Chapter 3 Notes: Standards in the Profession — Ethics, Accreditation, Credentialing, and Multicultural Counseling
Ethics
Chapter opening themes: ethics, accreditation, credentialing, and multicultural counseling reflect a profession maturing and examining its past, present, and future.
Real-world tensions: ethics often collide with legal obligations, personal/moral values, and professional codes; the difference between what we have the right to do and what is right is highlighted by a famous remark attributed to Potter Stewart.
Personal anecdote underscores: ethical complexity in crisis situations (e.g., a client threatening suicide) and how supervisors, law, and morality interact in urgent decisions.
Career-path variability: licensure and credentialing differ by state and by degree type; CACREP accreditation affects exam eligibility (e.g., NCE) and hours required for certification; differences across states illustrate lack of uniform recognition of training background.
Cross-cultural and social justice evolution: early training often paid only lip service to cross-cultural elements; modern practice emphasizes multicultural competence and social justice implications for clients.
The Development of Ethical Codes
Ethical codes emerged as professional standards to protect consumers, promote professional identity, guide behavior, provide decision-making frameworks, and sometimes defend against malpractice claims.
Historical milestones:
1953: APA publishes its code of ethics.
1960: NASW adopts its code.
1961: ACA develops its code.
Codes are living documents: revised over time to reflect societal changes; however, there can be lag between societal values and code content.
Purposes of codes (Corey et al., Dolgoff et al., Remley & Herlihy):
Protect consumers and enhance professional standing.
Reflect maturity and identity of a profession.
Guide professionals toward desirable behaviors.
Provide a framework for ethical decision-making.
Serve as a potential defense in malpractice actions.
Limitations of ethical codes:
Do not address all issues or provide clear responses to every scenario.
Conflicts can occur within or between codes, and with the law, licensing boards, or personal values.
Enforcement can be difficult; public involvement in code creation is limited.
Codes may not address cutting-edge issues.
Debates in code content: universal values vs. cultural variation (e.g., self-determination vs. family/authority norms; universal ethics vs. culturally contingent norms).
Practical implication: when values clash with law, associations may seek to change the law or modify the code to align with the law.
Codes of Ethics in the Helping Professions (Overview)
ACA’s code is central but not sole reference; many other codes exist and can be used in combination depending on context.
ACA’s nine sections (A–I) summarized briefly; detailed reading is recommended via ACA’s knowledge center.
Section A: The Counseling Relationship
Respect client welfare, keep good records, have a counseling plan, involve client networks when appropriate.
Obtain informed consent; consult with others involved with the client; avoid harm and avoid imposing personal values.
Maintain boundaries; document boundary extensions (e.g., attending graduations); advocate for clients at multiple levels.
Screen groups, manage fees, determine if and how to terminate or refer; clarify roles when clients have overlapping relationships.
Section B: Confidentiality and Privacy
Respect client confidentiality and privacy; know when to keep vs. break confidentiality (e.g., harm, end-of-life decisions, contagious diseases, court orders).
Confidentiality in group/family work; special considerations for clients lacking capacity; records confidentiality; consulting with colleagues.
Section C: Professional Responsibility
Practice within competence; address impairment; honest advertising; accurate credential representation; nondiscrimination.
Public responsibilities (e.g., not engaging in sexual harassment; correct third-party reporting); informed consent for new procedures; separate personal and professional statements.
Section D: Relationships with Other Professionals
Maintain respectful, collaborative relationships; competent consultation; informed consent of consultee.
Section E: Evaluation, Assessment, and Interpretation
Use psychometrically sound tools; informed consent; release data to identified parties; accurate diagnoses with cross-cultural consideration; appropriate test selection; nondiscrimination; test security; up-to-date information; objective forensic results.
Section F: Supervision, Training, and Teaching
Supervisors’ responsibility for supervisee welfare; ongoing training; ethical supervisor-subordinate relationships; informed consent and access to consultation; ACA knowledge for supervisees; ongoing evaluation and remediation; infusing multicultural issues; field placements; disclosure statements; prohibitions on sexual relationships with students; multicultural infusion in training.
Section G: Research and Publication
Human participant protections; informed consent; confidentiality; deception considerations; boundaries in research; accurate reporting and publication.
Section H: Distance Counseling, Technology, and Social Media
Emphasis on knowledge of technology and law; informed consent and confidentiality in tech-enabled work; verifying client identity in remote work; discuss benefits/limits/boundaries with clients; recordkeeping and accessibility; separating personal and professional online presence.
Section I: Resolving Ethical Issues
Steps for reporting and resolving suspected violations; addressing conflicts between codes and law; informal resolution first, then ethics committee involvement when needed.
Related Ethical Codes and Standards
Besides ACA, other codes exist for specialized groups: AMHCA, ASCA, IAMFC; NBCC and CRCC have separate codes; ASGW has best-practices guidelines; NBCC/CRCC focus more on credentialing.
Other related codes: APA, NASW, AAMFT, American Psychiatric Association, NOHS.
Selection of codes when faced with dilemmas:
1) Include a statement in informed consent about which code(s) will be used.
2) Determine which codes apply based on professional membership or legal requirements.
3) If codes disagree, consider which code has precedence given employment context (e.g., school vs. clinical).
4) If codes are equally authoritative and conflict, generally follow the stricter guidelines.
5) Use an ethical decision-making model and incorporate multiple codes’ guidance.
6) If conflict with law, prioritize client best interests while attempting resolution (lawful path if necessary).
Ethical Hot Spots for Counselors
Tables 3.1 and 3.2 identify common ethical concerns grouped into categories; examples include:
Counseling Relationship/Boundaries: bartering, asking clients to text, expressing strong feelings, personal phone numbers, pressuring for services, sexual involvement with former clients, hugging, attending ceremonies, informal settings (e.g., walking in park), selling related products.
Values and Culture: advocating for causes publicly, referring due to cultural or religious differences, insisting on autonomy regardless of client’s background, excluding LGBTQ+ clients due to values, pre-session referrals based on values.
Confidentiality and Legal Issues: minor consent, failure to report abuse, group/couple confidentiality, sharing confidential information with non-supervisory staff, withholding minor information, etc.
Legal and Professional Issues: misrepresentation of credentials, violating the law to protect client rights, denying access to process notes, preventing client access to information, etc.
Professional Responsibility: lack of ongoing CE credits, failure to provide pro bono services when needed, not maintaining professional association membership, cross-cultural training gaps, countertransference, etc.
Technology: client access to personal social media, inadequate distance counseling consent, cross-state telemental health issues, accessibility of websites for disabilities, online information sharing.
Note: the full lists are extensive; refer to Tables 3.1 and 3.2 for comprehensive itemized details.
Resolving Ethical Dilemmas: Models of Ethical Decision-Making
Four model families: problem-solving, moral (principle and virtue ethics), social constructionist, developmental.
Important caveat: CRW identities (culture, religion, worldview) should be considered in all models.
Problem-Solving Models
Practical, step-by-step approach; Corey's eight-step model:
(a) identify the problem or dilemma;
(b) identify issues involved;
(c) review relevant ethical guidelines;
(d) know applicable laws and regulations;
(e) obtain consultation;
(f) consider possible/probable courses of action;
(g) enumerate consequences of each action;
(h) decide on the best course.
Moral Models (Principle Ethics and Virtue Ethics)
Principle ethics (Kitchener): five core principles, sometimes with a sixth added (veracity):
Autonomy; nonmaleficence; beneficence; justice; fidelity; veracity.
Virtue ethics (Meara et al.; Kleist & Bitter): focus on counselor character
Virtues include prudence, integrity, respectfulness, benevolence; counselor traits like self-awareness, compassion, cultural sensitivity, and a growth-oriented vision.
Both approaches emphasize using central moral commitments to guide decisions, with virtue ethics centering on the kind of professional one should be.
Social Constructionist Perspective
Knowledge in codes is intersubjective, fluid, and open to interpretation; realities are socially constructed via language and narrative.
Solutions emerge through dialogue among counselor, client, supervisor, and others; emphasis on humility, equality, collaborative problem-solving; de-emphasizes “one right answer” in favor of negotiated understandings.
Developmental Models
Propose levels of counselor development (e.g., Kohlberg, Perry, Kegan):
Lower development: tend toward dualistic thinking, rigid rules, seeking definite answers from authority.
Higher development: relativistic, contextual, complex thinking; open to multiple perspectives; less dogmatic.
Counseling education should provide opportunities to progress toward higher levels of development.
Summarizing and Integrating the Models
Table 3.3 provides a synthesis of the four models, outlining their assumptions, key points, and the role of the counselor.
Box 3.2 uses a vignette (e.g., a depressed patient with terminal illness) to illustrate applying multiple models to a single dilemma.
Box 3.3 emphasizes informal resolution first; Box 3.4 highlights the “topsy-turvy” world of credentialing terminology and reciprocal recognition across states.
Reporting Ethical Violations and Legal Issues
When suspecting unethical conduct, ACA’s Standard I.2.b recommends informal resolution first (discuss with the colleague); escalate if needed to ethics committees, licensing boards, or institutional authorities.
Civil vs. criminal liability: civil misuse focuses on monetary damages; criminal liability involves statutory violations with a different standard of proof; cases may involve both civil and criminal actions; examples include sexual boundary violations (criminal, civil, or both).
The role of ethical codes in lawsuits: not legal documents, but highly persuasive as evidence of standards and professional conduct.
Malpractice insurance: increasingly essential in today’s litigious environment; typical policy limits and costs vary; ACA-affiliated insurance through HPSO is common; coverage examples include $1,000,000 limits and costs around and ; ACA members often receive free liability insurance.
Best practices to avoid lawsuits (Gerry Corey et al., 2019): practical actions to demonstrate adherence to standards, including knowledge of laws, good record-keeping, informed consent, competence boundaries, treatment documentation, confidentiality, appropriate disclosures, and cultural competence.
Accreditation
History and purpose:
Accreditation is about program quality and minimum standards for training programs, contrasting with credentialing, which concerns individual qualifications.
CACREP is the primary accrediting body for counseling programs; its standards shape program structure and graduate preparedness.
Short history of CACREP:
Roots trace back to 1940s in social work; counseling standards formalized later; CACREP was established in 1981 to oversee accreditation.
CACREP standards revised over time; 2016 set current framework; CACREP launched the International Registry of Counselor Education Programs (IRCEP) for international programs.
Why CACREP accreditation matters:
Credibility and credibility-building within the profession; linked to licensure and credentialing.
Benefits include deeper theoretical and practical training, longer field placements, better job opportunities, and potentially fewer ethical violations among graduates.
Accredited programs are more likely to have graduates eligible to sit for the NCE before graduation and for licensure in some states.
Quick overview of CACREP standards (for master’s programs and doctoral studies):
Four primary areas: Learning Environment, Professional Counseling Identity, Professional Practice, Evaluation in the Program.
Core content areas across programs include: foundations, contextual dimensions, and practice.
Professional practice requires supervised field experiences (e.g., 100 hours practicum and 600 hours internship).
Other accrediting bodies:
MPCAC (Masters in Psychology and Counseling Accreditation Council) as a competitor to CACREP.
COAMFTE for marriage and family therapy programs; APA accreditation for doctoral-level psychology programs; CSWE for social work; ACPE for clinical pastoral education.
Impact and expectations: CACREP accreditation is growing, and most states require or prefer CACREP-backed credentials for licensure and employment.
Credentialing
Credentialing across professions: historic parallel to medieval licensure; today involves three major forms:
Registration: listing members; minimal competence; regulated by states; usually modest fees; declining use.
Certification: formal recognition of meeting predetermined standards; protects title rather than scope of practice; often requires ongoing CE; NBCC often oversees NPC-based certifications.
Licensure: most rigorous; defines scope of practice; mandatory to practice; typically requires post-master’s supervision (e.g., years), sometimes additional coursework; enables third-party reimbursement.
Why credentialing matters: increases professional status, parity with related professions, public protection, and delineation of practice scope; essential for reimbursement and professional legitimacy.
Key counseling credentials and pathways:
CRC (Certified Rehabilitation Counselor) via CRCC.
NCC (National Certified Counselor) via NBCC; NBCC also offers CCMHC (Clinical Mental Health Counselor), NCSC (National Certified School Counselor), MAC (Master Addictions Counselor).
Eligibility for NCC often requires CACREP program completion; non-CACREP grads may require 2 years of post-master’s experience with supervision and hours to become NCC.
IAMFC’s National Credentialing Academy (NCA) offers a national certification for marriage and family counselors (CFT).
BC-TMH (Board Certified-Telemental Health) credential via CCE in response to telehealth expansion.
Credentialing in related fields:
Social Work: ACSW, QCSW, DCSW, LCSW; licensure widely pursued.
Psychology: state licensure; increasing presence of board certification; some states allow prescription privileges for certain psychologists.
Psychiatry: medical doctors; board certification often tied to hospital privileges and insurance reimbursement.
Psychiatric–Mental Health Nurses: PMH-NPs/PMH-APRNs with prescriptive authority in many states.
The “topsy-turvy” nature of credentialing terminology across states (e.g., “certification,” “licensure,” “endorsement”) and how state regulations can vary—check local regulations!
Lobbying and professional advocacy: credentialing and licensure expansions have historically required organized advocacy; associations fund lobbying to maintain access to reimbursement and practice rights.
Practical implication: credentialing and licensure influence who can practice where, how they can get paid, and what standards they must meet to maintain professional status.
Multicultural Counseling and Social Justice Competencies (MSJCC)
Core idea: multiculturalism and social justice are essential to competent counseling; they are integrated into contemporary standards and practice.
MSJCC merged multicultural and social justice competencies (Ratts et al., 2015, 2016).
Four domains of MSJCC:
Domain I: Counselor Self-Awareness
Attitudes/beliefs: awareness of social identities, power, privilege, oppression, strengths, biases.
Knowledge: understanding of own identities, power, oppression, biases.
Skills: ability to explore and address identities and biases.
Action: actively increase self-awareness of identities, power, and bias.
Domain II: Client World View
Attitudes/beliefs: awareness of client worldview, identities, and experiences with power and oppression.
Knowledge: knowledge of client worldview and experiences.
Skills: engage in discussions about how worldview shapes counseling.
Action: increase understanding of client worldview and experiences.
Domain III: Counseling Relationship
Attitudes/beliefs: awareness of how worldviews and identities influence the counseling relationship.
Knowledge: understanding of cross-identity dynamics in the relationship.
Skills: engage in conversations about impact of power, privilege, and oppression on the relationship.
Action: actively explore and address relational dynamics.
Domain IV: Counseling and Advocacy Interventions
Intrapersonal, Interpersonal, Institutional, Community, Public Policy, International/Global Interventions.
Each domain includes Attitudes/Beliefs, Knowledge, Skills, and Action (the four-part aspirational/ developmental framework).
The four domains emphasize a progression from self-awareness to understanding client worldview to transforming the counseling relationship and moving toward advocacy interventions.
Power and privilege in the counseling relationship: a developmental perspective describes four quadrants (Figure 3.1) showing how counselor and client identities (privileged vs. marginalized) affect dynamics.
Quadrant I: Privileged Counselor – Marginalized Client
Quadrant II: Privileged Counselor – Privileged Client
Quadrant III: Marginalized Counselor – Privileged Client
Quadrant IV: Marginalized Counselor – Marginalized Client
The quadrants illustrate how power dynamics shape counseling and the need to work toward equitable, collaborative relationships.
The MSJCC approach calls for a lifelong commitment to culturally competent social justice work; it emphasizes that multicultural competence should be integrated into ongoing professional development and accreditation/credentialing decisions.
The Counselor in Process and the Big Picture
Multicultural and social justice orientation is presented as foundational, transforming how codes are written, how programs are accredited, and how credentialing is pursued.
The chapter argues that standards across ethics, accreditation, credentialing, and multicultural counseling help define the profession’s identity, while also challenging members to continuously evaluate and update practices.
The conclusion emphasizes lifelong professionalism: ongoing learning, self-improvement, and commitment to ethical practice, with the understanding that future generations will critique and refine current standards.
Quick Takeaways
Ethical codes provide a framework but have limitations; always consider law, culture, client welfare, and context when applying codes.
ACA’s Code of Ethics (A–I) covers the counseling relationship, confidentiality, professional responsibility, relationships with colleagues, assessment, supervision/training, research/publication, distance/tech, and resolving ethical issues.
Ethical decision-making can be approached via multiple models (problem-solving, principle/virtue ethics, social constructionist, developmental); integrating models often yields better outcomes.
Ethical hot spots are common; be vigilant about boundaries, confidentiality, cultural differences, and technology use.
Accreditation (CACREP) ensures program quality and has several benefits for students, faculty, and licensure. Other accrediting bodies exist, and international programs are supported via IRCEP.
Credentialing (registration, certification, licensure) varies by state and profession; NBCC and IAMFC offer national certifications; licensure often defines practice scope and reimbursement eligibility.
Multicultural and social justice competencies (MSJCC) require ongoing development across four domains and emphasize power, privilege, and advocacy within and beyond the counseling relationship.
The field’s standards reflect a balance between protecting clients, ensuring professional quality, and advancing social justice, all while navigating evolving legal, cultural, and technological contexts.
Note: Where specific tables, boxes, or figures were referenced (e.g., Tables 3.1/3.2, Box 3.2, Fig. 3.1), the notes above summarize their content and intent. For exam preparation, consult the tables and boxes in the source text for verbatim items and detailed examples.