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Mental Health and ACA Code of Ethics Discussion

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Topic 7 DQ 1 (Obj. 7.5 and 7.6)

You are the executive director of a small publicly funded behavioral health agency that serves indigent clients.

After 10 years of being able to serve all clients seeking help, your agency has just received a 20% budget cut and

must prioritize which services to discontinue and which clients to turn away. The community has many

suggestions: stop serving undocumented immigrants and their children; stop serving substance abuse clients, limit

all clients to six sessions, discontinue providing expensive services like psychiatry, lay off professional counselors

and hire non-licensed paraprofessionals, stop providing counseling and instead simply offer peer self-help groups

and parenting classes, serve only the most seriously ill (or the least seriously ill), and serve only children. How

would you approach the difficult task of cutting services by 20% in a manner that reflects your ethical obligations

as a community counselor? Would your plan differ if you were in a private sector? If yes, how? What criteria would

you consider? What theoretical or standard of care practice will you follow to make a final decision about what to

cut from your program? Reference the ACA and/or NAADAC Code of Ethics to support your answer.

When looking at the community as the client, Corey et al., (2015) states,

The foundation of all ethical practice is promoting the welfare of clients. To overlook the abilities,

strengths, and resources within the community is doing a great disservice to the individuals we serve. If

we hope to bring about significant changes within individuals and communities, Homan (2011) states that

we need to change conditions that affect people, rather than merely changing people who are affected by

these conditions. (p. 463).

This clearly goes against discontinuing services to any group of the community. And how does one determine who

is more or less ill? The answer isn’t found in singling out an individual or group within the

community. Furthermore, Corey et al. (2015) says, “that by adhering to traditional roles, practitioners are

maintaining and reinforcing the status quo, which results in passively supporting the social injustices, inequalities,

and discriminatory treatment of certain groups of people” (p. 464). The community orientation is based on the

premise that the community itself is the most appropriate focus of attention, rather than the individual, and the

community also is the most potent resource for solutions. (Corey et al., p. 456)

The answer to the budget cut must be found from within the community and the agency itself. Look at all the

people being served, are there ways to go from individual to group therapy? Are there any extraneous expenses

and/or overlapping of services? Is it possible to cut back on custodial and support staff? Does any of the

professional staff want to work part-time? Is the agency itself top-heavy in management? Is the drug screening

done in-house or outsourced? There are innumerable of ways to save money if everything is broken down by cost

analysis. Look to the community as well. Often when working with indigent clients, it is possible to find donors to

help financially or have a fund raiser. The ACA Code of Ethics (2014) says, “Counselors are encouraged to

contribute to society by devoting a portion of their professional activity to services for which there is little or no

financial return (pro bono publico). Some of the current counselors, or some from another agency, may be willing

to donate some of their time to counseling sessions.

If this were in the private sector, a lot of the same methods could still be used. However, is this a for-profit

facility that already does pro bono work and/or uses private money for expenses? Could money be channeled from

one area of the agency to another? If the market could withstand it, a rate increase for therapy could be an

option? Reach out to other agencies for assistance with referrals for individual and group therapy. In the end, the

survival of the agency is paramount while still providing services to the indigent clients of the

community. Wherever cuts are made, it should be done with the good of the community in mind. By looking at

the community as a whole, where are cuts possible that will cause the least amount of disruption to all the people

who have come to rely on the agency for the past 10 years?

American Counseling Association. (2014). 2014 ACA code of ethics. Retrieved Aug. 13, 2020

from https://www.counseling.org/docs/default-source/default-document-library/2014-code-of-ethics-

finaladdress.pdf

Corey, G., Schneider Corey, M., Corey, C., & Callanan, P. (2015). Chapter 13 Community and Social Justice

Perspectives. In Issues and ethics in the helping professions (Ninth ed., pp 460-487). Stamford, CT, USA, CT:

Brooks/Cole Cengage Learning.

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Topic 7 DQ 1 (Obj. 7.5 and 7.6) You are the executive director of a small publicly funded behavioral health agency that serves indigent clients. After 10 years of being able to serve all clients seeking help, your agency has just received a 20% budget cut and must prioritize which services to disco ...
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Tags: American Counseling Association ACA code of ethics ethical practice ethical principles Group Therapy