Introduction

The young mother Simone has a lot of childhood issues that have led to her present situation of being a single mother without a good education or a job to depend on. Moreover, while this session is meant to prepare her for parenthood, it should be noted that she needs to be prepared for adulthood as well. Generally, her ability to take care of her child is largely questionable owing to her mental state and issues that she faces as an individual. Her childhood was abusive and she seems to have suffered some level of neglect. The fact that she is not willing to talk about it yet implies she is still stuck in that moment and needs help coming out of it. This paper explores Simone’s situation in detail to establish the ethical and legal issues in the case 

Key Legal and Ethical Issues Presented In the Case

There are a number of legal and ethical issues in this case. First, Simone is a parent and her condition must be shared with her social worker, who is possibly the only person who would be able to help the young mother. Confidentiality, in this case, would imply keeping the issues of concern in Simone’s mental status between the client and the therapist (Fisher, 2013). The client could be either Simone only or Simone and the social worker who recommended the therapy for her. Considering the involvement of a baby and, thus, the issue of maternal competence, the social worker would need to know the situation in order to be ready with an alternative arrangement in case things go bad for Simone. 

This therapy is aimed at improving the young woman’s competence as a mother, and this can only be done by dealing with her childhood issues. The possible outcomes here vary depending on the dedication of the patient and, thus, there could be dangerous bouts in the process. It would be wise to inform the social worker although this may also threaten the patient’s wellbeing by piling pressure on her. The social worker could feel obliged to take the child away from mother, thus, creating even bigger problem for the young woman. Hence, the conflict here is whether to involve the social worker or not especially with regards to the details of the case. This challenge is not only ethical but also legal considering that a young woman could lose custody of her child if things do not go well. 

The second issue would be about the treatment. Preparing an individual for parenthood is a relatively easier concept than preparing them for adulthood when they are in their late teens and having gone through such challenging childhood. The sessions were initiated for parenthood purposes but the patient has a lot of underlying problems from her childhood that must be resolved for her to become well-adjusted as a mother. The challenge here is that going back to her childhood may create bigger problems for the young mother given her current resistance to the idea. She will need to remember her childhood if the events are to be prevented from recurring in her adulthood especially as she is a mother now. Rather than running away from the memories, she will have to face them and heal from them before she can move on and become a good mother. This will not only take much more time but also require a lot of cooperation from the client and the responsible authorities. The challenge here would be whether to address the childhood issues or to focus on parenting as the reason for the therapy. A major factor to consider when tackling this issue would be that Simone’s childhood is very traumatizing in the context of an alcoholic father, a bipolar mother and very unfair teachers.

Simone is unwilling to talk about her problems with the therapist. This means that there is an ethical issue about compliance and cooperation (Gory, 2011). The patient is very evasive and evidently not ready to open up in order to get the necessary help. The therapist needs to find a way of getting her to cooperate and talk about her day to day challenges where she will be able to identify the underlying issues and, thus, deal with them effectively to avoid compromising her parenting. A possible path would be to create a personal relationship based on trust, where personal relationships are actually considered unethical and, thus, not encouraged. The client needs to be able to trust the therapist, and the options that they have in this situation could be rather limited. Her present situation implies that she has a problem with forming and maintaining conventional relationships and getting her to commit with the therapist could be a great challenge without the provision for bonding at a personal level.           

The Ethical Decision Making Model

The ethical dilemmas in this case are mainly about choosing between right and right, meaning that each possible choice has both negative and positive implications to the client and the therapist. The selected ethical decision-making model here would be the moral reasoning based model whose major steps include recognizing the moral issue, making a judgment, establishing the intent of the judgment, considering the moral intensity of the judgment and then acting as per the resulting decision (Bush, Connell & Denney, 2006). 

In Simone’s case, three moral issues must be considered. First, should the social worker be informed about the underlying issues that could challenge Simone’s ability to be a good parent? The social worker is more interested in the welfare of the child and, thus, they may not really look at these challenges from the therapist’s point of view. Her interest in protecting the child is likely to cloud her judgment in a matter that could heavily impact Simone’s wellbeing. Therefore, the judgment here would be not to let the social worker know about the details of the case seeing, as there is hope for progress in the event that the young mother is made to cooperate with her therapist. 

The intent of this judgment is to protect the client from the kind of harm that would come from having her child taken away from her on the basis of mental incompetence especially seeing, as she is not with her family anymore. The circumstances are rather unique in that the patient needs to be with her baby, and it is rather cruel to risk the baby being taken away. The social worker’s obligation is the baby and not the mother, thus, implying that they are unlikely to consider the needs of the mother with respect to her getting better. It should also be noted that the child is a great part of Simone’s healing as she needs a reason to be better than her parents, and the reason at this point is her baby. Without the baby, she is likely to fall apart and even lose the motivation to live altogether. This judgment is not likely to harm anyone given that the patient is expected to adjust well over time and, thus, become a good parent. If it does not work however, the baby may be in danger of neglect and abuse over time. 

The social worker is, however, expected to get involved in the event that the therapy does not succeed especially if it is due to Simone’s refusal to cooperate. As for the social consensus, it can be understood that mothers need their children to be motivators in difficult situations, and when the probability of success is much higher than that of failure, it should be noted that keeping the child with the mother is not the best option only for the mother but also for the child. The bad turn outs that will come with a failed therapy are expected to be manifested later on in the child’s life and not immediately, thus, swaying the concept of temporal immediacy in favor of the decision made. Having established all these facts, the consequent action would be to discuss the therapy approach with Simone and assure her that the social worker will not be involved in the details of her case, thus, she will be able to take care of her baby to the best of her abilities and be a better parent than the ones she had (Melton et al., 2007). 

The second issue is with respect to the treatment that Simone will be receiving in her therapy sessions. The moral factor here is whether or not to indulge in the whole process given that she is only in for the parenthood preparation program and not adulthood and recovery from a bad childhood. It can, thus, be expected that she will have to undergo both healing and preparation sessions as she gets ready to become a better parent (Cottone, 2001). The judgment is to indulge her in both healing and parenting to ensure that she does not turn out to be like her parents. The intent of this judgment is to ensure that the baby is not exposed to bad parenting in the future as the underlying issues from Simone’s childhood could easily affect her mental state and, thus, compromise her ability to be an objective and rational parent. Therefore, she needs to be guided in dealing with her childhood issues as well as adjusting into life as a parent. 

This decision is likely to affect the baby positively as the mother will become a well-adjusted individual with no possibilities for bad parenting in the future. It may be costly to the responsible authorities but this cost is justifiable in the long term considering that it prevents cases of child abuse and neglect in the future. Rather than having to take the child away from Simone later due to bad parenting, the authorities only have to pay for her therapy sessions and help her to become a good parent. The actions here will, thus, involve planning the therapy with Simone in order to ensure that she is not just prepared for parenting, but rather helped with her underlying issues from childhood experience that could affect her parenthood.  

The third issue is about getting the patient to comply and collaborate with the therapist. Forming a bond would be unethical seeing as the therapist allowed creating a personal relationship with the client. In this case, however, Simone is rather alone and trust is not something that she comes by easily owing to the kind of childhood she was subjected to and the fact that she is now estranged from her family. The judgment here would be to use information as a way of getting the patient to comply as the bond may also bring about some dependence that will not be healthy for the patient in the long term. The intent is to ensure that the patient can continue to improve even after the therapy as opposed to getting attached to the therapist and becoming unable to sustain the mental improvement after the sessions (Senn, 2006). Here, the probability of effect is fully positive, as once she knows what she stands to lose if she does not cooperate and undergo full therapy she will be determined to prevent it by complying.     

Ethical Standards and State Laws

The relevant ethical standards for this case include having the client’s best interests as the influence for each decision while the state law could be about child protection from harmful or risky conditions. Each of the choices made in this case address the client’s best interests without necessarily neglecting the ethical considerations that must be made by the therapist. As such, the decisions are considerably sound and favorable for all those involved (Cottone, 2001). As with the state laws, Simone is not a danger to her child at the present, and this therapy is designed to prevent her from becoming a risk in future. Therefore, it can be stated that there are absolutely no violations in the actions of the therapist here (Yalom & Leszcz, 2005). The decisions have been made with full consideration of the ethical standards as well as state laws.   

Developmental and Cultural Sensitivity

In addressing the issue of confidentiality, my major concern is the developmental aspects of the client where she may not be a fully adjusted individual owing to her childhood experience. Rather than expecting the social worker to understand her situation, the choice is to keep her in the dark to allow the client to work through these challenges without fearing for her child’s custody. In addition, she needs her child to be with her in order to find a reason for getting better, thus, risking the removal of her motivation would be risking her recovery. As a mother in a society where family is elevated, I believe that the need for her child would keep the child safe as the mother recovers. The second issue is also addressed with consideration for the developmental impacts where the childhood experiences affect the parenting habits of the young mother. If her childhood issues are not addresses she is likely to turn out like her own parents, thus, the need to go back in the past and correct these wrong notions that were planted in her mind and heart (Cottone, 2001). As for the third decision, the patient needs someone to depend on but this must be someone who is likely to be with her for much longer than the therapy. As such, avoiding a personal relationship is the wise choice. 

Personal Values and Beliefs

I believe that a child’s best caregiver is mother and as such, I am inclined to think that the best way to help Simone out is to ensure that her baby is not taken away from her. In order to do this, I decided to keep the social worker out of the case details so as to ensure that the baby is not taken away at any time owing to the possible risks presented by the mother’s abusive childhood. This belief also drove me to desire a complete therapy for the mother, as she needs to get well enough to be a good parent rather than just preparing her for parenting without handling the underlying problems from her childhood. Another value that I hold dear is that parents define their children based on how they treat them while growing up. This means that I fear for Simone’s child, thus, fuelling my determination to ensure that she gets over her bad childhood experiences in order to protect her child from going through the same issues. 

Conclusion

Simone is a person who needs help with her childhood issues in order to adjust and become a good parent. Therefore, all the decisions made in her case must be guided by values in which the child’s welfare is considered as paramount without neglecting the mother’s wellbeing. It should thus be noted that even though the first judgment seemed to put the baby in harm’s way it is also meant to help the mother in a way that would eventually secure the child. This implies a holistic approach in the moral reasoning based model of ethical decision-making.

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