Case Study
Patient Demographic: Client Age: 32 Sex: Female Gender: Female Sexual Orientation: Heterosexual Ethnicity: Latina; Mexican American Relationship Status: Married Counseling Setting: Community Mental Health Type of Counseling: Individual and Psychoeducation Presenting Problem: Depression Diagnosis: Major Depressive Disorder (MDD) with Psychotic Features 296.24 (F32.3)
Mental Status Exam: Mental Status Exam: The client is well groomed and appropriately dressed. Her voice is soft and low, and she avoids eye contact, mainly when talking about her family. She states, “I’ve put them through so much. And I feel so ashamed when I’m unable to care for them.” She endorses feelings of hopelessness but denies suicidal and homicidal ideations. The client says that she hears voices and believes that they are the voices of her deceased ancestors trying to communicate with her. She explains that the “spirits” whisper her name in the middle of the night and come to her when she is alone. The client denies command hallucinations. Her appetite is poor, and she has difficulty sleeping “most nights.” She has experienced depressive symptoms most of her life, but, outside of the recent hospitalization, she has not sought treatment due to believing that mental illness is a sign of weakness. History of Conditio
Presenting Problem: You work in a community mental health setting. Your client is a 32-year-old Latina presenting with symptoms of depression and psychosis. She reports that she was hospitalized more than 6 months ago and did not attend follow-up appointments due to losing her health insurance coverage. The client currently reports anhedonia, sadness, feelings of worthlessness, and poor concentration. She explains that there are many days when she cannot get out of bed and is unable to fulfill her role as a wife and mother. The client also reports audio hallucinations and says this began when her grandmother died more than a year ago. She explains that her grandmother lived in her home and that her loss was “devastating” to the client. The client is fluent in Spanish and English.
Other Contexts: The client informs you that she is upset because of a recent incident involving her two sons. She states that her teenage sons were walking in a neighborhood park when they came across a group of white men who used xenophobic slurs and threatened them. The boys said the men spit on them and told them to “go back to where they came from.” The client’s bouts of depression persist, and this is now coupled with the feeling that she has somehow failed to protect her sons. The client is also concerned that her husband is becoming increasingly intolerant of her inability to cook, clean, and care for their boys. The client states this makes her feel “worthless” and a “nobody.” She has also become more isolated and misses “having the energy” to connect with those in her community

Question: Which core professional value calls on counselors to promote equity for all people and groups by actively confronting oppressive systems of power?
(A): Multicultural awareness
(B): Social justice
(C): Professional integrity
(D): Beneficence

Correct Answer: Social justice
Explanation: The ACA Code of Ethics defines social justice as “the promotion of equity for all people and groups for the purpose of ending oppression and injustice affecting clients, students, counselors, families, communities, schools, workplaces, governments, and other social and institutional systems” As such, promoting social justice is considered a core professional value for all certified counselors. Counselors must be aware of their client’s uniqueness within the client’s culture and within the counselor’s own culture. Counselors must consider multiple ways that the intersectional identities of the client and counselor exist within the surrounding society. Professional integrity involves protecting and honoring the client-counselor relationship. Counselors are also called to honor diversity and embrace a “multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts” (ACA, 2014). Lastly, beneficence is a professional value demonstrated when one is “working for the good of the individual and society by promoting mental health and well-being” (ACA, 2014). Therefore, the correct answer is (C)
Competency: professional practice and ethics