Case: Patrice and the ethics of diagnosis

Patrice: As a counselor, you begin working with a young African-American woman who came for counseling because her mother was worried about her perfectionism and her isolating herself sometimes for periods of time. The mother asked you to visit with her. Patrice is an honor student in high school and a good athlete. She works out for extended periods of time. Patrice agreed to see you and said she does “worry about things” and she simply needs to “quit being so hard on myself.” Patrice has seen you over several sessions, talking about herself and her future, when she reveals some self-induced vomiting after meals. She sees herself as “fat,” and is really fearful of her weight getting out of control. You are not sure what this means, but you are wondering about an eating disorder. Patrice does not want you to share this with her mother, unless it is in a session with you. You don’t have any experience working with an eating disorder (Adapted from Remley