Case Study
Patient Demographic: Client Age: 18 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: University Counseling Center Type of Counseling: Individual and Group Presenting Problem: Interpersonal relationships Diagnosis: Autism Spectrum Disorder. 299.00 (F84.0)
Mental Status Exam: Mental Status Exam: The client is sloppily dressed and appears his stated age. He exhibits pressured speech at times; otherwise, he speaks in a monotonous tone. The client becomes irritable when discussing the incident with campus police, and brightens when expressing his passion for snakes. He displays poor eye contact and there is difficulty with normal back-and-forth conversation. The client denies suicidal or homicidal ideation. He lives on campus in sober student housing and denies drug or alcohol use. History of th
Presenting Problem: You are a counselor a university counseling center. The university has a program providing limited assistance to students diagnosed with Autism Spectrum Disorder (ASD). The ASD program director has referred an 18-year-old white male enrolled in the program. She is concerned over his recent run-in with campus police. The client arrives to his scheduled counseling session today and explained that he has a girlfriend who “now apparently wants nothing to do with me.” Campus security has been involved due to the client showing up at his girlfriend’s dorm, yelling and creating a disturbance. The client explains that his peers told him he would have sex in college once he got a girlfriend. When his girlfriend refused to have sex, he said he didn’t understand and only wanted to talk. The client continues to express a desire to have sex now that he is in college by stating matter-of-factly, “I haven’t had much luck, but I’m going to keep trying.” When asked about interests, the client spoke at length about his love for snakes and knowledge of all 300 worldwide species.
Other Contexts: The client arrives twenty minutes late for his appointment today. He explains that Mondays are the days he does laundry, and he cannot come again on a Monday. You review the required components of informed consent with the client. He expresses an understanding of the counseling process and provides written consent. The client states he has re-considered counseling because he believes you can help him find another girlfriend who will have sex with him. You tell him about a small group you run with other neurodiverse men, most of whom are on the autism spectrum. He expresses an interest in joining after hearing that sexual intimacy would be part of the curriculum. He provides a more solid commitment when you tell him the group is not held on Mondays.  You arrive to your client’s group to find members on their cell phones sharing pictures of you and your family from your private social media account

Question: You arrive to your client’s group to find members on their cell phones sharing pictures of you and your family from your private social media account. How should you respond?
(A): Use it as a basis to explain the importance of group-specific parameters regarding confidentiality.
(B): Use it to explain the benefits, limitations, and boundaries included in your social media policy.
(C): Redirect the members to group tasks and personally seek technological knowledge and skills required for the ethical and legal use of social media.
(D): Use it as a teachable moment to educate members on respecting the privacy of others.

Correct Answer: Use it to explain the benefits, limitations, and boundaries included in your social media policy.
Explanation: You should first use this as an opportunity to initiate a discussion or review your social media policy. According to the ACA Code of Ethics (2014), “Counselors clearly explain to their clients, as part of the informed consent procedure, the benefits, limitations, and boundaries of the use of social media” Using the event to teach members to respect the privacy of others does not explicitly address social media use. Using the event as a basis for discussing group confidentiality, privacy, and violations is helpful, but this does not expressly address the use of social media. The ACA Code of Ethics (2014) states, “Counselors who engage in the use of distance counseling, technology, and/ or social media develop knowledge and skills regarding related technical, ethical, and legal considerations (eg, special certifications, additional course work)” If counselors have a social media presence, they have an ethical and legal obligation to seek required technical knowledge and skills (eg, use privacy settings). However, the primary course of action must include informing group members of their use of social media as part of the ongoing process of informed consent. Additionally, the NBCC Code of Ethics (2016) states that “After carefully considering all of the ethical implications, including confidentiality, privacy, and multiple relationships, [counselors] shall develop written practice procedures in regard to social media and digital technology, and these shall be incorporated with the information provided to clients before or during the initial session”. Therefore, the correct answer is (D)
Competency: professional practice and ethics