A Colleague's Dilemma

Discuss your reaction to Ricardo’s approach to counseling and the decisions he has made to provide services to lower-income adolescents and families.

  • Identify the key ethical issues in this case, with reference to the ACA or ASCA ethical code.
  • Include the recommendations you might make to Ricardo in terms of the approach he is taking in his counseling practice, if you were one of his colleague

***USE case study below***


Ricardo is a licensed counselor in a large city who works with adolescents and their families. Monday through Thursday Ricardo provides services at an office downtown for clients who have a limited ability to pay for ongoing counseling. Many of the insurance companies used by these clients will not reimburse for family therapy, so Ricardo provides an individual diagnosis for one of the family members, such as “Generalized Anxiety Disorder” or “Adjustment Disorder with Depression,” so the insurance companies will cover the sessions and the clients will only have to come up with the co-payment. Otherwise, they would not be able to receive any counseling at all. For clients without insurance, Ricardo lowers his fee substantially so they can afford their counseling sessions, and often lets clients go without payment because he knows that they really need the help.

Conversely, every Friday afternoon, Ricardo provides services in an upscale section of town from an office that he rents from a friend who is also a licensed therapist. His friend has a full practice and can provide many clients for Ricardo; Ricardo pays her $50.00 for each client that she refers to him. At this site, Ricardo charges an hourly rate of $135, knowing that the clients can easily afford this fee. He administers a battery of tests as a standard intake process for all clients, knowing that the clients’ insurance companies reimburse at a high rate for these assessments.

Ricardo says that the money he makes on Fridays supports his ability to see less fortunate clients.

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