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1. Analyse and reflect upon why this case is personally challenging, outlining the personal values that are involved.
2. Discuss the potential risks and difficulties for you as a counsellor and consider the potential ethical implications if these ethical risks are not managed.
3. Outline how you would respond to such challenges in your work by providing practical strategies to support ethical practice for counsellors.

Background on Ethics in Counseling

The term ethics has originated from the ancient Greek word ethos, which means customs or rules. Ethics is present in each and every profession and the professionals must be sticking to the same. The counselors or the healthcare professions have to make sure that they are abiding by all the ethics or the basic rules of their profession. One of the most important ethics that had to be maintained by the counselor is keeping the whereabouts or the details of the patient safe.

This essay will mainly talk about the challenges that I have faced while treating a patient who was dominated and caught in an abusive relationship. However, at the same time, she did not wish to come out of this relationship as she did not any to stay alone. I really found this particular case to be very challenging because I found a lot of connection of my own life in this case. This client was a 23 years old girl who was in a love in relationship with her college mate for about 7 long years. As per her opinion, things worked out well during the beginning of the relationship but then as time passed by it was worsening. After talking with her I came to know that she was not really ignorant. She knew that she was being dominated by her partner and was not really very happy in this relationship.

However, she tried to adjust a lot and wanted to somehow stay within the relationship as she did not want to be lonely. I had to keep in mind all the ethical code of conduct that I have been taught during the course of my profession. I knew that I had to ensure her that none of the personal; information will be shared with an outsider. I realized that she was very hesitant in the beginning and was unwilling to speak frankly. I ensured her that all her statements will be kept a secret. However, during the course of my diagnosis, I realized that she was suffering through a huge mental trauma and had the chances of causing harm to herself. In other words, she was showing signs of suicidal tendency. This was one of the major concerns and I had to somehow stop her from harming herself. This was one of the challenges that I faced. As per my ethical values, I must not disclose any information about the patient to any outsider or external individuals. However, in this case, I have to involve somehow who would take care of the fact that she does not harm herself.

Personal Challenges in Managing a Patient with Abusive Relationship

I think that this case was becoming personally challenging for me. This is because one of my greatest personal values is empathy. I cannot really keep myself aloof from the pain or the grief that the patient is suffering from. After hearing to the pain that my client was suffering through I wanted to reduce her pain and somehow share her pain as well.  I realized that the client was getting too attached to me. However, this was becoming a problem as she was trying to gain my sympathy even outside the clinic. She felt that I will be there to assist her every single time and so she started calling me and texting me every now and then. I knew that she gains a feeling of security and comfort by talking to me. However, I also had to abide by the professional ethics. As far as the ethics are concerned I cannot keep any personal contacts with my client. So, it was my duty to teach her how to maintain the distance between a counselor and the clients. In the act of doing this, I had to avoid taking up her calls or responding to her texts every now and then. I had to maintain my professional standards and stop being too over friendly with the client.

The other aspect is that I am of a very loyal and dedicated nature. I know how to stay loyal to my duties and carry on with my work in a dedicated manner. I knew that in order to help the client I had to refer her to another doctor who would check her for conditions like short-term memory loss, multiple personality disorders or any other such problems. I was also very honest with myself. I did not like to make any false pretensions. I knew that this client needs some referrals as some parts of her condition were beyond my level of competency. However, the client was unwilling to accept any referrals as she was becoming over-friendly with me.

I am of a very friendly nature and I always try to make my clients very easy and free with me. Even in this case, I made sure that there is a friendly relationship between me and my client. However, this client was becoming too much friendly and dependent on me and was expecting guidance even outside the clinical premises. I knew that this was wrong and I had to prevent this. As I am of a very soft-spoken nature I find it difficult to say no. So, initially, I did not know how to stop these over the friendly gestures of my client. I thought that if I say no then she might get angry and again suffer from loneliness.

Establishing Boundaries of Professional Competency

I also had this aspect of suffering from personal biases at times. I often get carried away by my own experiences while dealing with my clients. I was getting too much engrossed and affected by the bitter experience that happened to my cousin due to her abusive relationship. This made me abuse the partner of my client. There was an uncontrolled and unnecessary outburst of my emotions. All these were really becoming a huge challenge for me based on my personal values. So I had to contact another counselor for getting a treatment for myself. This counseling session would help me in my future endeavors as well.

Abiding by the ethics, I had to carry on the treatment procedure without demeaning or judging the present situation of the patient. I could have suggested her to come out of the relationship but I saw that she was really very helpless and was not willing to come out of her relationship. However, I had to abide by the ethical code those talk about the boundary of the professional competency. I did not have the capacity of giving any relationship advice. Apart from this, I realized that the patient was always in a fluctuating mood. In other words, she seemed to be very sad at one point in time while talking about the initial stages of her relationship and how they not with each other. However, just in the very next moment she would appear really very sad and started crying. At times, she was even behaving abnormally and was unwilling to even recognize anyone by her partner's name. I thought that this might be a case of multiple personality disorder or even short-term memory loss.

These cases were surely out of my area of expertise. However at times, I had a feeling that being a fresher in this field, I must not seek a referral or send my client to any other colleague doctors as this might hamper my reputation. So, this was another challenge that I faced. However, I also knew that if I do not send this client to another colleague or refer her to the concerned specialist then she will suffer and this will be my greatest failure. I knew that I cannot take any risk with the well being of a patient. So, I knew that I was facing an ethical dilemma but I had to overcome it somehow. If I did not refer the patient to someone else then it would not benefit the client or me in any way. There would be no improvement in the condition of the client.

Managing Potential Risks: Stalking and Gift-Giving

This is one of the potential risks that I faced while dealing with this patients the problem of stalking. She was becoming so much dependent and obsessed with my assistance that she literally started stalking me over the phone and also on the social media. I knew that I had to stop her from doing this else there would have been the charge of ethical violation against me.

I told her to slowly come out from the relationship and concentrate on her own. I also involved her parents and told them that they have to support her in every instance. They must tell her to focus on her own happiness. She needs to be ensured that she is not alone. She could finally recover from her condition and was very thankful to me. She started sending me thanking letters and gifts. I was facing a challenge here as accepting gifts from clients is considered an ethical violation.

The other personal challenge that I faced was the issue of countertransference. This was one of the most challenging issues for me. I remember the incident of one of my cousin who had to suffer a lot because of an abusive relationship. She was very close to me and we share almost everything with each other. She was in a relationship with one of her college mates for 3 years. However, after 1 year, there were many problems with the relationship and it grew worse day by day. Unable to bear with the trauma my cousin started taking drugs and became an addict. This kept on ruining her life day by day.

Even after all these, she was unwilling to come out of this above relationship. As a result of this prolonged mental trauma, she became involved in addictions and many other illegal activities. This had a bad impact on her health and she suffered from a mental breakdown. Since then she has been rendered mentally disabled. This was a very disturbing phase as I was very sorry for my cousin. So, after getting a similar case like this, I was somewhere becoming biased and was trying to take out my anger on the partner of this patient without even knowing him. This was one of the major ethical dilemmas that I was suffering from. I had to carry on the treatment of the patient in a totally unbiased and non-judgmental manner. Being a mental health counselor I cannot disrespect anyone or anything that is currently related to the client. I have to maintain a level of decency and deal with the patient respectfully.

Practical Strategies for Counsellors

I have to take some of the other strategies to deal with such challenges in my career. I will have to deal with such sensitive cases with extra care and understanding. I can neither compromise with the ethics nor neglect the client. Confidentiality is one of the greatest ethical challenges that I might face even in the future. In such cases, I have to contact the family members or the carer of the client right from the beginning of the case so that they can stay updated with the information. In this case, I contacted the family members of this patient so that they can always be there for rendering the necessary support. I will always be very transparent about why the information needs to be shared and on account of which valid ground.

I know that breach of confidentiality is a severe offense but decisions have to be taken as per the demands of the situations. For an instance, in the given case the client neither was in a controlled and critical relationship but did not want to come out due to the fear of loneliness. So, involving some close ones was really very important who would narrate the past history of the client or to know the current status of the relationship. I also had to keep any close friend or family member of the client ready so that they can support her during loneliness.


I will henceforth try to avoid being over friendly with my clients. I will also avoid entering into multiple relationships. There is a high chance of developing a personal association with the client as I am of a very friendly and soft nature. I will have to keep a proper distance between me and my client.

I will also try to keep myself distanced from my personal experiences.  Counter-transference is one of the major issues that I can face in the future. I will try to stay u biased and non-judgmental. I have to treat my clients from a totally neutral point of view. I cannot disrespect or dishonor any of my clients only because their cases remind me of some of my own life experiences. I will also consider taking some special counseling sessions that will help me to deal with this problem.

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