MODULE 4 - Ethical Issues in Counseling Practice

American Counseling Association (ACA) Code of Ethics

Addresses the responsibilities of professional counselors toward their clients, colleagues, workplace, and
themselves by delineating the ideal standards for conducting one’s behavior

Kitchener's five moral principles

1. Autonomy - concept of independence and the ability to make one's own decision
2. Justice - treating each person fairly, not treating each person the same way
3. Beneficence - doing good or the best interest of the client
4. Nonmaleficence - doing no harm to others
5. Fidelity - involves the concept of loyalty, faithfulness, and honoring commitments

Eight Sections of the Code

A. The Counseling Relationship
B. Confidentiality, Privileged Communication, and Privacy
C. Professional Responsibility
D. Relationships with Other Professionals
E. Evaluation, Assessment, Interpretation
F. Supervision, Training, and Teaching
G. Research and Publication
H. Resolving Ethical Issues

Section A: The Counseling Relationship

 Counselors must wait five years after the counselor-client relationship has ended before engaging in any
romantic or sexual relations with a client, a client’s family members, or a client’s romantic partner.
 Informed consent
o Purposes, goals, techniques, procedures, limitations, potential risks, and benefits of services; the
counselor’s qualifications, credentials, and relevant experience; the intended use of tests and reports,
fees, and billing arrangements; etc.

Section B: Confidentiality, Privileged Communication, and Privacy

 Be respectful of differing views and inform clients with whom, when, and how information will be shared.
 Take precautions to ensure confidentiality when using technologies such as computers, electronic mail, or
voicemail.
 Maintain the confidentiality of deceased clients as is consistent with legal requirements and policies.
 Inform parents and legal guardians of the confidential nature of the counseling relationship as well as establish
a working relationship with them in order to better serve clients.

Section C: Professional Responsibility

 Be alert to signs of personal impairment and refrain from providing or offering services if the impairment could
potentially harm a client.
 Assist supervisors or colleagues in recognizing impairment and if necessary, provide assistance, intervention, or
consultation.
 Designate a specific colleague or “records custodian” and create a proper plan for file and client transfer in the
case of incapacitation, termination of practice, or death.
 Use techniques, modalities, or procedures that have a scientific or empirical foundation and are grounded in
theory. Otherwise, techniques must be labeled as “unproven” or “developing.

Section D: Relationships with Other Professionals

  Become knowledgeable about colleagues and develop positive working relationships and communication
systems.
 Be respectful of differing approaches to counseling services as well as the traditions and practices of other
professional groups.
 Work to develop and strengthen relations with interdisciplinary colleagues.

Section E: Evaluation, Assessment, and Interpretation

 Take into account cultural, social and personal factors when making assessments.
 Be aware of social and historical prejudices in the pathologizing and misdiagnosis of specific individuals and
groups, and be cognizant of the role of mental health professionals in the continuation of these problems.
 Generate objective findings that are supported by appropriate techniques and information when conducting
forensic evaluations.

Section F: Supervision, Training, and Teaching

 Foster professional relationships and create appropriate boundaries with students.
 Be accurate, honest, and fair during the training and assessment of students

Section G: Research and Publication

 Take the appropriate steps to destroy any documents or records that contain confidential data or may identify
research participants within a reasonable period of time after the completion of a research study or project.
 Do not plagiarize or present another person’s work as your own.
 When reviewing documents in a professional capacity, counselors should make valid publication decisions,
review materials in a timely manner, avoid biases, and only evaluate documents that fall within one’s field of
competency.

Section H: Resolving Ethical Issues

 If there is a conflict between ethical responsibilities and laws, professional counselor should make known their
commitment to the Code of Ethics and work to alleviate the conflict.
 Counselors may follow legal requirements or regulations if the ethical conflict cannot be resolved in this
manner.
 Seek out further action such as referring to voluntary national certification bodies, state or national ethics
committees, state licensing boards, or any suitable institutional authorities when informal resolution is not
appropriate or the issue is not properly resolved.
 Do not deny a person’s advancement, admission to academic programs, employment, promotion, or tenure
based only upon their having made an ethics complaint nor their being the subject of an ethics complaint.

Ethical Issues That Influence Clinical Practice

Client Welfare
Client needs come before counselor needs and the counselor needs to act in the client's best interest

Informed Consent
Counselors need to inform clients as to the nature of counseling and answer questions so that the client can make
an informed decision.
o Involves the right of clients to be informed about their therapy and to make autonomous decisions pertaining
to it

Confidentiality
Clients must be able to feel safe within the therapeutic relationship for counseling to be most effective. What the
client says stays in the session unless the client is threatening harm to self or others.
o Confidentiality - an ethical concept, and in most states the legal duty of therapists to not disclose information
about a client
 o Privileged communication - legal concept that generally bars the disclosure of confidential communications in a
legal proceeding

o When To Break Confidentiality

 If a client threatens another person’s life or with significant bodily harm.
 When a child under the age of 16 is being sexually abused.
 If the counselor determines the client needs hospitalization.
 If the information is involved in a court action.
 It is legal protection of the client which prevents a counselor from disclosing what was said within the
counseling session(s).
 This right belongs to the client and not the counselor.
 Laws concerning privileged communication vary from state to state.

Dual Relationships
When a counselor has more than one relationship with a client. This may involve assuming more than one
professional role or combining professional and nonprofessional roles. Sexual or nonsexual.
o Nonsexual dual or multiple relationships
 Combining the roles of teacher and therapist or of supervisor and therapist; bartering for goods or
therapeutic services; borrowing money from a client; providing therapy to a friend, an employee, or a
relative; engaging in a social relationship with a client; accepting an expensive gift from a client; or
going into a business venture with a client.

Sexual Relationships
Professional organizations strongly prohibit sexual relationships with clients and in some states it is a criminal
offense.
For example, becoming emotionally or sexually involved with a current client is clearly unethical,
unprofessional, and illegal. Sexual involvement with a former client is unwise, can be exploitative, and is generally
considered unethical.

Other Ethical Issues

Ethical Issues in a Multicultural Perspective
 Take the client's cultural context into account
 Multicultural specialists have asserted that theories of counseling and psychotherapy represent different
worldviews, each with its own values, biases, and assumptions about human behavior.

Ethical Issues in the Assessment Process

 Assessment and diagnosis are integrally related to the practice of counseling and psychotherapy, and both are
often viewed as essential for planning treatment.
 Regardless of their theoretical orientation, therapists need to engage in assessment, which is generally an
ongoing part of the therapeutic process.
 Assessment should not precede and dictate intervention; rather, it is woven in and out of the therapeutic
process as a pivotal component of therapy itself.

Malpractice
When a counselor fails to provide reasonable care or skill that is generally provided by other professionals and it
results in injury to the cient

Four conditions must exist

 The counselor has a duty to the client
 The duty of care was not met
 The client was injured in the process
 There was a close causal relationship between the counselor's failure to provide reasonable care and the client's
injury
Suggestions on Avoiding Malpractice
 Pre-counseling
o The financial costs of counseling.
o Any special arrangements.
o The competencies of the counselor.
o Avoid dual relationships.
o Clearly indicate if a treatment is experimental.
o Identify limits to confidentiality.
o Help the client make an informed choice.
 Ongoing counseling
o Maintain confidentiality.
o Seek consultations when necessary.
o Maintain good client records.
o Take proper action when a client poses a clear and imminent danger to themselves or others.
o Comply with the laws regarding child abuse and neglect.
 Termination of Counseling
o Be sensitive to the client’s feelings regarding termination.
o Initiate termination when the client is not benefiting from services.
o Address the client's post-terminations concerns.
o Evaluate the efficacy of the counseling services.

Ethical Decision Making

Part of the process of making ethical decisions involves learning about the resources from which you can draw when
you are dealing with an ethical question.

Steps in Making Ethical Decisions

 Identify the problem or dilemma
o Gather information that will shed light on the nature of the problem. This will help you decide whether
the problem is mainly ethical, legal, professional, clinical, or moral.
 Identify the potential issues.
o Evaluate the rights, responsibilities, and welfare of all those who are involved in the situation.
 Look at the relevant ethics codes for general guidance on the matter
o Consider whether your own values and ethics are consistent with or in conflict with the relevant
guidelines.
 Consider the applicable laws and regulations, and determine how they may have a bearing on an ethical
dilemma.
 Seek consultation from more than one source to obtain various perspectives on the dilemma, and document in
the client’s record what suggestions you received from this consultation.
 Brainstorm various possible courses of action.
o Continue discussing options with other professionals. Include the client in this process of considering
options for action. Again, document the nature of this discussion with your client.
 Enumerate the consequences of various decisions, and reflect on the implications of each course of action for
your client.
 Decide on what appears to be the best possible course of action.
o Once the course of action has been implemented, follow up to evaluate the outcomes and to determine
if further action is necessary. Document the reasons for the actions you took as well as your evaluation
measures.