10.12 Case Study

Emily is a licensed professional counselor working in a private practice setting. She specializes in working with adolescents and young adults, helping them navigate issues like anxiety, depression, and identity development. One of her clients, 16-year-old Jason, was referred by his school counselor after experiencing a decline in academic performance and increased social withdrawal.

During one session, Jason discloses that he has been experimenting with alcohol and marijuana to cope with stress. He also reveals that he has been having thoughts of self-harm but insists he is not in immediate danger. Jason makes it clear that he doesn’t want his parents to know about these issues, fearing their reaction and possible disciplinary measures.

Emily is aware of the delicate balance between respecting Jason’s confidentiality and ensuring his safety. She also understands that, as a minor, Jason’s parents have certain rights to be informed about his treatment. The situation becomes more complicated when Jason’s mother calls Emily, asking for an update on Jason’s progress and expressing concern about his behavior at home.

Discussion Questions

1. How should Emily address Jason’s concerns about confidentiality while meeting her ethical and legal responsibilities as a counselor?
2. How can Emily involve Jason’s parents in his treatment in a way that respects his autonomy and privacy while fostering a supportive family environment?
3. What role does informed consent play in counseling minors, and how can Emily clarify these boundaries with Jason and his parents?
4. How might cultural or family dynamics influence Emily’s decisions and approach to working with Jason and his parents?
5. How can Emily address Jason’s substance use in an age-appropriate and ethical manner?
6. What ethical considerations should Emily keep in mind when communicating with Jason’s parents about his progress?