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FACULTY OF PSYCHOLOGY AND SOCIAL SCIENCES

BPSY 1133 ETHICS

INDIVIDUAL ASSIGNMENT

LECTURER’S NAME: HO YI MING

DATE: 11 AUG 2023

PREPARED BY

ASIA ABDULHAKIM

(BPSY 2210-6928)

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An Ethical Dilemma in Adolescent Counselling: Dealing with Academic and Mental Health

Challenges

During the turbulent stage of adolescence, young people face a slew of challenges and

transformative experiences. As a school counselor, I recently faced an ethical quandary that left

me with serious concerns. My 13-year-old client, whom I knew as a vibrant and enthusiastic

student, experienced significant behavioral changes that raised concerns. She bravely disclosed

an alarming revelation during her struggles to cope with her studies - she claimed to hear voices

coercing her to abandon her educational journey. This realization put me at a crossroads because

I realized that addressing her academic and mental health concerns would necessitate a delicate

and thoughtful approach.

The 13-year-old client, Sarah, had consistently achieved high academic standards throughout her

early school years. She did, however, drastically alter her behavior in recent months. According

to her teachers, her academic performance suffered, she withdrew socially, and she experienced

emotional distress episodes. Sarah went to the school counselor for advice and support because

she understood how serious the situation was.

Hearing troubling voices that discourage further schooling could be an indication of several

underlying mental health issues. Hearing voices, also known as auditory hallucinations, have

several origins, including spiritual experiences, physiological causes, grief, sensory deprivation,

and trauma. According to studies, most people who have auditory hallucinations hear voices

giving orders. Research has shown that 53% of clinical patients have command hallucinations

(Bogen‐Johnston et al., 2020).

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According to studies substantial stressful life events frequently come after which people report

hearing voices. When related trauma is still unresolved, these occurrences appear to serve as

triggers. For clinically meaningful auditory experiences to begin with and continue, the

psychological effects of such trauma are crucial. These traits have been directly linked to

suffering and dysfunction in those who are afflicted, in addition to influencing how these voices

are perceived (Bogen‐Johnston et al., 2020). According to Romme and Escher (2009) (Bogen‐

Johnston et al., 2020), hearing voices may be a symptom of pre-existing psychological issues

brought on by traumatic events. Importantly, their research shows a link between the frequency

of traumatic events and the propensity to display psychotic symptoms. The complex connection

between trauma, mental health, and the formation of auditory hallucinations is highlighted by

this. These findings support the preceding discussion about the relationship between auditory

hallucinations and mental health issues.

Students in secondary and postsecondary school endure a variety of persistent pressures

associated with academic responsibilities. Previous study has shown that academic stress can

lower academic achievement, diminish motivation, and raise the likelihood of dropping out of

school (Pascoe et al., 2019). Continuous stress can also lead to the development of more serious

mental health problems such as anxiety and depression (Pascoe et al., 2019).

Stress and depression and anxiety have a well-established reciprocal association. Indeed, large

stressful life events are one of the greatest predictors of depression development. As a result,

substantial life stressors frequently precede the onset of depression in young people. Aside from

hurting overall health and well-being, depression and anxiety symptoms can have a negative

impact on academic performance. There is ample evidence that adolescents, particularly girls,

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perceive school and education as a major source of stress in their lives and that this stress is

linked to mental health problems (Pascoe et al., 2019). In a large study, for example, five out of

ten major components of stress among adolescents were related to education, and of the ten

components, stress about school performance and stress about future uncertainty (including

uncertainty about educational careers) were among the strongest predictors of anxiety and

depression. (Pascoe et al., 2019)

In my role as the school counselor, I am faced with the complex task of navigating through

ethical challenges presented by this case. It is crucial that I approach these dilemmas with care

and consideration for both the student's well-being and ethical standards. Preserving the

confidentiality of the student's information takes top priority to ensure her trust and privacy

remain intact. However, it becomes difficult when we also must protect her from potential harm

resulting from her mental health struggles. If we ignore her concerns, it may jeopardize her

overall welfare. Additionally, there is an unresolved issue surrounding obtaining informed

consent from the student's parents. While involving parents is important, I must acknowledge

that she might be hesitant to disclose her experiences due to fears of negative consequences at

home. This presents a delicate balance between respecting the autonomy of the student and

including parental involvement in decision-making processes. The key lies in creating an

environment where she feels heard and understood while also prioritizing her safety and

complete growth as an individual. My aim is to strike this equilibrium so that she can receive

appropriate support in improving her mental well-being and achieving academic success on this

journey. (A Correlational Study of School Counselor Rapport and Student Connection to School

- ProQuest, n.d.)

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As a counselor dealing with the ethical intricacies of Sarah's case, my primary concern is

respecting the standards that govern our profession. While prioritizing Sarah's well-being,

education, and mental health, ethical concerns play a critical role in selecting the optimal course

of action. Confidentiality is essential in building trust, but it is not absolute when safety is at

stake. If auditory hallucinations suggest a risk of harm, the ethical responsibility requires

thorough disclosure to the appropriate people, such as parents, school officials, or mental health

specialists. The obligation to safeguard is vital. My primary responsibility is to ensure Sarah's

safety and to intervene quickly if danger is imminent. To mitigate hazards and offer the

necessary support, parents and school officials must be involved. It is critical to respect Sarah's

autonomy. Collaborative decision-making and the acquisition of informed consent enable her

and her parents to make educated decisions regarding her mental health journey. Recognizing
my

skill limits is an ethical requirement. In circumstances where specialized expertise is required for

auditory hallucinations, such as Sarah's, ethical practice dictates referring her to a competent

mental health specialist. Every decision is made with the child's best interests in mind. Given her

age, developmental stage, and individual needs, we follow this philosophy. Balancing her ethical

obligations while prioritizing her well-being necessitates a caring and cautious approach. In

Sarah's situation, I plan to work with mental health professionals, integrate academic help,

involve parents and keep open communication with all parties. My commitment to ethical

practice, empathy, and collaboration strive to aid Sarah's recovery and academic progress.

(School Counselor Consultation, n.d.)

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REFERENCES

Bogen‐Johnston, L., deVisser, R., Strauss, C., & Hayward, M. (2020, February 21). A
qualitative study exploring how Practitioners within Early Intervention in Psychosis Services
engage with Service Users’ experiences of voice hearing? Journal of Psychiatric and Mental
Health Nursing, 27(5), 607–615. https://doi.org/10.1111/jpm.12612

A Study of Stress Factor and Its Impact on Students Academic Performance at Secondary
School Level. (2019, May). Journal of Education and Practice. https://doi.org/10.7176/jep/10-
13-01

A Correlational Study of School Counselor Rapport and Student Connection to School -

ProQuest. (n.d.). A Correlational Study of School Counselor Rapport and Student Connection to
School - ProQuest.
https://www.proquest.com/openview/615ff8051266a66ab73c2236e33d81a5/1?pq-
origsite=gscholar&cbl=18750&diss=y

School Counselor Consultation. (n.d.). Google Books.

https://books.google.com/books/about/School_Counselor_Consultation.html?id=VpdLEAAAQB
AJ

ScienceDirect.com | Science, health, and medical journals, full text articles and books.
(n.d.). ScienceDirect.com | Science, Health and Medical Journals, Full Text Articles and Books.
https://pdf.sciencedirectassets.com/271821/1-s2.0-S0277953620X00256/1-s2.0-
S0277953620308352/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2lu

Psychological processes mediating the association between developmental trauma and

specific psychotic symptoms in adults: a systematic review and meta-analysis - CORE Reader.
(n.d.). Psychological Processes Mediating the Association Between Developmental Trauma and
Specific Psychotic Symptoms in Adults: A Systematic Review and Meta-analysis - CORE
Reader. https://core.ac.uk/reader/384445641

Pascoe, M. C., Hetrick, S. E., & Parker, A. G. (2019, April 11). The impact of stress on
students in secondary school and higher education. International Journal of Adolescence and
Youth, 25(1), 104–112. https://doi.org/10.1080/02673843.2019.1596823

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