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Emotional State of A Client Discussion

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Ethnic Studies
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Discussion
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Topic 4 DQ 2 (Obj. 4.2)
Marcie is a new client and a 22-year-old female who works as a receptionist in a doctor's office. She has just
revealed to you during the intake session that she has recently lost interest in most activities, has been sleeping a
great deal yet feels tired all the time, and sometimes wishes she could cease to exist. She mentioned feeling as
though she has been "on an emotional roller coaster" during the past year, throughout her on-again/off-again
relationship with a 35-year-old married man. The last breakup with him seemed final, and Marcie has felt herself
sinking deeper and deeper into depression ever since. When probed further about suicidal ideations, Marcie
admitted that she has considered killing herself, although she is uncertain whether or not she would actually do it.
She said that she is currently in possession of a gun that her friend allowed her to keep in her home following a
rash of burglaries in the neighborhood, but she does not know whether she would actually use it.
You have consulted with your supervisor, who has agreed that Marcie should be referred immediately for a
psychiatric evaluation and has instructed you to arrange for Marcie to go directly from your office to a nearby
hospital. Marcie told you that her mother accompanied her and is in the waiting room, but she has emphatically
stated that she does not want her mother to know what is going on with her. How should this delicate situation be
handled? Why? What are three ethical and/or legal concerns about this case?
Corey et al. (2015) states, “It may not be possible or clinically appropriate to discuss informed
consent in great detail at the first session due to the emotional state of a client.” Since this is an
intake session, confidentiality issues would normally be disclosed. In this case, it may be
mentioned, but considering Marcie’s state of mind, she may be wary to any talk outside her
suicidal feelings. Corey et al. (2015) continues, “It is a mistake to overwhelm clients with too
much detailed information at once, but it is also a mistake to withhold important information that
clients need if they are to make wise choices about their therapy.
According to the ACA Code of Ethics Exceptions B.2.a (2014), “The general requirement that
counselors keep information confidential does not apply when disclosure is required to protect
clients or identified others from serious and foreseeable harm or when legal requirements
demand that confidential information must be revealed. It could be that confidentiality
concerns are put aside at the moment. Corey et al. (2015) suggests,
Even if clients argue that they can do what they want with their own lives, including
taking them, therapists have a legal duty to protect suicidal clients. The crux of the issue
is knowing when to take a client’s hints seriously enough to report the condition.
Certainly not every mention of suicidal thoughts or feelings justifies extraordinary
measures.
Since it was already determined that Marcie should go directly to the hospital for a psychiatric
evaluation, it may be best to get the mother involved. In suspected suicide cases, it is best to
involve family and/or significant others (Corey et al., 2015). In this situation it would be nearly
impossible to even get Marcie out of the office without her mother knowing what was happening
since she’s in the waiting area. A family knowing could be of benefit in the long run. According
to Corey et al. (2015),
The law does not require practitioners to always make correct assessments of suicide risk,
but therapists do have a legal duty to make assessments from an informed position and to
carry out their professional obligations in a manner comparable to what other reasonable
professionals would do in similar situations.

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Topic 4 DQ 2 (Obj. 4.2) Marcie is a new client and a 22-year-old female who works as a receptionist in a doctor's office. She has just revealed to you during the intake session that she has recently lost interest in most activities, has been sleeping a great deal yet feels tired all the time, and sometimes wishes she could cease to exist. She mentioned feeling as though she has been "on an emotional roller coaster" during the past year, throughout her on-again/off-again relationship with a 35-year-old married man. The last breakup with him seemed final, and Marcie has felt herself sinking deep ...
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