Apparent emotional anguish

Select one of the cases available in Engage. Using the Steps in Ethical Decision Making on pp. 80-81, discuss how the social worker should handle the situation moving forward.

Your initial discussion board post should be no less than 250 words in length. Be sure to use APA style and format: in-text citations and references. You should also include a descriptive subject line in this initial post.

Vignette #1

A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. The client, Mr. Don Tellanyone, is a 47-year-old man who is seeking services for depression. During the initial phone contact, he asked repeatedly about privacy and wanted assurances that information discussed in session was confidential. The patient repeated this line of questioning during the first face-to-face session. As the session progressed, he revealed that the source of his depression was the death of his mother one year ago. His mother had suffered from a combination of severe respiratory problems and Alzheimer’s. Mr. Tellanyone had been caring for her and his father in his home for 6 years prior to her death. During the last two years, she required total care. He revealed that she had been suffering greatly and, out of compassion for her, he gave her an excess dose of her sleeping and pain pills. Medical personnel never questioned the death as the woman had been quite sick and “It was only a matter of time.” Mr. Tellanyone goes on to explain that he is now caring for his father in similar circumstances, although there is no dementia. His father has declined rapidly since the death of his wife and now requires total care. Mr. Tellanyone reveals that recently he had a conversation with his father in which the father commented how peaceful his wife’s death was and how he hoped for a similar passing. Mr. Tellanyone is feeling quite guilty about his mother. Simultaneously, he strongly believes he made the right decision. He would like help to work through the issues. He is also very concerned about confidentiality and wants assurances from Dr. Solomon. Dr. Solomon, feeling uncomfortable with the situation, contacts you for a consultation about the potential ethical issues for this case.

Vignette #2

A social worker had an intake appointment with a new client. As soon as he looked at the intake form, he realized that she is the ex-wife of his former client. The therapy with the ex-husband was brief, and he focused on how he wanted to leave the marriage. The prospective client was using her maiden name and gave no indication that she had known about her ex-husband’s treatment with the psychologist. When asked about the reason for the referral, she said that her physician had referred her for anxiety. During the session, she stated that he is still in communication with her ex-husband because they share three children.

Vignette #3

Dr. Smith is a social worker who has worked with a young woman for about 9 months. The patient presents with a history of rejection and abandonment as well as persons of power misusing her. She recently received an offer to become a sales representative for a pharmaceutical company. The social worker and patient discussed the type of job she was entering because she may experience rejection from doctors, nurses, and other office personnel. After her 6 weeks of training, the company assigns her to a regional director that the social worker knows personally. Along with the initial anxiety of the new job, her territory, and her boss, she reports a fear of failure and other anxiety related symptoms. The social worker knows her new boss, Mr. Biggy. The social worker seeks to reassure the patient that he, the social worker knows Mr. Biggy on a personal basis and that “he is a really a good guy” that seems bright, friendly, and fair. He indicates that Mr. Biggy is a good “family man”. The patient is reassured, and reported less anxiety. In actuality, Mr. Biggy’s wife is a very close friend of Dr. Smith’s wife. They have dinner as couples several times per year. Several weeks into going on sales calls, your patient reports that Mr. Biggy is complimenting her on the way she looks and her ability to make the sale. They start spending more time together. However, she begins to feel uncomfortable as she feels like they are spending too much time together. Mr. Biggy starts asking questions that are more personal, forwards her “funny” emails, and texts some inappropriate remarks to her, mainly about her alluring power that helps make sales. Mr. Biggy and Dr. Smith meet in an unplanned social venue. Mr. Biggy pulls Dr. Smith aside and explains how he has become very attracted to a new sales representative. He thinks that she is young and impressionable. He confides that he would like to have an affair with her. Dr. Smith politely explains that he feels uncomfortable with them discussing his more personal marital issues. Mr. Biggy indicates that he wants to talk more about his feelings. Dr. Smith suggests a referral to a psychologist, but Mr. Biggy states that he feels more comfortable talking with Dr. Smith. After some other small talk, Dr. Smith leaves to mingle with other friends.

Vignette #4

A female social worker receives a call from Buddy, her very close high school friend. The social worker speaks with Buddy about once every six to nine months. During those calls, the conversations typically focus on careers, family members, and the whereabouts about other classmates. Buddy phoned the social worker in an apparent emotional anguish by the tone of his voice. Buddy states that he has been feeling “stressed” over the last month. He explains that he recently lost his job and has been worrying about the financial impact that this is having on his family. Buddy adds that he has had trouble sleeping, has stopped exercising, has little energy, and fleeting thoughts of hurting himself. Buddy also shares that he has been short tempered with his wife and kids. During the 90-minute call, the social worker tries to be a good listener, empathizes with Buddy’s difficult situation, offers advice on ways that Buddy can better manage his stress, provides him with general encouragement, and suggests a book that outlines stress management and anxiety reduction strategies. At the end of the call, Buddy tells the social worker that he is feeling much better. Just as he is about to hang up, Buddy says, “Thanks. My wife told me that I should see a therapist but I told her that I could talk with you and that it would be much cheaper.” The social worker is unclear whether Buddy is serious or joking.