Social Workers. (2021). NASW Code of Ethics. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English