Case Study
Patient Demographic: Client Age: Husband, 38; wife, 37 Sex: Husband,male; wife, female Gender: Husband,male; wife, female Sexuality: Husband,heterosexual; wife, bisexual Ethnicity: Caucasian Relationship Status: Married Counseling Setting: Counseling clinic Type of Counseling: Couples counseling Presenting Problem: The couple is experiencing distress because the wife has had a sexual affair with a woman. Diagnosis: Adjustment disorder, unspecified (F43.20) and relationship distress with spouse or intimate partner (Z63.0)
Mental Status Exam: Mental Status Exam: The couple presents as withdrawn at the start of the session, but they open up as they talk about lighter subjects. Both individuals are oriented to person, place, time, and situa
Presenting Problem: You are a licensed counselor meeting with a couple in your private practice clinic. The couple comes in, and they both sit down at far ends of the couch and do not look at each other. After explaining informed consent and other intake policies, you begin to ask the couple what brought them to counseling, and they both sit silently. You ask the couple if it is hard to start this conversation because of why they came, and they both nod. You ask the couple if it might be easier to start with how they met and why they fell in love with each other, and they both nod in agreement that they can talk about that. The couple appears more comfortable after this and even say a few statements to each other about shared experiences during the conversation. You circle back to the reason why they came to therapy, and the wife says that she assumes that she should talk first. She states that about a week prior she told her husband that she had an affair with a woman a few months before. She continues that, at the time, she was curious and it occurred while she was drunk and insists that it meant nothing. The husband states that he still loves her, but he is not sure how he is going to move past this. He emphasizes that not only did she have an affair, but her action exposed an aspect of her that he did not know about, making him question whether she even finds him attractive.
Other Contexts: tion. Family History: The husband and wife have been married for 13 years. They report that they met when friends introduced them and that they dated for about 2 years before getting married. The couple have two children: two daughters (ages 7 and 10). The couple reports that they have been in “parent mode” for the past few years and have not been emotionally connected to each other because their attention has been predominantly focused on their children.  You supervise an intern in your clinic who is working with a couple that is in counseling for coparenting but is also in a legal battle for custody

Question: You supervise an intern in your clinic who is working with a couple that is in counseling for coparenting but is also in a legal battle for custody. Which of the following is the most ethically sound indication to release information for legal purposes?
(A): The husband’s lawyer requests records of sessions, so you provide them to the lawyer because they are a legal representative and you have written consent to release the information.
(B): The court subpoenas the records, so you provide them without written consent from either individual.
(C): The wife’s lawyer requests you to appear in court, so you attend and testify without written consent from either the wife or husband.
(D): Both individuals can request and receive records because they are both the identified client, and you must provide records when they are subpoenaed.

Correct Answer: The court subpoenas the records, so you provide them without written consent from either individual.
Explanation: You can release information to the court if the court provides an official subpoena for recordsThis is a situation in which you can release information without any ethical conflicts because it is a legal requirement. The husband’s lawyer may be his legal representative, but you do not have written consent from the wife to release records. The wife’s lawyer can request that you appear in court, but you still would not have the husband’s consent to do so. Although both individuals are the identified client, you can withhold records if it causes potential harm to the other client. In this case, harm may be likely if information is released to one of the individual clients because it may affect the couple’s relationships with their children. For that reason, ethically, it would not be sound judgment to release the requested records to the individuals at this time. Therefore, the correct answer is (B)
Competency: professional practice and ethics