You are the executive director of a small publicly funded behavioral health agen

Question

You are the executive director of a small publicly funded behavioral health agency that serves indigent clients. After 10 years of being able to serve all clients seeking help, your agency has just received a 20% budget cut and must prioritize which services to discontinue and which clients to turn away. The community has many suggestions: stop serving undocumented immigrants and their children; stop serving substance abuse clients, limit all clients to six sessions, discontinue providing expensive services like psychiatry, lay off professional counselors and hire non-licensed paraprofessionals, stop providing counseling and instead simply offer peer self-help groups and parenting classes, serve only the most seriously ill (or the least seriously ill), and serve only children. How would you approach the difficult task of cutting services by 20% in a manner that reflects your ethical obligations as a community counselor? Would your plan differ if you were in a private sector? If yes, how? What criteria would you consider? What theoretical or standard of care practice will you follow to make a final decision about what to cut from your program? Reference the ACA and/or NAADAC Code of Ethics to support your answer.

Explanation / Answer

American Counseling Association Code of Ethics:

Counselors play a key role in developing individuals and shaping communities. In their role, counselors are often responsible for cultivating and maintaining relationships, monitoring clients’ well-being, and working with different cultural values and confidential information. The American Counseling Association (ACA) understands this and has a code of ethics, updated every 10 years, to help counselors navigate the challenging and sensitive aspects of their roles. Below we have compiled a basic summary of the 2014 ACA code of ethics, so counselors have the foundational knowledge to work in the field confidently and ethically.

Purpose for the ACA Code of Ethics:

Ethics codes provide professional standards for counselors with the purpose of protecting the dignity and well-being of clients. The main reasons for the code of ethics include informing professional counselors and counselors-in-training of their ethical guidelines, professional obligations, and responsibilities to their clients. This helps counselors decide an appropriate plan of action for their clients and provides the ethical standards by which complaints and inquiries can be made regarding ACA members.

The importance of community counseling is focusing on social justice and prevention of problems rather than remediating problems (Corey, Corey, Corey & Callanan, 2015). The ACA Code of Ethics encourages counselors to be involved in the community in assistance with their clients such as community leaders, religious leader, etc. When it comes to cost reduction especially in the health sector one should take the decisions wisely. It should be seen that every need is met to the maximum extent. Stopping treatment for the needy is not correct. When we have to adjust budget, we could set some minimal pricices on certain things which are of high cost. We can set a limit to the number of times a person can visit the camp. Hiring professionals is a compulsory criterion and should never be violated. The decisions may differ if it is private firm as the funds provided may be a bit high and more advanced equipment could be afforded.

Reference:

Corey, G., Corey, M. S., Corey, C., & Callanan, P. (2015). Issues and ethics in the helping professions (9th ed.). Pacific Grove, CA: Brooks/Cole.

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