TPC-Journal-V4-Issue2

The Professional Counselor \Volume 4, Issue 2 99 his fitness for duty on his next deployment. And although Robert has not been caught drinking and driving or charged with a crime, his behavior also puts him at risk of military conduct violations. However, when Robert originally came to the clinic, he did so of his own accord, not under orders, which could mean that notifying a commanding officer is an ethical violation. In consideration of the stealth approach, Megan may review the ACA (2005) ethical guidelines and conclude that there are no violations at risk if she chooses not to report Robert’s drinking habits. However, Megan contemplates whether addressing Robert’s drinking binges is in his best interest overall. She understands that the money associated with deployment is important to Robert’s fam- ily at this time; however, his drinking may put him at increased risk during deployment. Finally, Megan applies the best-interest approach to Robert’s situation. Megan may refer Robert to the center’s substance use support group. This referral will be reflected in Robert’s records, but if he begins receiving treatment for his alcohol abuse now (3 months before deployment), there may be time for Robert to demonstrate significant progress before his fitness for duty assessment. Analysis from stage model. Megan may consider her ethical dilemma from Barnett and Johnson’s (2008) 10-stage model. In stage 1, she clearly defines the situation as Robert’s alcohol abuse and pending deployment. In stage 2, Megan considers who may be affected in this situation. She understands that Robert’s family would benefit from the extra money associated with the deployment, and therefore the family may be impacted if Rob- ert is not deployed. Megan also notes that the family is already negatively impacted by his recent drinking binge (e.g., conflict with his wife, missed soccer games). If Robert’s problematic drinking continues, he is at risk for evaluation and promotion issues. In stage 3, Megan reflects upon the ACA (2005) ethical codes in order to better understand her dilemma from a counselor’s view. Robert has a right to confidentiality (B.1.c., p. 7) with limita- tions including illegal substance use (B.1.d., p. 7). However, Robert’s current substance is alcohol, which is a legal substance. Megan considers the importance of his support network (A.1.d., p. 4) including his family and unit, but she does not have the ethical right to disclose her concerns about his substance abuse. In stage 4, Me- gan considers the pertinent laws and regulations of the dilemma. As per the clinic regulations, she is aware that if she makes a substance use program referral, it will be reflected in Robert’s record, which is the property of the military. Megan also is aware that Robert has not committed a documented crime of driving under the influence. In stage 5 of the 10-stage ethical decision-making model, Megan must reflect on her personal thoughts and competencies. She is very concerned about Robert’s increased use of alcohol and is worried for his safety if de- ployed. Megan feels less confident in her ability to accurately assess for substance use problems. She facilitates the PTSD support group for the clinic, which is her specialty area. Megan recognizes that she is fond of Robert as a client and is disappointed that he could be jeopardizing his family and career with his alcohol abuse. She considers whether she is overreacting to his binge-drinking incident because of her higher expectations of him. In stage 6, Megan consults with her colleague who leads the substance use support groups at the clinic. She de- scribes Robert’s recent abuse of alcohol and inquires as to whether he is a good candidate for the substance use group, needs more intense treatment, or needs no treatment at all. The colleague suggests that the group would be a very appropriate fit for someone with Robert’s symptoms. In stage 7, Megan develops her course of action to refer Robert to the substance use group. Then, in stage 8, she evaluates the plan for potential impact on parties involved. Megan conceptualizes that Robert may be at risk for losing his deployment orders if he is accessing substance use treatment. Megan believes she has reduced this potential impact by referring to the substance support group, rather than an inpatient treatment facility, which may be more appropriate for a dependence issue. Megan recognizes that attending a 90-minute group each week will take Robert away from his family, but she also realizes that the 90-minute commitment is less than his current time spent away from the family when binge drinking. Megan reflects upon how her therapeutic relationship with Robert may be strained at the time of referral, and is prepared for a potential negative response from her client. She trusts in their therapeutic relationship and moves forward. In stage 9, Megan presents her