Case Study
Patient Demographic: Client Age: 45 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Divorced, single Counseling Setting: Private practice Type of Counseling: Individual counseling Presenting Problem: The client is experiencing difficulty in functioning in all areas of his life due to inhalant use. Diagnosis: Inhalant use disorder, severe (F18.20)
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client does not appear to be under the influence of inhalants because he does not display any symptoms of use. The client is friendly and engaged in the ses
Presenting Problem: You are a licensed counselor working in a private practice. You specialize in substance use disorders. The client comes into the session, is very friendly, and states that although his sessions are court ordered, he wants to get help with his inhalant use. The client spent the first half of the session explaining what happened to lead to him getting his third charge of driving under the influence of inhalants. The client says that he had twin sons 13 years ago and they both were in the ICU; one of his sons died after about a month. The client began drinking alcohol to excess daily for about 6 months, which then transitioned to inhalant use. The client says that he uses contact cement, model glue, paint, and permanent markers to become intoxicated. The client identified the following symptoms of inhalant use disorder: increase in frequency and amount of use over the past 5 years, several failed attempts at cessation of inhalant use, craving inhalants throughout every day, losing several jobs because of his inability to get to work on time due to inhalant use, use that has affected his ability to have visits with his children and maintain employment, use that increases the risk of harm to himself and others such as driving under the influence, increased tolerance, and continued use even when he knows it is negatively affecting his life. The client wants to become sober, improve his relationship with his children, and maintain employment.
Other Contexts:    sion. Family History: The client has three sons that are 11, 13, and 16 years old. The client is divorced as of 3 years prior and reports a contentious relationship with his ex-wife due to his difficulty following through with visits with their children. The client and his ex-wife were married for 17 years and dated for about 5 years before they were married. The client states that he loves his ex-wife but that she has currently been dating another man for the past 2 years and he knows they likely will not reconcile. He says that he understands why she does not want to be with him, and he thinks that he is not good for her or his children at this time.  The client’s sessions are court ordered

Question: The client’s sessions are court ordered. Which of the following is the most therapeutic course of action with regard to sharing information with the court?
(A): Restrict access to the client’s records; even though therapy is court ordered, it does not mean that the court has access to all documentation.
(B): Take steps to get written consent from the client, attempt to limit information given to the court, and/or prohibit the release of information if possible
(C): Provide all of the information that the court requests per the legal requirements.
(D): Provide minimal information to protect your counseling relationship with the client.

Correct Answer: Take steps to get written consent from the client, attempt to limit information given to the court, and/or prohibit the release of information if possible
Explanation: The court can subpoena information if needed, and records must be provided in such cases. Therefore, it is best to gain consent from the client, if possible, so you are not sharing information against his wishes, while also explaining to the client certain limits in confidentiality that are unique to his circumstances. Limiting the amount of information provided to the court or attempting to restrict it altogether if it is best for the client is ideal because it protects your counseling relationship. The other answer options do not fulfill the counselor’s needs to meet court orders and to protect the counseling relationship. Sharing all information does not allow the client to have space to speak freely with you, yet you also cannot restrict all information from the court. Therefore, the correct answer is (A)
Competency: professional practice and ethics