Counseling as a family therapist
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You are a marriage and family therapist. Gretchen, a 29-year-old newlywed, has sought your counseling services about 6 months after her marriage to Thomas because she feels that something has changed since their wedding. They don’t talk as much as they used to; Thomas seems very ‘distant’.
In her first individual session, Gretchen attempted to identify when their pattern of communication changed. She seems to remember that Thomas stopped talking freely to her about three weeks prior to the wedding.
When you first meet Thomas individually, he is very resistant to talking to you. Thomas discloses that he is feeling extremely guilty in his relationship because he had a one-night stand with a stranger a few weeks before his wedding. You begin to discuss the implication of this affair on his current relationship and whether or not Thomas should share this information with Gretchen.
Later that week, Thomas shows up at your office obviously distraught. He’s just been to the doctor for his annual physical and has found out that he contracted HIV, probably during the one-night stand. The two of you talk about the recent HIV diagnosis, and Thomas absolutely refuses to bring Gretchen into the discussion. He feels that she doesn’t need to know about it yet, and assures you that he will do whatever he can to protect Gretchen until he feels it’s the right time to tell her.
The couple never returns to counseling.About a month later, you run into Gretchen in the supermarket. She greets you and cheerily tells you that “everything’s better now…we’re trying to have a baby, and that has fixed the relationship!”, how do you respond to Gretchen? in mandatory reporting and confidentiality Use the 8-step decision-making model to guide your response, considering relevant ethical principles, guidelines, and laws.
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