Ethical Violations Case: Informed Consent

Instructions: For the assignment, please read the provided case example and answer the 3 discussion questions following the case example. **Course material attached separately. **No cover page needed.
Case Example:
Aneka is a Licensed Chemical Dependency Counselor (LCDC) and is a Licensed Marriage and Family Therapist Associate (LMFT-A), meaning she is still working on her supervised hours required to be fully licensed as a LMFT. Aneka has been seeing Kayin in therapy for three sessions. Kayin is a 33 year old male, presenting for issues related to substance dependence (alcohol, marijuana) and anxiety. During the first three sessions, Aneka has been gathering relevant assessment information and preparing a treatment plan for her work with Kayin. Thus far, she has confirmed that based on the information she has gathered and the assessment measures Kayin has completed that he does have general anxiety disorder, and suffers from substance use disorder, both for alcohol and marijuana. Based on her initial assessments, she believes that Kayin has suffered from an anxiety disorder for most of his life, and there is also a family history of anxiety and depression based on Kayin’s reports. Due to these assessments, Aneka discussed the option of Kayin seeing a psychiatrist to discuss the possibility of anti-anxiety medication.
During session five, Kayin reports that he has been working with a psychiatrist, Dr. Rodger Thompson, who has prescribed him Ativan, to manage his generalized anxiety disorder, and that he is starting his second week of the medication. Although Aneka is not a psychiatrist, she asks Kayin if he has been successful on being abstinent from alcohol or marijuana use, as she knows that many psychiatric medications can be intensified or cause serious side effects when used with other substances. Kayin says he has decreased his marijuana use, although he still is smoking several joints a week, but no longer daily, but that his alcohol use has remained high, with 7-8 beers each night and several shots of tequila when he is out with friends. He also reports that he has been feeling confused lately, has been light-headed, has been more tired than usual, which has impacted school, and is not eating very much anymore because he “is just not hungry.” She requests that he follow up with Dr. Thompson and share all of this information with him to potentially adjust or change medications.
Kayin comes in the next week for session 6. Aneka asks if he has seen Dr. Thompson, which Kayin says “No, I think I just need time to adjust to the medication. I am hopeful this will fix my anxiety and I do not want to give the doc reason to take me off these meds.” Kayin seems aggravated at Aneka’s concerns for the reported side effects and Kayin’s lack of concern that using alcohol while on the medication is dangerous. She asks him if he has had any more symptoms and he says “I mean I know the medication is making me feel bad when I drink, but it isn’t that bad and I think that the anxiety is getting better.” He also tells her that he is still drinking at the same levels, but would like to talk about how to help him quit drinking in therapy. When she asks him to sign a release of information to talk with Dr. Thompson to help them both better assist Kayin in reaching his goals he says that is not necessary and he’d rather her focus on the alcohol and marijuana use and for Dr. Thompson to worry about the anxiety.
After the session ends, Aneka looks up Dr. Thompson’s number. She is torn because she knows Kayin did not sign a release of information but she also has a big concern for Kayin’s safety in using the anti-anxiety medication with alcohol and the safety of others if he chooses to get behind the wheel and drive while he is feeling dizzy, tired, and not alert. She decides that due to her concerns for his health it is best to call Dr. Thompson. She reaches his voicemail and leaves him the following message: “My name is Aneka and I am an LCDC and LMFTA working with one of your patients, Kayin Jameson. In our recent sessions he has revealed that he is seeing you for medication for his generalized anxiety disorder. He also informed me that he is drinking alcohol with his medication and smoking marijuana. I am treating him for his substance dependence but also have concerns about the side effects he is experiencing. He requested that I not inform you of this information but I believe you need to know for us to both provide him with the best level of care. Please return my call when you have a chance.”
Questions:
1. What is the ethical violation that the case scenario depicts?
2. What are the potential options for a professional working on this case? Specifically, what options for addressing the situation does the professional have, or what should the professional have done differently?
3. Provide two different examples of professional organizations’ ethical codes that address the issues presented in the example (e.g., American Association of Marriage and Family Therapy, NAADAC, National Association of Social Workers).