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Ethical dilema in children Assignment

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Added on: 2022-12-10 05:36:49
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Ethical dilema in children 

Amanda (14yrs) has presented at CYMHS following the discovery by her mother (Tracey) that she was engaged in self-harming (cutting mostly). Her attendance and performance at school has been declining, and there is constant conflict between Amanda and Tracey. Amanda’s father was abusive to Tracey and the relationship ended when Amanda was only 3, and she has had little contact with him over the years. On intake, Amanda is not overly cooperative, and is angry with her mother for bringing her to the hospital. Amanda is very insistent that what is discussed not be shared with Tracey. The self-harm is assessed and found to be minor superficial cutting of the skin on the arms. There is no reported suicide ideation by Amanda, although she reports to feel pretty ‘dark’ sometimes. 

  1. What potential ethical issues do you foresee working with Amanda?

There are major traces of anger and emotional disbalances which have been accompanying their mind of Amanda, The main reason can be the difficult relationship with her parents. The irritation and the anger have led to the anger issues coming up to self harming. Privacy and safety issues can be the ethical concerns which can be seen while working iteh a teengaer whoc is self harming. Informed consent is natehr ethical issue which cannot be ignored in this case as well because any treatment would not be done prior consent. This is due to the lack of trust and the trust issue would be there as she has been facing family neglect from both parents. These are the issues that would be alarming enough in dealing with providing treatment to Amanda (Kadzikowska-Wrzosek, 2018). 

  1. How will this guide you in working with her? 

Reporting the incident would not only help the counselor and the psychologists but also it helps in providing a proper guideline for other associated parts such as police, doctors, and other people who would be involved legally in providing help and protection to the child. Through the above case study, it is obvious that there is a case of self-harm, emotional abuse, and neglect from the caregivers and the parents. Proper reporting would also help the other individual and allow them to take proper steps in managing the situation (O’Donoghue et al., 2020).  While counselling the holistic approach would be taken which would pressurise on all the matters of wellness starting from metal, physical, emotional and psychological. Stepped care would be given which would allow interventions and evidence based treatment for the client providing the right solution at the right time. It is essential in understanding the abilities and disabilities, engaging in the active life, personal autonomy, meaning and purpose in life and positive sense helping in coming out of the issues faced on a mental level.

  1. How should matters like confidentiality and informed consent be explained and established with Amanda and her mother? Give examples of the wording you might use. 

Confidentiality and informed consent can be given and explained in written format and understanding can be provided by mutual communication. In this case, the importance of privacy can be explained to the client and her mother which would help them understand that the information and the issues which they have shared and have been facing respectively would not be put front and would be kept as a secret. Confidentiality is essential and it must be done with informed consent. The matter of confidentiality includes things like using a form of medication and often there are chances when the things nust be shared with other people in the medication and that time the policies must be enumerated to the client and the guardian as well in written and in verbal form (Chakraborty & Bhide, 2020). 

  1. You have developed a good therapeutic relationship till this point. What are the ethical principles you will use to guide you now? 

After Developing a good therapeutic relationship with the client, further ethical issues which would be taken care of by me are about the connection through touch, informed consent, right to refusal, and transference. The right to touch must be maintained which would have boundaries and would allow the client to be protected from any harmful touch or such initiation. Taking any form or gift or token of affection that would subdue a state of the personal affair can be harmful to being in the profession. be it a female client but maintaining the line is essential and that must be followed by me as well (Kadzikowska-Wrzosek, 2018).  

  1. What are the risks/concerns that you hold for Amanda? What will you do? 

The risk and the concerns which are being held in the case of Amanda is the issue of trust which I can have as a concern or a risk. The sensitive behavior or abrupt emotional or anger outburst can be one of the reasons which can be calculated as a risk or a concern. The state where Amanda is expressive in relation to her personal life has to be kept intact by me and I must avoid getting directly into her personal issues as it may call for an action which would be unethical and risky as a professional. Her consent and her parent's approval are also essential in case any projected treatment or counseling would be done. any form of forceful action can be dangerous and unethical and also cause a case of concern (Bjønness et al., 2022). 


Kadzikowska-Wrzosek, R. (2018). Insufficient Sleep among Adolescents: The Role of Bedtime Procrastination, Chronotype and Autonomous vs. Controlled Motivational Regulations. Current Psychology. https://doi.org/10.1007/s12144-018-9825-7

O’Donoghue, J., Moss, H., Clements-Cortes, A., & Freeley, C. (2020). Therapist and individual experiences and perceptions of music therapy for adolescents who stutter: A qualitative exploration. Nordic Journal of Music Therapy, 29(4), 353–370. https://doi.org/10.1080/08098131.2020.1745872

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  • Posted on : December 10th, 2022
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