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Question - Ludwig is a counselor whose education and training have been exclusively in individual counseling. Ella comes to him for counseling. After more than a dozen sessions with Ella, Ludwig realizes that much of her difficulty lies not just with her but with her entire family system. By this time Ludwig has established a strong working relationship with Ella. Because he has no experience in family therapy, he decides to refer Ella to a colleague who is trained in family therapy, but he realizes that doing so could have a detrimental effect on her. One of Ella's problems has been a sense of abandonment by her parents. He wants to avoid giving her the impression that he, too, is abandoning her. He decides to stay with her and work with her individually. Much of the time is spent trying to understand the dynamics of the family members who are not present.
1) Do you agree with Ludwig's clinical decision? Do you agree with his rationale?
2) From your perspective, would it have made a difference if he had consulted with Ella? Would it have made a difference if he had consulted with or obtained supervision from a colleague?
3) Would it have been ethical for Ludwig to see the entire family and attempt to do family therapy for the benefit of his clients, even though he was not trained as a family therapist?
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