Ethical Decision-Making in Counseling: A Case Analysis
This paper applies the Forester-Miller and Davis (2016) ethical decision-making model to a counseling scenario involving a conflict between client autonomy and counselor beneficence. The client, Carla, is a first-year college student receiving counseling for depression and anxiety who wishes to pursue a romantic relationship. Her counselor, Joe, must navigate whether to respect her self-determination or intervene based on potential harm. The paper walks through seven structured steps — problem identification, ACA Code of Ethics application, dilemma analysis, possible courses of action, consequence evaluation, course selection, and implementation — ultimately recommending a balanced approach that advises without coercing.
- Introduction: Overview of the ethical decision-making model used
- Identification of the Problem: Joe's ethical concern about Carla's romantic plans
- Applying the ACA Code of Ethics and Defining the Dilemma: ACA standards and autonomy vs. beneficence conflict
- Possible Courses of Action: Three options Joe could take with Carla
- Consequences of Each Course of Action: Outcomes and trade-offs of each option
- Selected Course of Action and Implementation: COA 3 chosen; counselor must have courage to act
- References: Cited sources for the paper
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What makes this paper effective
- The paper follows a clearly numbered, step-by-step model, making the reasoning process transparent and easy to follow at each stage of the ethical analysis.
- It grounds each step in established frameworks — the Forester-Miller and Davis model, the ACA Code of Ethics, and Proctor's scholarship — rather than relying on personal opinion alone.
- The three-option structure for possible courses of action demonstrates genuine critical analysis: each option is fairly evaluated before one is selected and justified.
Key academic technique demonstrated
This paper demonstrates applied ethical reasoning — the ability to take an abstract framework and systematically apply it to a concrete dilemma. By working through each step of the Forester-Miller and Davis model, the author shows how competing principles (autonomy versus beneficence) can be weighed methodically rather than resolved by intuition. Citing Proctor (2014) to introduce the competence criterion is a particularly effective move, as it provides theoretical grounding for why client autonomy ultimately takes precedence in this case.
Structure breakdown
The paper mirrors the seven-step structure of the Forester-Miller and Davis model: introduction of the framework, problem identification, code of ethics application, dilemma dimensioning, generation of possible courses of action, consequence analysis, course selection, and implementation. This mirrored structure is intentional and serves as a demonstration of the model itself, making the paper both an analysis and an exemplar of the process it describes.
Introduction
The following analysis applies an ethical decision-making model to resolve the ethical dilemma presented in a counseling scenario. The model used here is largely based on the work of Forester-Miller and Davis (2016), titled Practitioner's Guide to Ethical Decision Making. This is just one of many ethical decision-making models available to practitioners. Indeed, according to Cottone and Claus (2000), "there are many practice-relevant models that can be chosen as guides for ethical decisions in particular practice settings…" (p. 281).
Identification of the Problem
Joe is concerned that Carla, his client who is undergoing counseling for depression and anxiety, will end up having sex with a classmate she is interested in dating. Carla is in her first year of college. In Joe's view, such an outcome would not only be inadvisable given her current mental health situation, but also raises ethical concerns rooted in the "do no harm" principle. Carla has already reached the age of majority. In the scenario presented, Joe has essentially embraced a moral stance by asking Carla not to date her classmate.
Applying the ACA Code of Ethics and Defining the Dilemma
A review of the ACA Code of Ethics indicates that the standard of relevance in this case is Standard C.2.e — Consultations on Ethical Obligations — which Joe has addressed by consulting with his supervisor.
To a large extent, seeking to implement a decision contrary to Carla's wishes would conflict with the principle of autonomy. However, because Carla is undergoing counseling for anxiety and depression, an unstable romantic relationship would likely worsen her symptoms — pointing to the need for Joe to discourage her from dating at this point. This concern aligns with the principle of beneficence.
It is worth noting, as Proctor (2014) points out, that in counseling scenarios it is not uncommon to encounter situations in which a counselor's beneficence comes into conflict with the client's autonomy. Proctor argues that in such cases, a determination must be made regarding the competence of the client. In the author's own words, "the principle of respect for patient autonomy overrides the principle of beneficence in a competent patient" (p. 109). Because Carla is of legal age and not demonstrably incompetent, her autonomy carries significant ethical weight in this analysis.
Possible Courses of Action
Three possible courses of action (COA) are identified for Joe to consider:
COA 1: Respect Carla's decision to date her classmate, with no attempt whatsoever to advise her on possible downsides.
COA 2: Refer Carla to another counselor.
COA 3: Involve Carla in the exploration of the downsides of her decision, and advise — but not coerce — that she consider dating at a later time. Ultimately, respect Carla's final decision.
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