Respond to A&B separately by advancing the discussion or adding value to it.
a.) When it comes to Ms. Roe and Rose, first and foremost, I would have told Rose and her parents from the onset that I would ensure strict confidentiality, but because Rose is a minor, I would inform her that there may be instances where I have to tell her parents things. Then, I would have gone with Decision Type 2 and had Rose make the disclosure to her parents with my assistance (Woodside & McClam, 2018). Because of her immediate risk of harm (which she is already doing), her future risk of harm (attempting to decide how to commit suicide), and her maturity level, I believe her parents knowing what is going on is imperative. I believe, though, that helping her be the one to tell them can be empowering for her and the fact that they both brought her in might mean that they are a cohesive unit, and both are willing to help her.
My second option would be Decision Type 4 and I would let her know that I will be disclosing the information to her parents even though she doesn’t want me to (Woodside & McClam, 2018). I would ensure her, though, that it is not to take control away from her or because she is “just a child” (as a 14 year old, I believe these are things she would feel strongly about), but because I am trying to ensure her safety.
For both options though, I would warn her parents ahead of time that what they might be upsetting, but that they should listen fully and try not to interrupt. Either way I go about it, I believe it is absolutely necessary that they know.
Woodside, M. and McClam, T. (2018). Generalist case management: A method of human service delivery (5th ed.). Boston, MA: Cengage Learning.
b.) In the case study of Rose and Ms. Roe, as a case manager the decision types I would consider would be decision type 3, where the case manager makes the disclosure;the client is fully aware of the case managers disclosure to the parents. The reason for chosen decision type 3, is the fact Ms. Roe explained her role within the hospital and the limits of confidentiality (Woodside and McClam, 2018, p.114) at the beginning of Intake. Further, there is a legal obligation to report self-harm or harm to others in which Rose had disclosed that she enjoyed cutting, had suicide tendencies and substance use. The second chose was decision type 4, where the case manager makes the disclosure to the parents: the client is fully aware of the disclosure: the client does not consent to the disclosure(Woodside and McClam, 2018, p.114.) Again, because Rose is a minor, who has repeatedly harmed herself and shows suicide tendency with her fascination with her father’s gun, Ms. Roe should ethically and legally disclose to parents. Given Rose age and the severity of the problem, I would be honest in conveying that it is my responsibility to disclose this information and to whom this information will be disclosed. The parents would be the first, and then I would seek their consent for care. Furthermore, the parents of the other’s in the pact should be notify. If Rose was not willing to disclose the names, then Child Services should be contacted to prompt an investigation. I would further consider decisions type 2 in which Rose makes the disclosure with encouragement from Ms. Roe and decision type 5, if I felt the child you immediately try to harm herself if she knew her parents was going to find out everything or Rose was incompetent. For this case disclosure by the case manager is the right thing to do.
Woodside, M. and McClam, T. (2018). Generalist case management: A method of human service delivery (5th ed). Boston, MA., Cengage Learning