Foundations of Counseling: Exam Prep and Practice Ethical DecisionMaking Models Coreys Model ForesterMiller Davis

Ethical Decision‑Making Models (Corey’s Model, Forester‑Miller & Davis)

What This Is

Ethical decision‑making models are systematic roadmaps that help counselors move from a confusing ethical dilemma to a defensible, client‑centered action. They keep practice aligned with the ACA Code of Ethics, protect clients, and shield counselors from liability. Example: A graduate student therapist notices a client’s suicidal plan while also being asked by the client’s parent for session notes. Using Corey’s model, the student evaluates confidentiality, duty‑to‑warn, and the client’s autonomy before deciding how to respond.

Key Terms & Theories

• Corey’s Ethical Decision‑Making Model (Gerard Corey): A 7‑step process (identify the problem, consult the ACA Code, consider relevant laws, develop options, evaluate consequences, choose action, document).
• Forester‑Miller & Davis Model: A 5‑step “ethical decision‑making triangle” (identify the dilemma, gather information, evaluate alternatives, implement decision, evaluate outcome).
• ACA Code of Ethics (Section A.2.a): Requires counselors to “maintain confidentiality” except when disclosure is required by law or for client safety.
• Duty to Warn / Duty to Protect (Tarasoff): Legal/ethical obligation to breach confidentiality when a client poses a serious threat to an identifiable person.
• Informed Consent (B.2.a): Clients must be told the nature, limits, and risks of counseling before services begin.
• Dual Relationship: Any non‑therapeutic relationship that could impair professional judgment or exploit the client (e.g., counseling a friend’s sibling).
• Cultural Competence (Multicultural Counseling Competence): Recognizing how culture, race, gender, and ability influence ethical choices.
• Professional Boundaries: Limits that protect the therapeutic relationship; includes time, self‑disclosure, and physical contact.
• Ethical Consultation: Seeking advice from a supervisor, ethics committee, or peer when uncertainty remains after initial analysis.
• Documentation (Record‑Keeping): Accurate, timely notes that reflect decisions made, rationales, and client responses.

Step‑by‑Step / Process Flow

Using Corey’s Model (7 steps)

1. Identify the Ethical Issue – Clearly state the dilemma (e.g., “Client disclosed intent to harm a coworker; parent requests session notes”).
2. Consult the ACA Code & State Law – Locate relevant sections (A.2.a, B.2.a, duty‑to‑warn statutes).
3. Determine the Client’s Rights & Counselor’s Obligations – Weigh confidentiality vs. safety, consider informed‑consent limits.
4. Generate Possible Courses of Action – Options might include: (a) maintain confidentiality, (b) warn the potential victim, (c) discuss limits with client, (d) seek supervision.
5. Evaluate Consequences – Use a “pros‑cons” table; consider client welfare, legal risk, therapeutic alliance, and cultural factors.
6. Select the Best Action & Implement – Choose the most ethical, legally sound option; communicate the decision to the client and any required parties.
7. Document Everything – Write detailed notes of the dilemma, consulted resources, decision rationale, and follow‑up steps.

Forester‑Miller & Davis (5 steps)

1. Identify the Dilemma – Same as step 1 above.
2. Gather Information – Collect client statements, legal statutes, supervision input, and cultural context.
3. Evaluate Alternatives – Apply ethical principles (autonomy, beneficence, non‑maleficence, justice).
4. Implement Decision – Act, inform client, and coordinate with any mandated reporters.
5. Evaluate Outcome – Review the result, seek feedback, and adjust future practice.

Common Mistakes

NCE / Clinical Insights

1. Model Recall: The exam often asks you to match a scenario with the correct model (Corey vs. Forester‑Miller & Davis). Remember Corey = 7 steps, includes “consult the ACA Code” explicitly; Forester‑Miller = 5 steps, emphasizes “evaluate outcome.”
2. Tarasoff vs. Confidentiality: A classic NCE trap is confusing “duty to warn” with “duty to protect.” The correct answer: duty to warn is about informing an identifiable potential victim; duty to protect may involve hospitalization or police notification.
3. Informed Consent Timing: The NCMHCE may present a client who is in crisis before consent is obtained. The correct ethical move is to obtain emergency consent (or follow state law) after ensuring safety, not to delay treatment.
4. Dual Relationships: Choose the most ethical response when a counselor is asked to supervise a friend’s child. The best answer: decline or refer, citing the dual‑relationship prohibition (ACA A.5.b).

Quick Check Questions

1. Vignette: A client tells you she is planning to overdose but asks you not to tell anyone.
   Answer: Implement duty‑to‑warn/protect – contact emergency services and follow state law.
   Why: Imminent risk to self overrides confidentiality (ACA A.2.a; Tarasoff).

2. Vignette: Your supervisor asks you to share session notes with a client’s employer for a workplace accommodation.
   Answer: Obtain written client consent before releasing any records.
   Why: Confidentiality can be breached only with client authorization or a legal mandate (ACA B.2.a).

3. Vignette: You discover that a client’s cultural belief discourages medication for depression.
   Answer: Integrate cultural competence – discuss treatment options, respect the belief, and collaborate on a culturally appropriate plan.
   Why: Ethical practice requires honoring client values while providing competent care (ACA C.2.c).

Last‑Minute Cram Sheet (10 One‑Liners)

1. Corey’s Model = 7 steps – Identify, Code, Laws, Options, Consequences, Choose, Document.
2. Forester‑Miller & Davis = 5 steps – Identify, Gather, Evaluate, Implement, Review.
3. ACA A.2.a – Confidentiality is the default; exceptions for danger to self/others.
4. Tarasoff (1976) ⚠️ – “Duty to Warn” protects identifiable victims; not a blanket breach of confidentiality.
5. Informed Consent (B.2.a) – Must be obtained before services, except in emergencies.
6. Dual Relationship (A.5.b) – Any non‑therapeutic overlap that could impair judgment is prohibited.
7. Cultural Competence (C.2.c) – Counselors must respect cultural values when making ethical decisions.
8. Documentation (A.11.b) – Record the ethical decision process, not just the outcome.
9. Ethical Consultation (A.11.c) – When stuck, seek supervision or an ethics committee; it’s a professional responsibility.
10. Duty to Protect vs. Duty to Warn ⚠️ – Protect may involve hospitalization; Warn is informing a specific third party.

Use this guide to walk through any ethical dilemma confidently, keep your practice aligned with the ACA Code, and ace those exam questions!