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Ethical Issues in Counseling Practice

 Ethics codes are a fundamental component of effective counseling:

 They are guidelines that outline professional standards of behavior and practice

 Codes do not make decisions for counselors

 Counselors must interpret and apply ethical codes to their decision‐making

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (1)

 Mandatory Ethics deals with the minimum level of professional practice

 Aspirational Ethics is a higher level of ethical practice

 Positive Ethics is an approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (2)

 The principles that underlie our professional codes  Benefit others, do no harm, respect other’s autonomy, be just, fair and faithful

 The role of ethical codes‐‐they:  Educate us about responsibilities, are a basis for accountability, protect clients, are a basis for improving professional practice

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (3)

 Making ethical decisions:

 Identify the problem, review relevant codes and laws, seek consultation, brainstorm, list consequences, decide and document the reasons for your actions

 To the degree it is possible, include the client in your decision making process

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (4)

 Clients need enough information about the counseling process to make informed choices

 Educate clients about their rights and responsibilities

 Informed consent should include information such as therapeutic procedures and goals, risks/benefits and alternatives to treatment, the right to withdraw from treatment, costs or fees, supervision, and the limits of confidentiality

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (5)

 Confidentiality is essential but not absolute

 Exceptions:  Client poses a danger to self or others  Clients who are under age 16, dependant adults, or older adults are victims of abuse

 Client needs to be hospitalized  Information is made an issue in a court action  Client requests a release of record

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (6)

 Biases are reflected when we:

 Neglect social and community factors to focus unduly on individualism

 Assess clients with instruments that have not been normed on the population they represent

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (7)

 Biases are reflected when we:

 Judge as psychopathological behaviors, beliefs, or experiences that are normal within the client’s culture

 Strictly adhere to Western counseling theories without considering their applicability to the client’s diverse cultural background

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (8)

 Assessment is an ongoing process designed to help the counselor evaluate key elements of a client’s psychological functioning

 Influenced by the therapist's theoretical orientation

 Requires cultural sensitivity

 Can be helpful in treatment planning

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (9)

 Diagnosis is the process of identifying a pattern of symptoms which fit the criteria for a specific mental disorder defined in the DSM‐IV‐TR (soon‐to‐be DSM‐V)

 Requires cultural sensitivity

 Counselors debate whether a diagnosis is necessary

 Can be helpful in treatment planning

 If used only for insurance purposes, can lead to ethical dilemmas

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (10)

Strengths of !Evidence-Based Practice {IEBP)

 Counselors use treatments that have been validated by empirical research

 Treatments are usually brief and standardized

 Are preferred by many insurance companies

 Calls for accountability among mental health professionals to provide effective treatments

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (11)

 Considered by some to be mechanistic and insensitive to individual differences

 Not well‐suited for working with existential concerns

 Difficult to measure both relational and technical aspects of a psychological treatment

 Has potential for misuse as a method of cost containment for insurance companies instead of a method of efficacious treatment for clients

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (12)

 Not inherently unethical

 Must be managed ethically to protect client’s well‐being

 Examples of nonsexual dual relationships include socializing or starting a business venture with a client, bartering services for goods, or borrowing money

 Sexual relationships with current or former clients are exploitive and can result in serious harm

Theory and Practice of Counseling and Psychotherapy - Chapter 3 (13)

 A few helpful questions:

 Will my dual relationship keep me from confronting and challenging the client?

 Will my needs for the relationship become more important than therapeutic activities?

 Can my client manage the dual relationship?

 Whose needs are being met? Theory and Practice of Counseling and Psychotherapy - Chapter 3 (14)