college counseling

college counseling

Ethical Dilemma #1 – Working with Thomas

Dr. Smythe, a therapist, has been working with Thomas, a 22 year old male, for about 6 months at the college counseling center where you are employed as a counselor. Based on his report and past records Dr. Smythe has received, Thomas has an autism spectrum disorder. At times, Thomas behaves in ways that are inappropriate for typical college students – he has called professors at home late at night to ask questions, he has appeared at University offices outside of his regular appointments and demanded to be seen, and has a habit of regularly calling his therapist between appointments to seek reassurance for his anxiety.

Thomas is aware these behaviors are inappropriate, and with Dr. Smythe’s help he has made some small progress in reducing them. He has never been physically threatening toward the therapist, or anyone else at the college as far as Dr. Smythe can tell; however, Thomas’ large stature and difficulty with self-control have made some staff and students frightened of him and reluctant to work with him. He is an average student, and receives substantial assistance from your school’s Disability Services office.

One day the counseling center director approaches Dr. Smythe and asks if she will attend a meeting with the director and with other University staff who work with Thomas, for the purpose of planning and “figuring out what to do” with Thomas. Dr. Smythe gets the sense that this meeting will occur whether she attends or not, and she concerned about what may happen as a result of the meeting, so she agrees to go.

At the meeting, Dr. Smythe sits down with the counseling center director, the Dean of Student of the college, and a member of the Disability Services staff. The Dean plays some voicemails he received from Thomas late at night, in which Thomas expresses high anxiety and furiously demands that the Dean call him right away. The Dean also has a voicemail in which Thomas called back later that evening and apologized for calling the Dean so late at night. The Dean looks to Dr. Smythe as the therapist, asking “what should we do about Thomas?” Dr. Smythe gives some general information about Thomas’ diagnosis, and the work they have been doing, but declines to share her notes about the case with the Dean or the Disability Services staff member. Dr. Smythe suggests that the Dean give Thomas some firm limits about when he can or cannot call the Dean, and expressed hope that if people can be consistent with their limits, eventually Thomas will learn to abide by them. Dr. Smythe speaks with the Disability Services agent about coordinating their work together, and they tentatively agree on some ideas for making these behavioral limits clear to him.

In your essay, you will evaluate Dr. Smythe’s actions, and argue for or against her decision. Make sure to follow the assignment instructions, and include all necessary sections of the essay!

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