Ethical and Legal Issues in Counseling (4 credit)

Spring 2023

Ethics Case Study #3:

Disputing Unhealthy Beliefs or Imposing Values?

Carl, a 55-year-old White male, is in counseling with Gina, a licensed professional counselor in private practice, to support his early recovery from alcoholism. He has just returned home from a 30-day residential program. He has suffered from alcoholism for more than 30 years but finally decided to enter recovery after his wife of 25 years left him and both of his daughters refused to talk to him. Carl’s parents have died within the past 5 years, and Carl, alone for the first time in his life, nearly drank himself to death in a binge drinking weekend. After barely surviving his binge, he entered recovery.

On his initial intake form, Carl indicated that religion/spirituality was very important (ranking this as a “5” on a 5-point scale) but that he did not want to talk about this in counseling. Although it was atypical for a client to say that religion was so important but not want to talk about it, Gina respected this request as the focus of the counseling initially was building rapport, developing coping skills, and finding a support community to assist in Carl’s sobriety. After these had been established, Gina gently pointed out that Carl had initially indicated that religion was “very important” to him but that he did not want to talk about it in counseling. Gina transparently disclosed her conflict around wanting to empower Carl by respecting his request to not talk about religion but also wondering whether she might be missing important information.

With this gentle invitation, Carl began to talk at great length about his religious life. He grew up in a highly religious family and had been very active in his church since childhood. He was an ordained deacon, had taught Sunday school for 25 years, and even had preached on occasion. He spoke at length about the “Jekyll and Hyde” experience of being so active in his religious community while keeping secret the shame of his addiction.

When Gina asked how he practiced his religion, Carl looked down and hesitantly responded: “Well, I used to pray every day, but not anymore.” When asked to say more about this, Carl quoted a passage of scripture. “The Lord is far from the wicked, but he hears the prayer of the righteous.” He spoke haltingly of all the damage he had done in the world, adding that there was no point in praying as he had pushed the Lord so far away that his prayers could not be heard. Although Gina was aware of her desire, as she listened, to reassure Carl that the Lord loves sinners, she set this aside and kept the focus on Carl. She helped Carl talk about how sobriety had led him to reflect on all the bad things he had done, which he reported included physically and emotionally abusing both his ex-wife and two daughters, along with engaging in numerous on-night stands over the years. He reported that he had missed his second daughter’s wedding, where he was supposed to walk her down the aisle, because he was too drunk to attend. Carl concluded, “The Lord has a lot to worry about, so why waste my time lifting up prayers to Him when He is so far from the wicked?”

Carl further described what it was like growing up in a conservative religious family in which he was punished severely for any misbehavior, often with threats of incurring God’s wrath and going to hell. Carl told a particularly emotional and poignant story of being punished severely for having a wet dream as a teenager, with the punishment being spanked in an age-inappropriate manner and lectured about the wickedness and immorality of sex.   

Ethical Case Study Questions:

  1. Is it appropriate for Gina to focus on Carl’s religious beliefs?
  2. What are your personal beliefs about Carl’s statements about religion and spirituality? How might these beliefs influence your work with Carl?
  3. If you were the counselor, Gina, in this case, what two (2) interventions might you consider implementing?
  4. From an intersectionality perspective, how does gender, race, religion/spirituality, and age influences Carl’s experiences?
  5. In Diversity and Culture in Counseling course we learned that sometimes it is important to consult with or invite client’s spiritual leaders into the treatment process. As Gina, you decide to ask Carl for his permission to invite his pastor to a counseling session with the two of you. Carl agrees. Pastor Franklin Jones joins Gina and Carl for a session. Carl shares with Pastor Jones his past struggles with addiction, familial relationship problems, and fear that God may not listen to or hear his prayers. As Gina, what would you do if Pastor Jones emphasized a shame-based approach to religion and agreed with Carl’s conceptualization that God would not hear his prayers because of his past transgressions against the Lord?

Please see the more detailed instructions handout for Ethics Case Studies.

In developing your response to the above five questions associated with this ethics case study, you must read and integrate knowledge and perspectives from the two articles listed below.  In addition, you must identify at least five (5) 2014 ACA Code of Ethics that would guide your understanding and ethical decision-making process relative to this case.

Parker, S. (2011). Spirituality in counseling: A Faith development perspective. Journal of Counseling and Development, 89, 112-119.

Matise, M., Ratcliff, J., & Mosci, F. (2017). A Working model for the integration of spirituality in counseling. Journal of Spirituality in Mental Health, DOI: 10.1080/19349637.2017.1326091

Stewart-Sicking, J. A., Deal, P. J., & Fox, J. (2017). The Ways Paradigm: A Transtheoretical model for integrating spirituality into counseling. Journal of Counseling & Development, 95, 234-241.

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