HUSC 233

Case Study #1

The first time you meet your client, Kolby, he is in the throes of heroin withdrawal. He has been
sent to your clinic by the Circuit Court judge as part of an alternative sentencing program. Kolby
was arrested for CDS possession, quickly arraigned, and sent along to your clinic instead of
going to lockup, because the judge recognized that Kolby's withdrawal symptoms and significant
dependence on opiates would make treatment a more reasonable option. While the doors at your
clinic are not locked, Kolby understands that he must stay there or he will be arrested and
transported back to jail.

Kolby hasn't had any heroin for about 30 hours by the time he arrives in your office. During
your intake interview, he is unable to focus on anything other than asking for the medication that
will alleviate his withdrawal symptoms. He vomits twice in your office, and is experiencing flu-
like symptoms. You're not able to collect a very clear history from Kolby, who quickly signs all
of the forms you give him, including releases for confidential information and the informed
consent agreement.

Considering what you've read, analyze this situation in terms of valid informed consent. Discuss
whether or not you believe that Kolby is able to provide informed consent for his own
treatment. Consider that he was placed in treatment by a judge--is this coercive? Also, consider
his physical and mental state while you describe his rights and your responsibilities in terms of
consenting to treatment.

Follow the “Steps in Ethical Decision Making” model (available in Module 1 folder on
Blackboard) to explain how you, the counselor, would handle this case. Be sure to list all eight
steps of the model and to cite information from your readings.

Bonus (earn up to five extra credit points): The judge who has court-ordered Kolby to treatment
has requested a report from you verifying that Kolby reported to treatment and is making
progress. Would you break confidentiality to provide this report to the judge? Why or why not?
What considerations are involved in whether you would provide the report?

**Submit your completed case study (in .docx format) in the Case Study #1 drop box located on
Blackboard. You can access the drop box by clicking on the link “Drop Boxes” on the left-hand
column on Blackboard.**