| Course | NU 672 Counseling and Psychotherapy |
|---|---|
| Unit | Unit 6 |
| Paper type | In-session ethical decision record |
| Length | About 900 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 672 Unit 6
In-Session Ethical Decision Record: A Disclosure About a Child's Injury During Therapy for Panic Disorder, and the Report That Followed
Student Name
Department of Nursing, Herzing University
NU 672: Counseling and Psychotherapy
Instructor Name
February 25, 2026
In-Session Ethical Decision Record: A Disclosure About a Child's Injury During Therapy for Panic Disorder, and the Report That Followed
The Moment
Session 8, February 19, about 30 minutes into the hour. Ms. J., a composite 29-year-old woman in cognitive behavioral therapy for panic disorder, was describing an attack the previous Sunday at her sister's house. She said: "I think it started because of what happened with Tyler. Ryan got mad and shoved him into the wall, hard. He's five. He had a bruise on his arm, like fingers. My sister told me not to tell anyone, she said Ryan's just stressed about the wedding." Tyler is her sister's son from a previous relationship; Ryan is her sister's fiancé, who lives with them.
Therapist's first response: "That sounds frightening to see, and I can hear how much you care about Tyler. I need to understand a bit more, because what you've told me matters for his safety."
What Was Asked Next
Q: "When did this happen, and did you see it yourself?" A: "Sunday afternoon. I was in the kitchen, I saw it through the doorway."
Q: "Where was the bruise, and what did it look like?" A: "His upper arm, four marks, like where fingers would be. Purple."
Q: "Has anything like this happened before, that you know of?" A: "Tyler told me once Ryan 'squeezes' him. I thought he meant hugs."
Q: "Where is Tyler now, and who is with him?" A: "Home with my sister and Ryan. My sister works days, so Ryan watches him after kindergarten."
Why these questions: to establish what she observed directly, the nature of the injury, whether there was a pattern, and the child's current circumstances. The questions were limited to what was needed to judge whether there was reasonable cause to suspect abuse; investigation is the role of child protective services, not the therapist.
The Obligation Identified
Nurses, including advanced practice nurses, are mandated reporters of suspected child abuse or neglect in every state, although the details of who must report and when vary by state (Child Welfare Information Gateway, 2019). In this state, a nurse who, in a professional capacity, has reasonable cause to suspect that a child has been abused must report promptly to the state child abuse hotline. The duty applies even though Tyler is not the patient, because the information was received in the course of professional practice. A five-year-old with a patterned bruise consistent with a hard grip, from an adult caregiver, observed by an adult witness, with a child's earlier statement suggesting a pattern, meets the standard of reasonable cause. Certainty is not required; the reporter's duty is to report reasonable suspicion.
The duty of confidentiality to Ms. J. is real, and she had been told its limits at intake, including that suspected child abuse must be reported. Her sister's request not to tell anyone does not change the legal obligation.
What Was Done
Before the end of the session: "I'm glad you told me. What you saw is the kind of thing I'm required by law to report to child protective services, so that someone trained can check on Tyler's safety. Do you remember when we talked about the limits of confidentiality at your first visit? This is one of them." She was tearful and worried her sister would never forgive her. We discussed that the report would come from the therapist, and that she could choose whether to tell her sister herself.
Consultation: the clinical supervisor was consulted by phone during a brief pause and agreed the report was required.
The report: made by the nurse practitioner to the state hotline at 3:40 p.m. the same day, with Ms. J. present at her request, giving the facts as she had described them. The intake worker assigned it for a response within 24 hours given the child's age and daily contact with the alleged perpetrator. The reference number was recorded.
Documentation: the disclosure in her words, the questions and answers, the consultation, the time of the report and reference number, and what she was told.
Effects on Her and on the Therapy
Mandated reports can strain the therapeutic relationship, although in a survey of psychotherapists many reported that clients stayed in treatment after a report, with effects that varied from case to case (Steinberg et al., 1997). A check-in call was scheduled for two days later. On the call, she said child protective services had visited, her sister was angry at first but then told her she had been afraid too, and Tyler was staying with his grandmother while the investigation continued. She said she had had two panic attacks since, and asked to add a session that week. Her safety and her therapy continue; the event is now part of the material the therapy will work with, including her fear that speaking up causes loss.
Who Carries the Outcome
The decision to report belonged to the nurse practitioner, and so does its cost: the strain on the relationship and whatever follows in the family. The ethical commitment to the patient's welfare and to the protection of vulnerable people points the same direction here (American Nurses Association [ANA], 2015). If the investigation finds no abuse, the report was still correct, because it was made on reasonable suspicion. The record is written so that anyone reviewing it can see that the decision rested on what was known at the time.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association.
Child Welfare Information Gateway. (2019). Mandatory reporters of child abuse and neglect. U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau.
Steinberg, K. L., Levine, M., & Doueck, H. J. (1997). Effects of legally mandated child-abuse reports on the therapeutic relationship: A survey of psychotherapists. American Journal of Orthopsychiatry, 67(1), 112-122. https://doi.org/10.1037/h0080216
What the NU 672 Unit 6 instructions ask for
Unit 6 asks you to document an ethical decision made during a therapy session. Expect to describe the moment, the questions you asked next, the obligation or dilemma identified, the action taken, effects on the patient and therapy and who carries the outcome. Many versions involve mandatory reporting, duty to warn or confidentiality limits. Check whether your section allows you to state what the law requires in your state. Quote the disclosure only as much as needed. The record should show you gathered enough information to judge the obligation without investigating. Supervision or consultation, if used, belongs in the record. Explain what the patient was told and how, since the way a report is handled affects whether therapy can continue.
How this NU 672 Unit 6 example is built
The record opens with the moment, giving session, time and the patient's words briefly. The next section lists the follow-up questions and answers, showing that the clinician clarified what was seen without interrogating. The obligation section names the reporting duty and its source. The action section records exactly what was said to the patient, the report made and when. The effects section is honest about strain on the relationship and cites research on how patients respond to reports. The final section names who carries the outcome: the clinician carries the decision and its cost, the patient carries a family conflict she did not choose. Each step is dated and factual, which suits a record that may be reviewed later.
Where the points sit in the NU 672 Unit 6 rubric
Herzing's rubric for an ethical decision record generally covers the description of the event, information gathering, identification of the obligation, the action, communication with the patient, attention to effects and documentation quality. Identification of the obligation is checked closely, with mandatory reporting duties cited accurately. Information gathering points reward clarifying questions without investigation. Action criteria look for timely, appropriate steps. Communication with the patient earns credit for honesty and care. Effects points go to realistic attention to the therapeutic relationship. Documentation should be factual and dated. The Child Welfare Information Gateway summary and Steinberg's survey belong in the APA 7 list.
Common NU 672 Unit 6 mistakes, and how to avoid them
Ethical decision records in Unit 6 often fall short by describing the decision without the reasoning or the source of the obligation. Another frequent problem is questioning that becomes an investigation, which is the job of child protective services. Students often skip what the patient was told. Effects on the therapy are ignored. Records include opinions rather than facts. Consultation or supervision is not mentioned when it occurred. The report's timing is missing. Finally, keep the record factual and dated, because graders read it as a document that may be reviewed by a board or court, and interpretive language weakens it.
Get a NU 672 Unit 6 example written to your instructions
Send the Unit 6 instructions and the rubric from your NU 672 classroom, and note which ethics code and which state the course expects you to work against. The custom example keeps the sequence chronological, separates obligations by source, treats legal thresholds as verified locally, and records what the client was told. First custom sample free, returned in 24 to 48 hours.
More NU 672 papers and PMHNP samples
- NU 672 Unit 1: Therapeutic modality comparison
- NU 672 Unit 2: Boundary and self-disclosure review
- NU 672 Unit 3: Session transcript analysis
- NU 672 Unit 4: Treatment goal hierarchy
- NU 672 Unit 5: Group therapy proposal
- NU 672 Unit 7: Treatment review and revision brief
- NU 672 Unit 8: Therapy episode portfolio
- NU 674 Unit 6: Shared decision making record
- NU 670 Unit 6: Special population handling brief
- NU 671 Unit 6: Rating instrument administration note
- NU 673 Unit 6: Follow-up interval rationale
NU 672 Unit 6 questions, answered
Can the record state what the law requires?
Not as a general claim. Duties around confidentiality and disclosure differ by state, by profession and sometimes by setting, and they change. The example names the category of obligation, then says which statute or board rule the writer checked and where. Instructors generally read that caution as competence rather than as hedging, and it protects you from asserting something your own jurisdiction contradicts.
How much of the disclosure should be quoted?
Enough for a reader to see the ambiguity you were working with, which is usually a sentence or two. Long stretches of quoted speech shift the record toward a transcript and crowd out the reasoning. Since the patient is composite, write the quotation to contain exactly the uncertainty the decision turns on, and say in a line that the material is constructed.
Does supervision belong in the record?
Note that consultation happened and what was asked, but do not draft supervision documents you have not written. Signed records, hour logs and preceptor confirmations are yours to produce inside your own placement and cannot come from an example. What belongs in a course submission is the reasoning, not the paperwork the setting keeps.
Where can I find a free NU 672 Unit 6 sample paper?
This page carries the complete NU 672 Unit 6 decision record at no cost, from the disclosure and questions to the report and its effects. A record for a duty to warn or confidentiality situation can be prepared on request.
Are psychiatric nurse practitioners mandated reporters?
Yes. Nurses, including advanced practice nurses, are mandated reporters of suspected child abuse or neglect in every state. This sample records a PMHNP making a report after a patient describes seeing her nephew struck.