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Ethical issues in the treatment of severe psychopathology in university and college counseling centers.

Increasing numbers of students with severe personality disorders are presenting for psychological services at college and university counseling centers. The influx of these students poses a number of ethical dilemmas for counseling centers. Clinical decisions about appropriate treatment modalities, philosophical decisions about agency mission, and available resources to carry defined missions converge and influence ethical decisions in this area. It is misguided kindness, as well as being ethically unwise and legally risky, to attempt to carry out a treatment mission with inadequate resources. It is not abandonment to have selection criteria grounded in the treatment literature and executed with fairness if the duty to refer is upheld.