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Ethics is a way of thinking about becoming the best practitioner possible. Ethical guidelines
do not make decisions for you and ethical sensitivity is required, often viewpoints differ but in
the end you have to assume responsibility.
Mandatory ethics: view of ethical practice that deals with the minimum level of professional
practice
Aspirational ethics: a higher level of ethical practice that addresses doing what is in the best
interest of the client
Positive ethics: an approach taken by practitioners who want to do their best for clients rather
than simply meet minimum standards and stay out of trouble.
Ethical decision-making:
Ethical behaviour must not be confused with legal behaviour. Unfortunately ethics codes
can take on a legal dimension and practitioners are more concerned with avoiding a
lawsuit than about doing what is right for the client – limiting their creative work.
To prevent being sued for malpractice you should:
- Demonstrate respect for clients
- Keep their welfare as a central concern
- Practice within professional codes
Ethics codes are best used as guidelines in making sound judgements and not hold ultimate
truths.
The more subtle the problem the harder it is to decide on a course of action. Be willing to
discuss the problem and explore various options. Keep the client involved.
Includes:
- General goals
- Responsibilities of counsellor
- Responsibilities of client
- Limitations and exceptions of confidentiality
- Legal and ethical parameters
- Qualification and background of counsellor
- Fees
- Service that can be expected
- Length of process
- Benefits/risks
- Possibility of discussion with other colleagues
Begins at the first session and continues throughout the process. Must balance too much and
too little info.
It is a good idea to have the basic outlines in paper which can be discussed.
Dimensions of Confidentiality:
Two aspects:
1. Privileged communication
Legal concept barring disclosure of confidential communication in a legal proceeding
2. Confidentiality
An ethical concept and in most places a legal duty of the therapist not to disclose
information about the client
- Therapeutic relationship is based on trust, must explain to client the limits, nature and
purpose of confidentiality early on including discussion of the case with supervisors
- Breaching confidentiality is a cloudy issue and the following must be considered:
o The law, nature of the institute you work for and repercussions for client
o Child abuse
o Abuse of elderly
o Abuse of dependant adult
o Client under 16 may be victim of incest, rape, child abuse or another crime
o Client needs hospitalisation
o Court issue
o Client requests files be released to selves or third party
Is Counselling Culture-bound?
o The individual must also be viewed in context of his/her family and culture
o Social action is favoured rather than increasing individual insight
o Maintain the notion that therapeutic practice is only effective if it changes the
factors creating the client’s problem (a social action), not blaming/working
with the individual alone
- Difficult for counsellors to bring about change in society, counsellors can use
techniques to increase client awareness of options when dealing with barriers and
struggles.
Ethical Issues In the Assessment Process:
Both clinical and ethical issues come into play when considering assessment and diagnostic
procedures.
Both assessment and diagnosis are an integral part of the therapeutic process and regardless
of orientation therapists need to engage in assessment.
Assessment: can be considered part of the process leading to diagnosis. Is an going process
consisting of evaluating relevant client factors in a client’s life to identify themes to be
explored
The purpose of diagnosis is to identify disruptions in a client’s present behaviour and lifestyle.
This allows goals as well as a treatment plan to be established. It also acts as a working
hypothesis for the therapist. Therapists use the Diagnostic and Statistical Manual of Mental
disorders.
- Diagnostic approach may fail to notice ethnic and cultural factors in certain patterns of
behaviour
- DSM does acknowledge this encourages awareness of it
- Cultural bias can lead to erroneous diagnoses
- Some behaviours and personality styles may be labelled as deviant because they are
not characteristic of the dominant culture
- Can we bridge gap between the poles of diagnosis seen as essential and as
detrimental?
- Can be collaborative event - client and therapist both engage in the search and
discovery process
- Some counsellors avoid diagnosis but share tentative hypotheses with client
throughout the process (consistent with feminist theory)
- Ethical dilemmas: diagnosis for insurance purposes
- Clinical/ legal/ ethical obligation to screen clients for life threatening problems: organic
disorders, schizophrenia, bipolar, suicide and depression
- Assess whole person: mind/body/spirit
- Must take biological processes into account and work with physician
- Holistic perspective: spiritual and religious too
- Client’s own values can be used in finding solutions to their problems
The Value of Evidence-Based Practice
Instead of using techniques based on their preferred theory, there has been a promotion
towards evidence-based practice.
- Sexual /nonsexual occur when the counsellor assumes two or more roles
simultaneously or sequentially with a client.
o Either more than one professional role or,
o Combines professional and non professional roles
- Non sexual relationships: teacher/therapist, supervisor/therapist, borrowing money
from a client, providing therapy to a friend/employee/relative, social relationship with
client, accepting an expensive gift from a client, going into business with a client
- Some multiple relationships can be exploitive can do harm to both parties
- Unethical: becoming emotionally or sexually involved with a current or former client
- Nonsexual dual relationships are complex – few simply answers
- Nonsexual, dual and multiple relationships are complex so there are few concrete
answers
- Give careful thought to your situation before becoming involved in questionable
circumstances
- Counselling professionals must learn to manage multiple relationships in an ethical
way specifically regarding:
o Power differential in counselling / training relationships
o Balancing boundary issues
o Addressing non professional relationships
- Multiple relationships that would not reasonably be expected to cause impairment or
risk exploitation or harm are not unethical