Ethical Guidelines 1
Ethical Guidelines: Determining Resolutions to Ethical Dilemmas
Hannah Wood Hostutler
School of Behavioral Sciences, Liberty University
Abstract
Abiding by state and federal laws as well as the ACA code of ethics is the foreground for a
professional counselor. Comparing and contrasting the video scenario “whose records” is used
to define a dilemma and then determine a resolution to the dilemma. By looking at the ACA
code of ethics and the ethical decision model. The scenario is looked at by if the counselor is
acting ethically in the situation. Federal and Virginia state laws are also looked by legal
standards a professional counselor is to uphold. Moving through the research using ACA moral
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principles it is determined which moral principle closely relates to the scenario. Upon
conclusion, actions are determined that could be used to resolve the solution from the scenario.
Key Words: Ethics, dilemma, Records, Confidentiality, Autonomy
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Introduction
Counselors have a duty to uphold to their clients. When counselors are faced with an
ethical dilemma there are steps to take to help get through the dilemma in an ethical and legal
way as a licensed professional. First, the counselor needs to identify the problem.
Understanding the facts of the situation. Next, apply the ACA code of ethics. Following ethical
morals allows for a counselor to act to the best ability for the client and their well-being. The
counselor needs to act ethically so that they do not impose their beliefs and are able to remain
biased in any situation that may arise. The counselor will also need to look at their state and
federal laws.
Counselors need to be able to identify their ethical and legal rights to navigate situations.
Understanding the dimension of the dilemma is a prerequisite to determining actions of
resolutions to a problem. Dissecting the situation at hand will better prepare a counselor to
brainstorm actions to resolve an issue.
Identify the Problem
There are multiple dilemmas regarding the video from Pearson Education, “Whose
Records”. The counselor in the video is questioning the client’s ability to decide to seek other
counsel. The client asked the counselor in a previous session about a referral to another
counseling professional. The client also asked for the counselor's session notes taken during
sessions. She also asked for the notes that the counselor received from the client’s previous
counselors. The counselor stated that she did not believe her notes would be of any benefit to
the client. The counselor imposed her beliefs by stating that the notes she had taken would not
be of any benefit to the client. The dilemmas stated interfere with the client’s autonomy in
making a sound decision for herself. The problem coincides with ethical practices such as a
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client's right to information. It also relates to federal and Virginia state law requiring that a client
has a right to their records.
Apply the ACA Code of Ethics
Section A of the ACA Code of Ethics demonstrates the counseling relationship. A.2.a
discusses informed consent. In the video “Whose Records” the client is asking to be referred to
another counseling professional. This coincides with section A.2.a because a client has the
freedom to choose to remain in a counseling relationship (ACA Code of Ethics A.2.a). In this
scenario, the client is choosing not to remain in the counseling relationship. Section A.4.b
discloses that counselors should not impose their beliefs or values onto a client. In the scenario
when the client asked for her records the counselor stated that her notes would not be any help
to the client. The counselor is imposing her belief that the notes will not help the client.
Determining whether the notes or records of the client are suitable or beneficial to the client is
the client’s decision.
Section B of the ACA Code of Ethics discusses confidentiality and privacy. Section B.6.e is
communicating a client's access to records. When the client asked for her records, the counselor
did not deny access but imposed her beliefs. The counselor is to provide appropriate access to
records when requested by the client (ACA Code of Ethics B.6.e). Rather than the counselor
discussing her beliefs about what the client’s records will do the counselor should have stated
that she needed a written request form for her records.
Section I of the ACA Code of Ethics involves resolving ethical issues. Section I.1.c
discloses the conflicts between ethics and laws. A counselor's responsibility is to the client and
is to remain committed to the ACA Code of Ethics. When conflict arises and cannot be resolved
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by following the ACA Code of Ethics the counselor is to follow the requirements of the law
acting in the best well-being of the client (ACA Code of Ethics I.1.c.).
Applicable State Codes/Laws and Federal Mental Health Laws
The Federal Code 45 CFR 164.524(a)(1) (Access of Individuals to Protected Health
Information, 2014). communicates how a client has the right to obtain his or her records. The
client in the scenario had the right to request her protected health information upon asking the
counselor. Federal code 45 CFR 164.524(b)(1) (Access of Individuals to Protected Health
Information, 2014) states that the client must put in a written request to obtain a copy of their
protected information. This law will be applicable to the course of action that the counselor will
need to follow in the future. The federal code 45 CFR 164.524(c)(1) (Access of Individuals to
Protected Health Information, 2014) is closely related to the ACA Code of Ethics B.6.e in that a
counselor is to provide access to the client's records upon request.
In Virginia, state law 18 VAC 115-20-130 (5) states that an individual who is licensed by
the board must document the need to terminate the relationship between counselor and client.
If the counseling relationship is not beneficial to the client, the counselor needs to aid in the
assistance of continuation of services. The counselor in this video should have listened when
the client communicated with her in a prior session to end services. Once the client started to
get upset as evidenced by using a higher voice volume the counselor should have respected her
wish to terminate services since the counselor/client relationship was being tarnished.
Determine the Nature and Dimensions of the Dilemma
By definition, autonomy is the principle of having respect for the client and allowing
them the freedom of choice. In the scenario of “whose Records” the counselor is questioning
the client on wanting to retrieve her records and wanted to end counseling. The counselor did
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try to have the client understand that she would often transition between clients every 4 weeks
or so. The counselor did encourage the client in this way to be autonomous. Another
consideration is when the client asked for all of the notes the counselor had written. The
counselor responded saying that the notes she had taken would not be of any benefit to the
client. This relates to the scenario because autonomy includes the client’s ability to make sound
decisions. The counselor’s response to the client did not display confidence in the client’s
choice.
Following ethical guidelines as a professional counselor is crucial. Ethical decisionmaking
allows counselors to act in the best way for clients and their well-being. All though there are
situations where laws do not validate the ACA code of ethics it does not mean that a counselor
is breaking the law (Robinson et al., 2020). This scenario resonates with the ACA code of ethics
as well as federal and state laws. Using other forms of support to determine the dilemma is
through the use of scholarly literature, colleagues, or others who follow the ACA code of ethics.
With the scenario given, we are only given a small bit. It can be hard to understand
without the full picture. Although the counselor is having the client self-reflect to determine
why she changes counselors so frequently as stated before she is having her work through that.
On the other hand, the counselor is not allowing her to make her own choice or is questioning
her choice. An article written by Perry, 2022 discusses autonomy and clinical ethics. It discusses
the standards that autonomy is held to and how it can turn a deaf ear to professional authority
(Perry, 2022). As counselors, it can be difficult not to impose beliefs and morals on a client. It
can be possible that a professional can influence a client’s choice and change the outcome
(Perry, 2022). In the scenario we see the counselor trying to persuade the client to not follow
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through with the termination. This links back to autonomy and letting the client have freedom
of choice.
In consulting help with this dilemma, I would reach out to Theresa Cox, LPC, BCBA. She is
my current supervisor who has to abide by the ACA code of ethics. She would be a great person
to consult with. Another professional counselor that I could connect with would-be Andrew
Chandler, LPC. Andrew has provided me with help in the past with learning from his
experiences. He would be another great person to consult with. Two counseling organizations
that I can use to help me navigate through the dilemma are the American Counseling
Association and the American College Counseling Association.
Generate Potential Course of Action
The first action plan I could take in this situation is tailoring. An article written by Carey
et al., 2023 discussed the act of tailoring. Being able to implement strategies or interventions
that closely fit with the client (Carey et al., 2023). In order to resolve the problem, I would need
to alter the way in which I communicate with the client. For example, the client starts to get
defensive when the counselor mentions that she switches counselors frequently. I would try to
change my open-ended question stating, “How do you feel I could be of more help to you?” This
gives way for a client to feel a sense of control over the conversation by stating how she feels.
The second course of action that I would take would be to let the client know about
putting in a formal written request for her records. The counselor made no effort to tell her this
information. Once the client had started to get elevated, I would have communicated that she
would need a request form and let her know the ACA code of ethics that I follow as well as
Virginia state licensure which both require a written request.
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The final course of action I would take to resolve the issue would be to seek consultation.
An article written by Tu et al., 2023 discussed ethical dilemmas and resolutions of counseling
psychologists in Taiwan. There are many different ethical dilemmas that professionals in the
mental health field encounter. 11% of the participants in the study sought guidance from
supervisors (Tu et al., 2023). As a way to resolve this issue pertaining to the scenario, I can
consult with other colleagues on an ethical decision and where to go from this point.
Conclusion
As a Counselor in training, it’s imperative to understand that you will face many
dilemmas. It's important to know the ACA code of ethics and ethical decision-making. This way
you can do your best for the client ethically and morally. By following the laws and ethical
guidelines you can better navigate dilemmas that you can be in. As in the scenario of the client
requesting her records and the counselor imposing her beliefs, we determined actions that
could be taken to resolve the dilemma. Dilemmas are inevitable, they will happen. Learning
ways in which you can resolve them creates a stronger professional identity.
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References
18VAC115-20-130. Standards of practice.
https://law.lis.virginia.gov/admincode/title18/agency115/chapter20/section130/#
Access of Individuals to Protected Health Information, 45 CFR 164.524(a)(1)
(2014). https://www.ecfr.gov/current/title-45/part-164/section-164.524#p-164.524(a)(1)
Access of Individuals to Protected Health Information, 45 CFR 164.524(b)(1)
(2014). https://www.ecfr.gov/current/title-45/part-164/section-164.524#p-164.524(b)(1)
Access of Individuals to Protected Health Information, 45 CFR 164.524(c)(1)
(2014). https://www.ecfr.gov/current/title-45/part-164/section-164.524#p-164.524(c)(1)
American Counseling Association. (2014). 2014 ACA code of ethics.
https://www.counseling.org/docs/default-source/default-document-library/2014 code-
of-ethics-finaladdress.pdf
Carey, E., Ryan, R., Sheikhi, A., & Dore, L. (2023). Exercising autonomy—The effectiveness and
meaningfulness of autonomy support interventions engaged by adults with intellectual
disability. A mixed methods review. British Journal of Learning
Disabilities, 51(3), 307-323. https://doi.org/10.1111/bld.12464
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Evans, C., Brown, D., & Davis, J. (2022). Professional counseling from a Christian worldview.
Journal of Spirituality in Mental Health, 24(3), 309-
326. https://doi.org/10.1080/19349637.2021.1885004
Liberty University. [n.d.]. Whose Records [Video]. Department of Counselor Education and
Family Studies.
https://mediaplayer.pearsoncmg.com/_blue-top_640x360_ccv2/ab/streaming/
myeducationlab/mhl_counseling/5-1_iPad.mp4
Perry, C. (2022). Autonomy and Clinical Ethics: Don't Throw Autonomy out with the
Bathwater. The Journal of Hospital Ethics, 8(3), 77-83.
https://go.openathens.net/redirector/liberty.edu?url=https://www.proquest.com/
scholarlyjournals/autonomy-clinical-ethics-dont-throw-out-with/docview/2758393713/
se-2
Robinson, J., Moyer, M., Maghsoudi, M., & Martinez-Smith, C. (2020). Deconstructing ethical
ambiguity: Ethical decision-making when working with multiple ethical codes of conduct.
Journal of Professional Counseling, Practice, Theory, & Research, 47(2), 61-
74. https://doi.org/10.1080/15566382.2020.1799675
Tu, S., Yeh, A., & Chan, M. (2023). Ethical dilemmas experienced by counseling psychologists in
Taiwan. Ethics & Behavior, ahead-of-print(ahead-of-print), 1-
14. https://doi.org/10.1080/10508422.2023.2177164
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