Ethical Principles & Standards in Counseling

Professional Ethics

• Ethics codes are a fundamental component of effective counseling:

• 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

Types of ethics to consider:

• Mandatory Ethics

• Aspirational Ethics

• Positive Ethics

The principles that underlie our professional codes

• Autonomy

• Justice

• Beneficence

• Nonmaleficence

• Fidelity

• Veracity

The role of ethical codes:

• Educate about responsibilities

• Basis for accountability

• Protect clients

• Basis for improving professional practice

Making ethical decisions

• Identify the problem

• Review relevant codes

• Seek consultation

• Brainstorm

• List consequence

• Decide

• Document the reasons for your actions to the degree it is possible, Include the client in your decision-making process

Making Ethical Decisions

1. Identify the problem or dilemma.

   • 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.

2. Identify the potential issues.

   • Evaluate the rights, responsibilities, and welfare of all those who are involved in the situation.

3. Look at the relevant ethics codes for general guidance on the matter.

   • Consider whether your own values and ethics are consistent with or in conflict with the relevant guidelines.

4. Review relevant laws and regulations to assess their impact on the ethical dilemma.

5. Consult multiple sources for diverse perspectives on the dilemma and document their suggestions in the client’s record.

6. Brainstorm possible actions, consult other professionals, involve the client, and document these discussions.

7. List potential consequences of each decision and consider their impact on the client.

8. Choose the best course of action, implement it, and follow up to assess outcomes and need for further steps. Document your actions and evaluation.

Informed Consent

• Clients need enough information about the counseling process to be able to make informed choices

• Educate clients about their rights and responsibilities.

Provide Informed Consent

1. Therapy Procedures

2. Risks/Benefits and Alternatives

3. Right to withdraw from treatment

4. Costs of treatment

5. Supervision

6. Privileged communication

7. Limits of Confidentiality

Limits of Confidentiality

• Confidentiality is essential but not absolute

• Exceptions:

  • Duty to Warn (Tarasoff Case)

    • The client poses a danger to self or others

  • A client under the age of 16 is the victim of abuse

  • A dependent adult or older adult is the victim of abuse

  • The client needs to be hospitalized

  • The information is made an issue in a court action

  • The client requests a release of record

Multicultural Issues

• Biases are reflected when we:

  • Overlook social factors, focusing only on individualism

  • Use assessment tools not normed for the client’s population

  • Judge as psychopathological – behaviors, beliefs, or experiences that are normal for the client’s culture

  • Apply Western theories without considering cultural relevance

Assessment and Diagnosis

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

  • Assessment practices are influenced by the therapist's theoretical orientation

  • Requires cultural sensitivity

  • Can be helpful in treatment planning

• Diagnosis is the process of identifying pattern of symptoms which fit the criteria for a specific mental disorder defined in the DSM-V-TR

  • Requires cultural sensitivity

  • Counselors debate its utility in understanding the client’s subjective world

  • Can be helpful in treatment planning

Evidence-Based Practices

• Strengths

  • Counselors use treatments that have been validated by empirical research

  • Treatments are usually brief and are standardized

  • Are preferred by many insurance companies

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

• Criticisms

  • Approach is mechanistic and does not allow for individual differences in clients

  • Not well-suited for helping clients with existential concerns

  • Difficulty in measuring both relational and technical aspects of a psychological treatment

  • Potential for misuse as a method of cost containment for insurance companies instead of a method of efficacious treatment for clients

Multiple Relationships

• Dual or multiple relationships

  • Either sexual or nonsexual, occur when counselors assume two (or more) roles simultaneously or sequentially with a client.

• Multiple relationships

  • Must be managed in an ethical way to eliminate non-professional interactions and protect client well-being.