There may be instances when someone will seek mental health assistance and may not meet the full diagnostic criteria for a mental disorder, or they may not want a diagnosis on their record. It is the clinician’s responsibility to ensure they are using diagnosis in an ethical manner, according to the ACA Code of Ethics, along with the APA Ethical Principles of Psychologists and Code of Conduct. There may be times when a client questions their diagnosis and wants their case reviewed, possibly because of issues with insurance coverage, or they may believe their diagnosis will cause harm to them in other aspects of their life.
Imagine you’re a consultant who reviews cases of potential ethical violations. A nonprofit mental health agency has hired you to review a recent case that came into question and determine if there was an ethical violation regarding the use of a diagnosis. The case was filed because the client disagrees with the diagnosis given and would like a different diagnosis. She is worried that the diagnosis given will be detrimental to her career and family life. The clinician has written a report justifying their use of the diagnosis for your review. You have been asked to present your findings to the agency board.
Kassi is a 38-year-old White woman who came to the agency seeking substance abuse treatment. She mentioned that she needed to show her employer that she was taking appropriate measures to treat the issue, since it has impacted her productivity at work.
Kassi stated that she works 40+ hours per week as an executive assistant and is also a single parent to a 14-year-old daughter. She reported that her job is quite stressful and requires her to be flexible with her schedule so that she can be available in the evenings, if needed. She mentioned that this causes her to be away from her daughter often, and she misses sporting events, band concerts, and other extracurricular activities and that has strained her relationship with her daughter.
She reported that she often comes home and will have a whiskey on the rocks, and that sometimes turns into 3 or more drinks. She mentioned that this amount has increased over time. This has caused her to be late to work on more than one occasion, and completely miss work once or twice over the last 6 months because she is nauseous, anxious, and has trouble sleeping. Her daughter has mentioned her concern about her drinking since it has also caused her to miss some of her extracurricular activities and her daughter’s friends do not want to come over when Kassi is drinking.
Kassi reported that she is only seeking treatment because her work is requiring it, but she does not believe she has a problem with alcohol. When reviewing the DSM-5 diagnostic criteria for alcohol use disorder, Kassi meets criteria A. 1, 3, 5, 6, 10a, and 11a. Since this is 6 criteria, she was given a diagnosis of severe alcohol use disorder (303.90).
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct.
(Note: The American Psychological Association is not affiliated with nor endorses the University of Phoenix or its course materials.)
American Counseling Association. (2014). ACA code of ethics.
Forester-Miller, H., & Davis, T. E. (2016). Practitioner’s guide to ethical decision making (Rev. ed.).
Utilize the model for ethical decision-making presented in the Forester-Miller and Davis article to analyze the case and describe your ethical decision-making process.
Evaluate the clinician’s justification for the diagnosis given.
Explain whether the use of the diagnosis in this case was ethical or unethical, according to the ACA and APA codes of ethics.