A prominent aspect of counsellor training involves the analysis of ethical situations. Counsellors want to be malleable to the variety of situations in which the client’s personality traits and environmental circumstances are prominent barriers to the relationship’s progress.
Codes of practice, ethical guidelines and counselling micro-abilities play a function in supporting the counsellor’s choice-making procedure towards the relationship nevertheless, client and scenario uniqueness are not the exception in the therapeutic method – they reign supreme. Powerful counselling invokes the ongoing want for adaptability and essential analysis.
In this context, 3 scenarios which frequently give rise to ethical dilemmas are dual relationships, mandatory reporting and informed consent. Are you conscious of the specific conditions which delineate every of these situations, and how to act upon them? This article gives a snapshot of the subject, along with some techniques for practising and student counsellors who are likely to face comparable circumstances throughout their careers.
Dual Relationships
Dual relationships can be defined as social interactions between counsellor and client, in addition to their expert (or therapeutic) relationship. Since the relationship was initiated in a therapeutic environment – which invokes behavioural restrictions and calls for specific decorum from both entities – clients and counsellors are likely to face natural obstacles when developing relationships outside of the counselling room.
As Corsini (2000, p. 447) states: “It is typically awkward for both the therapist and the client when interactions occur outside the psychotherapeutic relationship. Some relationships, such as those that contain sexual or financial involvement, clearly violate the ethical codes of nearly all professional organizations. Other people, such as permitting a client to get the therapist a cup of coffee following a chance meeting in a restaurant, seem to be fairly harmless. Most decisions are not this straightforward, even so, and deciding no matter whether to accept a Christmas gift or flowers for the waiting room can become a vexing dilemma”.
The primary question to be asked is how considerably influence particular social interactions can wield in the professional relationship – that is, the counsellor’s perspective towards the client, and vice-versa. Basic interactions, such as a chat on the street or even the cup of coffee cited by Corsini are likely to have small influence over both entities’ mindsets, therefore it is normally not perceived as a challenging situation. But certain situations which induce emotional attachment can be damaging to counselling objectives and/or outcomes.
Mental wellness professionals diverge in opinions when it comes to dual relationships. However, the vast majority of therapists agree that dual relationships ought to be avoided, arguing that transference and counter transference are powerful responses that will inevitably influence the therapeutic relationship. Along with most ethical dilemmas, it is largely a matter of every case: context, individual personality traits and nature of the counselling relationship.
According to Karen Kitchener (1988), the kinds of dual relationships which had been most likely to be detrimental to a therapeutic relationship included the following aspects: “incompatibility of expectations between roles diverging obligations associated with various roles, which increases potential for loss of objectivity and increased power and prestige between professionals and buyers, which increases the possible for exploitation”.
To surpass difficulties with dual relationships, counsellors ought to ascertain clear and realistic boundaries around the expert relationship with their customers. Such boundaries want to think about the needs and characteristics of every client, and how that will reflect in the overall relationship. Codes of practice and guidelines are essential to set these boundaries however, experts should be sensitive to particular wants in every relationship and apply such knowledge to increase decision-generating in the counselling process.
Mandatory Reporting
Mandatory reporting, or duty to warn, is 1 of the most sensitive topics in therapy and mental wellness. The bare existence of this concept already conflicts with ethical principles of confidentiality, therefore deciding to report a client is a paradoxical pattern of thinking for any such professional. Nevertheless, it is an incredibly critical concern.
It can be defined as the necessity to break client confidentiality in order to protect the client or the community as a entire, when the client imposes a threat to his/her own safety, the community’s safety or the framework of law to which the community abides by. When laws and values conflict, which side really should you take? Most instances of information disclosure in therapy are for the benefit of the client, such as sharing data with colleagues or supervisors in order to acquire an alternative opinion or perspective. Even so, when it comes to mandatory reporting, greatest interest of the community or society are preceded over the client’s interests. Therefore, the default answer to the previous question is in truth, the law.
Needless to say, counsellors need to be flexible when making decisions regarding mandatory reporting. There are many law frameworks which govern countries, states and regions, and every single of them has its own agenda in respect to mandatory reporting requirements. Moreover, a wide variety of codes of conduct are also most likely to influence the decision-creating method for therapists and mental health professionals.
A widespread basis for reporting a client is the imminence of danger for the individual (self harm) or other people (e.g. an ex-partner). “Exceptional circumstances could arise which give the counsellor great grounds for believing that serious harm might happen to the client or to other men and women. In such circumstances the client’s consent to change in the agreement about confidentiality should be sought whenever probable unless there are also good grounds for believing the client is no longer willing or able to take responsibility for his/her actions. Typically, the choice to break confidentiality really should be discussed with the client and should be made only right after consultation with the counselling supervisor or if he/she is not offered, an skilled counsellor.” (Australian Counselling Association – Code of Conduct)
Informed Consent
Informed consent involves the communication of any information which matters to the client and which is pertinent to the therapeutic relationship. A creating aspect of the client-counsellor relationships is the development of trust and rapport. A premise for creating trust and rapport is excellent communication. Excellent communication, conversely, is based on honesty. Therefore, informed consent is not only an ethical requirement for the counsellor, but also a condition to accomplish the collective objectives of the relationship.
“Clients are entitled to know about all matters that affect them. They deserve to know the likelihood of harm (physical or mental) that could result from treatment, the possibility of side effects, the probability of success for treatment, the limits of confidentiality, regardless of whether student counselors will be involved, and the most likely duration and price of treatment.” (Corsini, 2000)
An efficient way to make sure customers are adequately informed is to generate a standard details disclosure statement: a contract which comprises the counsellor’s and clients’ responsibilities and rights. A nicely-defined statement will offer the client with valuable details about areas such as: confidentiality, record-keeping, counselling management, relationship boundaries, and far more. It is also a measurement which improves the high quality of the service provided as it creates a clear framework of conduct for customers which are not acquainted with the process of therapy.
“Counsellors are responsible for reaching agreement with their clients about the terms on which counselling is becoming provided, such as availability, the degree of confidentiality provided, arrangements for the payment of any fees, cancelled appointments and other significant matters. The communication of crucial terms and any negotiations need to be concluded by having reached a clear agreement prior to the client incurs any commitment or liability of any type.” (Australian Counselling Association – Code of Conduct)
Reference List:
Australian Counselling Association (2002). ACA Code of Conduct. (4th version). Brisbane: Author. Corsini, R., & Wedding, D. (2000). Current Psychotherapies. (6th Edition). Belmont: Brooks/Cole. pp. 445-453. Kitchener, K. S. (1988). Dual function relationships: What makes them so problematic? Journal of Counseling & Development, 67(4), pp. 217–221.
Subscribe to our No cost eZine.