Gabriella is an 18-year-old Hispanic female with a strong Catholic background. She is midway through her first semester in college and has enjoyed all the freedom college has to offer. Gabriella is the youngest of three children and is the first to go to college. Her parents immigrated from Mexico and hold strong traditional Hispanic values and beliefs. While Gabrielle is bilingual, her parents are fluent in Spanish only. Gabriella and her siblings were born in the United States and she wants to embrace all that the United States culture has to offer. Her oldest brother graduated from high school and began working with their father at their family restaurant. Gabriella's sister dropped out of high school at the age of 17 to marry the type of man Gabriella's parents would also like for Gabriella to marry: A good Catholic, Hispanic man with the means to support a family. Gabriella has been drinking excessively since she began college. She attends parties at least three nights a week, drinking 6-12 beers per party. Her family disapproves of her underage drinking and her going to all these "wild parties." Gabriella was brought into treatment by her parents after she was caught over the weekend drinking alcohol in her dorm. This should have resulted in immediate expulsion; however, the Dean is willing to allow her to remain enrolled provided she receives proper treatment for underage drinking. Her parents insist on sitting in on Gabriella's sessions as they feel she is not making good decisions. They have also presented you with a letter from the Dean requesting that documentation be sent to his office as proof of session attendance prior to her returning to her dorm or attending her classes. Gabriella is asking for the freedom to choose her own path in life and is looking to you for guidance. She confides to you in the presence of her parents that despite her reluctance to follow her parent's traditional Hispanic beliefs, she is Catholic and is concerned that her "underage drinking and partying" has led her to an unforgivable sin in the eyes of God and her parents. Gabriella desires to incorporate her religion into treatment.

• What ethical dilemmas are presented in the case scenario?
• Describe the cultural, gender, and spiritual considerations in the case scenario.
• Although you feel that you hold no personal biases, should you reflect onyour own biases and values before beginning treatment with Gabriella? If so, discuss one way that you could carry out this reflection.