What are the limits to confidentiality in counseling sessions?

  

This is the transcript of Deidre sitting with the counselor. For this discussion I have decided the rational emotional behavior therapy is the best approach:In this Discussion, you select a CBT theory that most resonates with you, dialectical behavior, rational emotive behavior, or reality therapy/choice. You then closely examine the media, Deidre Part 2, found in this weeks Learning Resources. Keeping Deidres questions and concerns in mind, how might you contextualize your theoretical approach? Furthermore, how might this specific theoretical approach help to guide your dialogue with Deidre?I have attached the transcript below.
Counseling and Psychotherapy Theories Program Transcript
Instructions: Watch the following interaction between Deidre and the counselor. Post by
Day 4 your response to Deidre and explain how you would contextualize your theoretical
approach. Then, explain how this theoretical approach may help Deidre to move toward her
goals.
Counselor: Hello, Deidre. Its nice to meet you. What brings you here?
Deidre: Well, Dr. Clark at the health center, I was talking to him about my anxiety, and he
gave me something for it. And its been working a little bit, but he thought I should come
here too.
Counselor: What do you think?
Deidre: I dont know. I think theres a lot of other people who could probably use this more.
Counselor: You think your anxiety isnt serious enough to warrant you to be here?
Deidre: I dont know. I mean, what are we going to do here, just sit and talk?
Counselor: Well, thats part of it. But before we get into our first session, I just want to
make sure that you understood what you signed regarding the informed consent
document and all of the elements regarding confidentiality.
Deidre: Yeah, the form that says that this is confidential unless I tell you Im going to
hurt myself or someone else?
Counselor: Yes, thats right. Im impressed that you remembered that.
Deidre: Yeah, Dr. Clark explained it to me when I said I was nervous about coming
here.
Counselor: Youre feeling nervous about being here right now?
Deidre: NoI mean yes. I understand the confidentiality thing, but its just that Ive never
talked to anyone about any of this before.
Counselor: Well, its very natural to be nervous in counseling sessions and especially the
first one that you attend. But let me assure you that this is a safe and nurturing environment
and that anything you say here stays here. But also, there are some limits to that
confidentiality. And first, like you already know, if you say anything about harming yourself
or harming others, I will have to break
confidentiality, because Im obligated as a counselor to protect you but also those around
you. Also, if for any reason theres talk about neglect or abuse, I would also have to break
confidentiality in those instances as well. And finally, if Im subpoenaed by a judge or a court
to turn over my records, I would be obligated to do so, so that would be another limitation on
confidentiality. Do you understand all of those limitations?
Deidre: Yeah, thanks.
Counselor: I noticed on your form that you mentioned that you wanted some help with
your anxiety.
Deidre: Yes.
Counselor: Okay. I think we can work together on this. But let me first tell you about my
approach to counseling. What I first do is I ask.
(the audio volume of the counseling session fades down.)

Introduction:

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Counseling and psychotherapy theories can be a valuable tool in helping people move toward their goals. In this discussion, we will be exploring how a specific cognitive-behavioral therapy approach, such as rational emotional behavior therapy, can guide our dialogue with Deidre, a patient seeking help for anxiety. Through analyzing the dialogue between Deidre and the counselor, we will discuss how this theoretical approach may help Deidre overcome her anxiety and contextualize her concerns.

Description:

Deidre, a patient seeking counseling for anxiety, meets with a counselor to discuss her concerns. Initially, Deidre is apprehensive about receiving counseling, questioning whether or not the discussion will be helpful. The counselor begins by explaining the limits of confidentiality and establishing that anything said during the sessions will be kept confidential unless mentioned otherwise. Once the confidentiality concerns are addressed, the counselor begins to reassure Deidre that the environment is safe and nurturing. Through employing a rational emotional behavior therapy approach, the counselor uses her expertise to guide the conversation, help Deidre confront her concerns, and provide her with the tools to move forward towards her goals of managing her anxiety. This approach can be used effectively to provide a context for patients to make sense of their emotions and thoughts and gain a newfound confidence in managing their conditions.

Objectives:

– To contextualize the theoretical approach of rational emotive behavior therapy with Deidre’s concerns and questions.
– To explain how the use of rational emotive behavior therapy can guide the counselor’s dialogue with Deidre.
– To identify how the use of rational emotive behavior therapy may help Deidre move towards her goals in counseling.

Learning Outcomes:

– Identify the key principles of rational emotive behavior therapy and its potential benefits in addressing anxiety.
– Explain to Deidre how rational emotive behavior therapy works and how it differs from other therapies.
– Demonstrate an understanding of the importance of confidentiality in counseling and the limitations to confidentiality that may arise.
– Evaluate Deidre’s progress in counseling using rational emotive behavior therapy, and adjust the approach as needed to help her achieve her goals.

Solution 1: Rational Emotive Behavior Therapy

Rational Emotive Behavior Therapy (REBT) helps individuals identify their irrational beliefs and replace them with rational ones, leading to improved emotional and behavioral responses. In Deidre’s case, she is hesitant about seeking counseling despite experiencing anxiety. Using REBT, the counselor can help her challenge her irrational belief that her anxiety is not serious enough to warrant counseling. The therapist may use techniques like disputing irrational beliefs, behavioural exercises, and teaching coping strategies to help Deidre overcome her anxiety.

Solution 2: Reality Therapy/Choice Theory

Reality Therapy/Choice Theory helps individuals identify how their current choices and behaviors affect their overall life satisfaction. In Deidre’s case, the therapist can help her recognize how her avoidance of seeking counseling is limiting her ability to manage her anxiety and make progress towards her goals. The therapist may use techniques like exploring Deidre’s needs and wants, creating a plan for change, and exploring the consequences of her choices to help her make positive changes in her life.

Suggested Resources/Books:

1. “Rational Emotive Behavior Therapy: A Therapist’s Guide” by Albert Ellis and Catharine MacLaren
2. “Dialectical Behavior Therapy: A Contemporary Guide for Practitioners” by Andrew Bein and Marsha Linehan
3. “Reality Therapy in Action” by William Glasser
4. “Cognitive-Behavioral Therapy: Basics and Beyond” by Judith Beck
5. “Mind Over Mood: Change How You Feel by Changing the Way You Think” by Dennis Greenberger and Christine A. Padesky

Similar Asked Questions:
1. How can rational emotive behavior therapy help with anxiety?
2. What is the difference between dialectical behavior therapy and rational emotive behavior therapy?
3. How does reality therapy address the root cause of a person’s problems?
4. Can cognitive-behavioral therapy be effective for depression?
5. How can changing thought patterns improve mood and behavior?

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