Three weeks ago Greg (who is a staff counselor) began working with a court ordered client, Cameron is a 32 year old single mom of 2, was referred by the court for anger 10 management sessions. She was charged with Domestic Violence for beating her boyfriend and causing physical injuries. She spent 5 days in jail and of her time in jail, her kids were ordered to go to a foster home. Cameron is currently working with a social worker to obtain full custody of her children and signed a release of the information for the court/judge and case manager.

Greg has noticed a pattern of missing and rescheduled sessions since Cameron entered the treatment as well as Cameron seeming disengaged and resistant during the sessions.Cameron generally talked about her everyday life; little of her anger issues was mentioned. Cameron called Greg four days ago and told him her boyfriend, Brian had committed suicide, and she would not be able to attend the upcoming counseling session. Cameron said her boyfriend was playing with a gun with his friends in the basement and accidentally shot himself. Greg asked Cameron if she was okay, and Cameron insisted she was fine and did not cry. Cameron and Greg agreed that she would attend the session tomorrow in order to process the situation. After he hung up the phone, Greg felt that Cameron did not react like a person who has just experienced an unthinkable situation. Cameron showed up yesterday as scheduled (Session 4).

During the session, Cameron seemed confused and presented different causes of Brian's death. At first, Cameron said the police ruled the death homicide. Then, Cameron said the police had begun their investigation. Cameron spoke minimally about her feelings of loss, even when Greg directly asked her about them. Cameron asked Greg to release a record of attendance to her case manager and attorney, with whom she was working to obtain a full custody of her children. When Greg asked why she made this request, Cameron said, “They asked for that.” Cameron is scheduled for another session next week (Session 5).

Dave is one of the staff counselors who has worked with Cameron and Brian. The death of his client put Dave over the edge. Dave shared with Greg that he could neither sleep nor eat. Dave said that Brian worked really hard in the session to repair his relationship with Cameron. Like Greg, Dave has observed that Cameron has seemed disengaged and not invested in the sessions Dave has conducted with the two of them; Brian has appeared much more committed. Dave also shared with Greg that during the last session, Brian mentioned that Cameron at times was very angry, but there had been no signs of physical abuse after the domestic violence charge. Dave and Greg have been following local news closely about the police investigation of this incident.

Cameron called Greg this morning and said that she would not continue counseling, because she was moving to Texas for financial reasons. Greg cautioned Cameron that she had not completed court ordered anger management sessions; however, Cameron said her attorney would take care of the issue. Greg has lingering feelings surrounding Cameron's sudden termination of treatment and consulted with Greg. Greg and Dave concluded that Cameron may have something to do with Brian's death, and she is getting away with it. Greg and Dave asked Dr. Phillips to do something. Dr. Phillips asked Greg to complete an incident report, to document a phone conversation with Cameron, and to close her file. Greg became very upset and said to Dr. Phillips, “You don't understand. She is getting away with this. We need to call the police.” Dr. Phillips responded, “There is nothing we can do at this time. Cameron is our client, and that would be a breach of confidentiality.

Plus, we don't know for a fact that she did murder her boyfriend. I know I didn't say what you wanted to hear, and you are frustrated with me.” Greg was not pleased with Dr. Phillips's response. Greg told Dr. Williams, the director of the agency, that he questioned Dr. Phillips's judgment and action surrounding this case. He also wondered if he had a duty to warn the public that Cameron may be a danger to society. Dr. Williams suggested that there may be other alternatives; however, she needed more time to process the incident. In the meanwhile, Dr. Williams said to Greg that she agreed with Dr. Phillips's judgment and action. Dr. Williams felt that she needed to speak with Dr. Phillips to follow up on this situation.

Below are questions Dr. Williams would like to follow up on with Dr. Phillips.

1. What is the ethical decision-making model you implemented?

2.What are other possible actions you may have chosen or taken?

3.What are the pros and cons of the decision you have made (to not report to the officials)?

4.Would you make a different decision if you could go back? If so, what would that be?

5.How will you handle your relationship with Greg and other staff counselors?