Review the Ethical Standards for human service professionals and counselors for guidelines that relate specifically to managed care and working with families and potentially violent clients.

Review the Ethical Standards for human service professionals and counselors for guidelines that relate specifically to managed care and working with families and potentially violent clients.

1. What are the guidelines in each of the two codes that relate to working with families?

2. Compare the guidelines from the two codes. What is similar? What is different?

3. How would these guidelines help you resolve the issues presented in the case of

Mrs. X and her son and daughter in this chapter? (This case is found within your textbook and at the end of this document.)

4. What are the guidelines in each of the two codes that relate to working with violent clients?

5. Compare and contrast the guidelines from the two codes.

6. How would these guidelines help you resolve the issues presented in the case of Susan in this chapter? (This case is found within your textbook and at the end of this document.)

7. What are the guidelines in each of the two codes that relate to working with managed care?

8. Compare the two codes to this issue. What is similar? What is different?

9. How would these guidelines help you resolve the issues presented in the case of Zhewei in the chapter? (This case is found within your textbook and at the end of this document.)

Case Studies

Mrs. X.:

The client, Mrs. X., was a woman fifty years of age with a history of severe depression. She had been cared for by her twenty-year-old daughter and placed in a hospital when the daughter could no longer care for her. The mother lost the ability to live independently, was unable to work, and had lost a majority of her social support. When the mother attempted suicide, she suffered brain damage. The daughter recommended that her mother be given comfort care or medical attention so that she was comfortable and out of pain. There was no written directive from the mother so the request went to the hospital ethics board. The board concurred with the request. The daughter was sure that this measure coincided with her mother’s wishes. Complications arose when the mother’s son (the daughter’s brother), who had not seen his mother in seven years, arrived in town. The son demanded that his mother receive aggressive medical intervention. He was furious with his sister and told the medical staff that he knew what was best for his mother. He told them that he knew she could be saved, and then could return home. During the next few treatment team meetings, he did not allow his sister to speak, and he refused to listen to the other professionals. He then left town abruptly.

The treatment team then again asked for a recommendation from the daughter. She again asked that her mother be taken off medical intervention and be made comfortable and pain-free. The mother died two weeks later, and the son did not return.

Susan:

Susan is a case manager for the persistently mentally ill. She has clients on a long-term basis. At a minimum she visits her clients at least once a week in homes or places of work. Last week, Susan experienced a scare that she believes she will never forget. She arrived at George’s home at 3:00 p.m. on Thursday afternoon. She had tried to find George at work but was told that he did not show up. George had a habit of taking hi meds regularly for several months and then discontinuing the use of them. Susan suspected that this was one of those times. Early in her relationship with George,  he was violent and had to be restrained. For the first two years, she did not visit with him alone; another member of the case management team accompanied her on the visits. But in the past three years, Susan had seen no signs of violence in George. Susan approached the door, knocked, and heard a faint sound inside. George quickly opened the door and beckoned her in. He had a gun he grabbed her. She was surprised and very frightened.

Zhewei:

Zhewei, diagnosed with schizophrenia at the age of fifteen, received treatment from various individuals and social service agencies for twenty years. By the time she was thirty-five, she was taking medication, holding a part-time job, and receiving weekly counseling. She had been stable for the past fourteen months. Her insurance paid for her weekly counseling sessions; the case manager at the local community health center coordinated her care. Team members included her counselor, her physician, her employer, the case manager, and one of her parents. Zhewei had decided that she did not want to attend treatment team meetings about four years ago. During the last month, individual members of the treatment team had noticed small signs that Zhewei’s behavior was changing, and her condition was deteriorating. All agreed that she needed additional intervention. A new plan was developed based upon these signs. The new plan, which required additional individual counseling sessions, a physical exam and individual sessions with her psychiatrist, was rejected by the managed care organization.

Reference

Woodside, M. R., & McClam, T. (2018). Generalist case management (5th ed.). Belmont, CA: Cengage Learning

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