PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation:
Introduction: Hannah & Adara Case Study
The case study centers around two people. Hannah, a 36-year-old African American woman, has lived in Riverbend City for ten years and works as a school counselor at Cargill Academy. She grew up in Detroit before moving to Riverbend City at eleven. Adara, a 15-year-old Muslim-American teenager, is one of her students. Adara’s parents moved to Detroit, Michigan, from Iraq in 1999. Adara has been dealing with depression and is a victim of bullying, but she does not believe her parents would accept her choice to seek treatment from Hannah. Adara recently threatened suicide.
Cultural Issues
There are some cultural issues highlighted in the case of Adara, who is the only Muslim-American student in her school. She wears a headscarf to represent her religious views. She is bullied because of her cultural and religious identity. Sirin et al. (2021) report there has been an increase in religious discrimination and Islamophobia since the 9/11 tragedy. Furthermore, Muslims commonly consider mental health as a shame and also suicide is both illegal and prohibited in Islam (Hajiyousouf & Bulut, 2022).
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Theoretical Perspective
Attachment and Erick Erickson’s Stages of Development Theory
Attachment theory discusses the connection that children build with their parents or primary caregivers, which is thought to be inherent at birth. Grigorenko (2019) describes how a lack of healthy attachment could cause developmental delays and neuronal atrophy in the growing brain. Erickson’s stages of development theory states that personality evolves via eight stages of psychosocial development. Each stage offers a psychosocial crisis that can have a positive or negative impact on personality development (Orenstein & Lewis, 2022).
In the case of Adara, attachment theory plays a role in her relationship with her parents Adara’s connection with her parents, as she feels a strong feeling of respect for them, probably because of an inherent bond that has developed. This bond could affect her inability to get treatment because she worries that her parents will not understand or accept her decision to visit a counselor.
Erickson’s stages of development theory are also relevant, specifically throughout adolescence, which is characterized by the psychological struggle of Identity vs. Role Confusion. Adara is managing her need to be accepted by her fellow students, which is an important component of this stage of development. However, instead of acceptance she feels alone and abused as a result of the continual harassment and abuse she suffers. This social rejection has led her to become extremely depressed and pushed her to the point that she thinks about suicide.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
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Diversity & Cultural Competency
Many professional counselors follow the Cultural Competency policy because it helps to reduce the negative effects that clients can experience by helping both the counselor and the client to get a better awareness of culture through a cultural lens (Tanaka-Matsumi, 2022). This strategy is very relevant in Adara’s case. While the counselor wants to include Adara’s parents in a session to discuss her mental health problems, Adara is concerned that her parents will not approve of her attending counseling sessions.
Despite her anxiety, Adara confessed to the counselor about her suicide ideas. which led the counselor to report her actions to her parents. Cultural competence plays an important role here because it allows the counselor to manage the complicated cultural dynamics and concerns that impact Adara’s situations and her parents’ potential reactions.
Research on Cultural Competency
One approach used in this study is qualitative research, which is beneficial in understanding the significance of people’s experiences, how these experiences create their reality, and what drives them to act. The research focuses on two major concepts and instructional approaches for cultural competency: multiculturalism and critical multiculturalism. The study’s transcripts were tagged to categorize the data, identifying both primary and subcategories. The findings indicated that all participants understood the link between self-awareness and cultural competency.
The study produced three main findings: first, there is a correlation between increased self-awareness and increased cultural competency; second, cultural competency can lead to increased self-awareness; and third, and maybe surprisingly, there is no automatic relationship between increased self-awareness and increased cultural competency unless intentional efforts are made to analyze the majority culture and its advantages (Kaihlanen et al., 2020). All participants underlined the necessity of being aware of their organization’s cultural policies and ensuring that ethics and policy are always consistent with cultural sensitivity.
Cultural Competency in Use
Nair & Adetayo (2020) present a professional model of cultural competency in healthcare. The study emphasizes that a lack of cultural competency can have psychological and behavioral effects on patients, particularly those from minority and low-income backgrounds. The study’s findings show that greater levels of cultural competence among healthcare professionals reduce patients’ feelings of shame and humiliation after unpleasant contact, demonstrating that providing cultural competence to clinicians helps buffer some of these negative consequences.
Another study by Di Stefano et al. (2020) suggests a new model of cultural competency based on a client-oriented paradigm. The results of this study demonstrate that this paradigm strengthens interactions between professionals and clients by acknowledging, respecting, and valuing cultural diversity.
Counselors should keep cultural sensitivity, socioeconomic origins, race, religion, and gender identity in mind while working with teenage clients. These elements could serve as possible triggers for symptoms and emotions resulting from a variety of fundamental issues, making cultural competency important in effectively addressing their specific needs (Asnaani & Hofmann, 2019).
Ethical Issues
The ethical issue in this case is that Hannah, the counselor, reported Adara’s state of “wanting to be dead” to her parents without first consulting Adara. This conduct has left Adara upset and suspicious, as it broke her faith in her counselor, whether Hannah intended to or not. Furthermore, there is serious concern about Adara’s bullying, which is affecting her mental, emotional, and physical well-being. This situation is made more difficult by Adara’s religious and cultural concerns, which must be carefully explored during the counseling process to ensure her needs are properly understood and fulfilled.
Ethical Codes
The American School Counselor Association (ASCA) is a professional association that serves school counselors, educators, interns, counseling programs, directors, and supervisors (American School Counselor Association, 2022). School counselors have specialized qualifications and abilities that need them to show ethical behavior, leadership, and professionalism. They must encourage student growth, promote confidentiality, maintain healthy relationships, manage boundaries, and advocate for social and emotional planning to create optimum learning environments. ASCA standard A.1.h states that counselors must respect children’s and their families’ values, beliefs, and cultural backgrounds, including sexual orientation, gender identity, and gender expression. Counselors must be careful not to impose personal beliefs, views, or values based on their own religion, culture, or ethnicity (American School Counselor Association, 2022).
Codes & Processors
According to the ASCA Code of Ethics, A.9.a, school counselors must inform parents, guardians, and school administration when a student poses a threat to himself or others (American School Counselor Association, 2022). This notice should be made after careful consideration and contact with authorized educational personnel or child protection services. According to A.9.b, Hannah, as the school counselor, must do an accurate suicide risk assessment to establish the level of risk (low, medium, or high). This is important because it is estimated that 20% of students who consult a mental health professional within 30 days are still at risk of suicide (Pappas, 2023).
Additionally, ASCA A.9.c and A.9.d provide that Hannah and the school administration should work together to ensure that Adara receives sufficient guidance and assistance. If Adara’s parents refuse counseling and she is not receiving proper mental health care, there could be reasons to report the issue to Child Protective Services. Furthermore, it is important to keep open lines of communication so that Adara’s parents can look for help or culturally sensitive mental health options if they so want.
Other Contributors
Better communication could have considerably improved Adara’s position. Improved communication between Adara and her counselor might have helped to create trust and understanding, perhaps avoiding the sentiments of anger and distrust that occurred when the counselor reported Adara’s comments to her parents without her consent. Furthermore, improving contact between Adara and her parents could have provided an opportunity for Adara to get the family support she needs. A conversation between the client and her family could have helped create a more supportive environment, making Adara feel less alienated and more understood of her challenges.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
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Ethical Violations
In this case, Hannah did not give Adara informed consent, which would have included clarifying the reasons, goals, tactics, regulations, and procedures of her treatment sessions (Kafka et al., 2024). This disclosure is important because it clarifies the boundaries of confidentiality and ensures the client understands the extent of the counseling relationship.
According to Siegle (2023), children’s “informed” consent to participate in treatment without parental or guardian authorization follows the normal code of ethics. A consent agreement would assist both the client and the counselor in understanding privacy and confidentiality problems by stating the responsibility of each party.
The consent agreement must specifically state that certain sensitive issues, such as thoughts of suicide, could have to be revealed to a parent, guardian, or school authority to protect everyone’s safety.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
Providing this information to Adara would have established clear expectations, allowing her to make an educated decision about what information she felt comfortable revealing and whether or not to continue with the sessions. Because no such permission existed, Hannah’s disclosure of her suicidal intentions to Adara’s parents resulted in a breakdown of trust between the two. Taking these measures could have given Adara the ability to make more educated decisions regarding the material she revealed, possibly leading to a more open and honest conversation with her counselor.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
Action Plan
First, Hannah should have given Adara a consent form to sign before the counseling sessions began. This form would have proven to Adara that her privacy is being maintained to the greatest degree feasible, while also emphasizing that privacy can be constrained in some cases based on what is discussed during the sessions. Hannah would have demonstrated to Adara that school counselors must follow laws, rules, and ethical standards governing confidentiality and disclosure in the school context. This understanding would have prevented Adara from being shocked by her mother’s phone call, and Adara and Hannah’s trust would not have been broken if this consent had been properly expressed to the student.
Hannah is ethically accountable for Adara’s well-being. According to Şensoy & İkiz (2022), one of the most important ethical concerns that school counselors face is regulating confidentiality limits. Adara trusted Hannah with delicate areas of her life, expecting her to keep them hidden. Autonomy is an important ethical principle that means recognizing an individual’s ability to stand up for oneself, preserving their privacy, and honoring their rights as individuals.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
In a clinical setting, recognizing autonomy is important regardless of the age group being counseled. According to the American Psychological Association (2019), a counseling relationship is based on trust, and the counselor must protect privacy and confidentiality. Hannah’s responsibility as a counselor is to give emotional support, establish trust, and foster strong, supportive relationships with the students she works with.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
Hannah should have researched Adara’s Muslim culture before informing her parents about Adara’s suicidal thoughts. According to Tanhan & Young (2021), Islam is more than a religion; it is a way of life that impacts a Muslim’s thoughts, relationships, and every other area of everyday life. They point out that Islam has long differed from Western medicine and care, highlighting a more holistic approach to mental health. Before contacting Adara’s parents, Hannah needed to educate herself and understand their perspectives on mental health through the lens of their Islamic beliefs. This cultural awareness could have helped Hannah handle the matter with better compassion, allowing for more successful and culturally appropriate communication with Adara’s parents.
Furthermore, it was Hannah’s responsibility to properly investigate the validity of Adara’s remarks before responding quickly. Hannah should have investigated the underlying reason and emotions behind Adara’s statements to establish whether it was a serious concern or a casual statement. If it had been the latter, Hannah could have resolved the matter without informing Adara’s parents, retaining confidence in their relationship.
Hannah could have used a risk assessment to determine Adara’s level of suicidal thoughts. Based on this assessment, Hannah could have taken the appropriate steps to ensure Adara received the assistance she needed in a way that was respected and suitable with her cultural and religious values. This strategy would have offered a more intentional and culturally appropriate answer to Adara’s needs.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
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Conclusion
The case of Hannah and Adara highlights the important role of cultural competency, good communication, and ethical responsibility in counseling. Hannah’s response to Adara’s situation could have been improved by learning more about her cultural and religious history, doing a comprehensive risk assessment to determine the seriousness of her suicidal thoughts, and properly communicating informed consent. These measures would have maintained trust and assisted in a culturally appropriate and respectful manner, ultimately resulting in improved outcomes for Adara.
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
References
American Psychological Association. (2019, October 19). Protecting your privacy: Understanding confidentiality. Apa.org; American Psychological Association. https://www.apa.org/topics/psychotherapy/confidentiality
American School Counselor Association. (2022). ASCA Ethical Standards for School Counselors. ASCA Ethical Standards for School Counselors. https://www.schoolcounselor.org/About-School-Counseling/Ethical-Responsibilities/ASCA-Ethical-Standards-for-School-Counselors-(1)
Asnaani, A., & Hofmann, S. G. (2019). Collaboration in Multicultural Therapy: Establishing a Strong Therapeutic Alliance across Cultural Lines. Journal of Clinical Psychology, 68(2), 187–197. https://doi.org/10.1002/jclp.21829
Di Stefano, G., Cataldo, E., & Laghetti, C. (2020). The client-oriented model of cultural competence in healthcare organizations. International Journal of Healthcare Management, 12(3), 189–196. https://doi.org/10.1080/20479700.2017.1389476
Grigorenko, E. L. (2019). Brain Development: The Effect of Interventions on Children and Adolescents (D. A. P. Bundy, N. de Silva, S. Horton, D. T. Jamison, & G. C. Patton, Eds.). PubMed; The International Bank for Reconstruction and Development / The World Bank. https://www.ncbi.nlm.nih.gov/books/NBK525261/
Hajiyousouf, I. I., & Bulut, S. (2022). Mental Health, Religion and Suicide. Open Journal of Medical Psychology, 11(01), 12–27. https://doi.org/10.4236/ojmp.2022.111002
Kafka, J. X., Kothgassner, O. D., & Felnhofer, A. (2024). A Matter of Trust: Confidentiality in Therapeutic Relationships during Psychological and Medical Treatment in Children and Adolescents with Mental Disorders. Journal of Clinical Medicine, 13(6), 1752–1752. https://doi.org/10.3390/jcm13061752
Kaihlanen, A.-M., Hietapakka, L., & Heponiemi, T. (2020). Increasing cultural awareness: Qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing, 18(1), 1–9. https://doi.org/10.1186/s12912-019-0363-x
Nair, L., & Adetayo, O. A. (2020). Cultural Competence and Ethnic Diversity in Healthcare. Plastic and Reconstructive Surgery – Global Open, 7(5). https://doi.org/10.1097/gox.0000000000002219
Orenstein, G. A., & Lewis, L. (2022). Erikson’s Stages of Psychosocial Development. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556096/
Pappas, S. (2023, July 1). More than 20% of Teens Have Seriously Considered suicide. Psychologists and Communities Can Help tackle the problem. Apa.org; American Psychological Association. https://www.apa.org/monitor/2023/07/psychologists-preventing-teen-suicide
Şensoy, G., & İkiz, F. E. (2022). Ethical dilemmas of school counsellors: A vignette study. Journal of Psychologists and Counsellors in Schools, 33(1), 1–14. https://doi.org/10.1017/jgc.2022.1
Siegle, D. (2023, January 16). Research Ethics and Informed Consent | Educational Research Basics by Del Siegle. Uconn.edu; Educational Research Basics by Del Siegle. https://researchbasics.education.uconn.edu/ethics-and-informed-consent/
Sirin, S. R., Choi, E., & Tugberk, C. (2021). The Impact of 9/11 and the War on Terror on Arab and Muslim Children and Families. Current Psychiatry Reports, 23(8). https://doi.org/10.1007/s11920-021-01264-6
Tanaka-Matsumi, J. (2022). Counseling Across Cultures: A Half-Century Assessment. Journal of Cross-Cultural Psychology, 53(7-8), 957–975. https://doi.org/10.1177/00220221221111810
Tanhan, A., & Young, J. S. (2021). Muslims and Mental Health Services: A Concept Map and a Theoretical Framework. Journal of Religion and Health, 61(1). https://doi.org/10.1007/s10943-021-01324-4
PSYC FPX 4900 Assessment 3 Comprehensive Case Presentation
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