Case Study
Patient Demographic: Client Age: 20 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Asian Relationship Status: Single Counseling Setting: College counseling clinic Type of Counseling: Individual counseling Presenting Problem: Panic attacks Diagnosis: Provisional diagnosis: panic disorder (F41.0)
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client does not appear anxious or depressed and was friendly and eng
Presenting Problem: You are a counselor working in a college counseling department. The client comes in after being late to class several times over the last month due to reported “freak-outs” in the morning. The client experiences the following panic symptoms: accelerated heart rate, sweating, shaking, shortness of breath, and a feeling of impending doom. The client reports a feeling of impending doom when she wakes up on days when she has classes, and this anxiety tends to escalate into fear of having a panic attack on a daily basis, often making her late to her first class. The client is worried that she will have panic attacks every day for the rest of her life. She says that her parents have put a lot of pressure on her to get a high grade point average at college. The client is worried about how this pressure and the panic attacks are going to affect her doing well at college and engaging socially.
Other Contexts: The client enters the room and appears distracted when she sits down because she has a furrowed brow and is looking off to the side of the room. You ask her what is on her mind, and she reports that this morning she had a panic attack that led to her throwing up. You ask her to talk through the moments when she noticed it starting and how the panic attack progressed. She says that she woke up and was worried that she might have a panic attack because she typically has one on school days, and this turned into worry that she might be late for class, which compounded into worry about how it might affect her grades and eventually into certainty that she would fail. The client then experienced an increased heart rate, chest tightness, difficulty breathing, a feeling of impending doom, shaking, and finally vomiting. You empathize with the client and provide psychoeducation on the management of panic attacks.  When this session is over, you check your online dating profile and notice that a past client’s sister reached out to you showing interest in going on a date. You and this past client terminated 3 years ago

Question: When this session is over, you check your online dating profile and notice that a past client’s sister reached out to you showing interest in going on a date. You and this past client terminated 3 years ago. Which one of the following is aligned with the ethical guidelines of the American Counseling Association (ACA)?
(A): You cannot date this person because she is related to a former client and 5 years have not passed since terminating the counseling relationship.
(B): Document your decision and how the relationship is nonexploitative prior to going on a date with this client’s sister.
(C): You did not have a counseling relationship with your past client’s sister, so this does not prohibit you from dating her.
(D): You can proceed with a date because it has been 3 years since you worked with her sister.

Correct Answer: You cannot date this person because she is related to a former client and 5 years have not passed since terminating the counseling relationship.
Explanation: According to ACA ethical guidelines, dating a former client and/or someone related to that client cannot be considered until at least 5 years have passed since terminating the counseling relationship; therefore, you cannot date this individual. In a case in which 5 years had already passed, it is also necessary to provide supporting documentation that this would not be an exploitative relationship. Therefore, the correct answer is (D)
Competency: professional practice and ethics