Ethics in Counseling

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Ethics in Counseling

• C6440 Argosy University
• Tampa Campus
• James J. Messina, Ph.D.

2
Issues and Ethics in the Helping Professions
6th Edition

• by Gerald Corey, Marianne Schneider Corey,
  Patrick Callanan
• Wadsworth Group
• A division of
• Thomson Learning, Inc.

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Second Weekend Sessions

• C6440 Argosy University
• Tampa Campus
• James J. Messina, Ph.D.

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Perspectives on Competence

• Professional codes of ethics on competence have
  common themes.
• Counselors practice only within the boundaries of
  competence, based on
• education
• training
• supervised experience
• state and national professional credentials
• appropriate professional experience

Issues and Ethics - Chapter 8 (1)
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Making Referrals

• When
• counselors become aware that they do not have
  skills to offer client needed services
• Counselors value system is in direct conflict
  with client behavior, which will hinder the
  relationship
• How
• counselors must have thorough knowledge of the
  type and caliber of service available in the
  community
• Who
• client must agree that problem exists and be
  willing to work with referral

Issues and Ethics - Chapter 8 (2)
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Ethical Issues in Training Therapists

• Training programs have an ethical responsibility
  to
• establish clear selection criteria
• provide exposure to major contemporary counseling
  theories
• teach students strengths and limitations of
  theories
• combine academic and personal learning
• screen candidates to protect public from
  incompetent practitioners
• teach range of skills to work with diverse
  clients
• provide training in ethics

Issues and Ethics - Chapter 8 (3)
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Certification and Licensure

• Certification
• voluntary attempt by a group to promote
  professional identity
• attempts to verify qualifications
• sets minimum standards
• does not assure quality practice
• Licensure
• governs professional practice
• highlights uniqueness of an occupation
• restricts both use of title and practice of
  occupation

Issues and Ethics - Chapter 8 (4)
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Rights of Supervisees

• Supervisory sessions free from distractions
• To be fully informed of supervisors approach
• Confidentiality with regard to supervisees
  disclosure
• Confidentiality with regard to clients except as
  mandated by law
• Continual access to records maintained during
  supervision
• To provide feedback to supervisors concerning
  supervision experience
• To seek consultation from other professional as
  necessary

Issues and Ethics - Chapter 9 (1)
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Legal Aspects of Supervision

• 1. Informed consent
• 2. Confidentiality and its limits
• 3. Liability
• direct liability
• vicarious liability

Issues and Ethics - Chapter 9 (2)
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Multicultural Issues in Supervision

• Dimensions of a good multicultural model
• pluralistic philosophy
• cultural knowledge
• consciousness raising
• experiential training
• contact with racial and ethnic minorities
• practicum or internship with culturally diverse
  populations

Issues and Ethics - Chapter 9 (3)
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Multiple Roles and Relationships in the
Supervisory Process

• Sexual intimacies during training
• core issue is difference in power and status
• Providing counseling for trainees
• dual relationship standard of ethical conduct
  should be used

Issues and Ethics - Chapter 9 (4)
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Ethical and Professional Issues in Consultation

• Ethical standards for consultants
• Value issues in consulting
• Competence in consultation
• Consultant training
• Relationship issues in consulting
• Rights of consultees
• Issues involving consulting groups

Issues and Ethics - Chapter 9 (5)
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Diagnosis as a Professional Issue

• Key terms
• Medical diagnosis
• Psychodiagnosis
• Differential diagnosis
• Diagnosis and statistical manual of mental
  disorders (DSM-IV)

Issues and Ethics - Chapter 10 (1)
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Arguments for Psychodiagnosis

• No third-party reimbursement without acceptable
  diagnosis
• Difficult to formulate treatment plan without
  defining problem
• Provides team members with a common frame of
  reference
• Allows therapists to rule out medical conditions
• Used to assess whether clients pose danger to
  self or others
• Provides framework for research

Issues and Ethics - Chapter 10 (2)
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Arguments Against Psychodiagnosis

• Emphasis of DSM is on pathology
• Can minimize uniqueness of client
• Ignores natural capacities for self-healing
• Can lead people to accept self-fulfilling
  prophecies
• Assumption that distress in family is result of
  individual pathology
• Many therapists not competent to use DSM
  diagnosis appropriately

Issues and Ethics - Chapter 10 (3)
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Using Tests in Counseling

• It is important for counselors to
• be familiar with tests being used and taking
  tests themselves
• recognize limits of competence to use and
  interpret tests
• know the reasons why a particular test is being
  used
• make clients aware that tests are merely tools
  that can provide useful information
• give test results, not simply test scores
• be sensitive to the ways in which clients respond
  to test results
• assure clients that test results will not be used
  against them
• assure confidentiality unless consent is given
• know the limitations of tests being used

Issues and Ethics - Chapter 10 (4)
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Critical Ethical Issues in Managed Care

• Informed consent
• Confidentiality
• Abandonment
• Utilization review

Issues and Ethics - Chapter 10 (5)
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Financial Incentives Inherent in Managed Care
Tempt Both Practitioner and Payor to

• Deny and limit access to long-term therapy
• Narrow the clients choice of a therapist
• Disrupt the continuity of care
• Rely on less qualified providers to provide
  services
• Use less qualified providers to review care
• Breach client confidentiality by giving reviewers
  too much personal information about clients
• Base practices on a business ethic instead of a
  professional ethic

Issues and Ethics - Chapter 10 (6)
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Consent for Release of Confidential Information

• Example
• I authorize the following disclosure of
  information
• 1. Name of therapist that is to make the
  disclosure.
• 2. Name of person or organization to which the
  disclosure is to be made.
• 3. Purpose of disclosure.
• 4. Extent or nature of information to be
  disclosed
• Signature of client __________________
• Date consent was signed ___________
• I understand that my records are protected under
  the federal and state confidentiality regulations
  and cannot be disclosed without my written
  consent.

Issues and Ethics - Chapter 10 (7)
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Ethics and Research

• Issues involved
• informed consent
• deception
• withholding treatment
• research with training and personal growth
• cultural diversity

Issues and Ethics - Chapter 10 (8)
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Ethical Standards in Couples and Family Therapy

• Responsibility to clients
• Confidentiality
• Professional competence and integrity
• Responsibility to students, employees, and
  supervisees
• Responsibility to research participants
• Responsibility to the professions
• Fees
• Advertising

Issues and Ethics - Chapter 11 (1)
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Training Issues in Couples and Family Therapy

• Personal Characteristics of Family Therapists
• self-knowledge is critical, especially
  family-of-origin issues
• Training, Supervision, and Clinical Experience
• didactic methods
• experiential methods
• Values in Couples and Family Therapy
• value system of therapist has crucial influence
  on formulation and definition of problems

Issues and Ethics - Chapter 11 (2)
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Gender-Sensitive Couples and Family Therapy

• Challenging traditional gender roles
• Gender roles and stereotypes
• Feminist perspective on family therapy
• placing same demands for change on both women and
  men
• valuing womens request for change
• challenging traditional roles
• valuing expression of emotion and nurturance in
  both partners
• challenging patterns of male dominance and female
  subordination
• questioning gender-specific rules
• valuing womens work in the family

Issues and Ethics - Chapter 11 (3)
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Confidentiality in Couples and Family Therapy

• Exceptions to confidentiality
• when mandated by law
• when it is necessary to protect clients from harm
  to self or others
• when family therapist is a defendant in a civil,
  criminal, or disciplinary action arising from
  therapy
• when a waiver has been previously obtained in
  writing

Issues and Ethics - Chapter 11 (4)
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Informed Consent in Couples and Family Therapy

• Before therapy begins, the counselor needs to
  give information to family members about
• purpose of therapy
• typical procedures
• risks of negative outcomes
• possible benefits of therapy
• the fee structure
• limits of confidentiality
• rights and responsibilities of clients
• the option that a family member can withdraw at
  any time
• what can be expected from the therapist

Issues and Ethics - Chapter 11 (5)
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Ethical Issues in Group Therapy

• Professional training standards
• knowledge competencies
• skill competencies
• Training for various types of groups
• task and work groups
• psychoeducational groups
• group counseling
• group psychotherapy

Issues and Ethics - Chapter 12 (1)
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Training Program for Group Workers

• Recommendations
• personal psychotherapy
• self-exploration groups
• participation in a training and supervisory group

Issues and Ethics - Chapter 12 (2)
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Ethical Issues in Group Membership

• Informed consent
• Screening and selection
• Preparing group participants
• Involuntary participation
• Freedom to leave group
• Psychological risks
• Confidentiality in groups
• exceptions to confidentiality
• confidentiality with minors

Issues and Ethics - Chapter 12 (3)
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Unethical Use of Group Techniques

• It is unethical for group leaders to use
  techniques
• that are unfamiliar
• to serve a hidden agenda or enhance power
• solely to create an intense atmosphere
• to pressure members or deprive them of their
  dignity

Issues and Ethics - Chapter 12 (4)
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Recommendations in Using Group Techniques

• Techniques should have therapeutic purpose
• Techniques should be grounded in a theoretical
  framework
• Clients self-exploration should be fostered
• Leaders should modify techniques for culturally
  diverse clients
• Techniques shouldnt be used haphazardly
• Techniques should be introduced in timely and
  sensitive manner
• Group members should be given freedom to
  participate or pass on experiment
• Group leaders should use techniques they are
  familiar with
• Leaders should be aware of potential impact of
  techniques

Issues and Ethics - Chapter 12 (5)
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4 Facets of Comprehensive Community Counseling
Programs

• 1. Direct community services
• preventive education
• 2. Indirect community service
• influencing policymakers
• 3. Direct client services
• focuses on outreach activities
• 4. Indirect client services
• client advocacy

Issues and Ethics - Chapter 13 (1)
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Alternative Counselor Roles

• Change agent
• Consultant
• Adviser
• Advocate

Issues and Ethics - Chapter 13 (2)
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Community Counseling Practitioner

• Duties involve
• Ability to support community needs
• Develop partnerships in creation and delivery of
  services
• Promote community organization and development of
  activities
• Outreach
• Develop strategies to empower the community
• Consultation with community agencies
• Evaluating human-services programs
• Advocate and assist with initiatives
• Develop and build community assets

Issues and Ethics - Chapter 13 (3)
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Relationships Between Counselor and the Agency

• Counselors who are dissatisfied with an agency or
  the system may decide to
• subvert it any way they can
• conform to institutional policies out of fear
• make compromises between institutional demands
  and personal requirements
• leave the agency

Issues and Ethics - Chapter 13 (4)
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Case Management

• Philosophy
• The primary goal of case management is to enable
  clients to achieve economic and personal
  independence and self-sufficiency
• The role of case manager
• identify which needs and desires could motivate
  the client to change
• help clients identify options and resources that
  can facilitate change and identify barriers
  blocking change
• provide information options and resources that
  make change seem achievable
• actively involve clients in all phases of the
  process

Issues and Ethics - Chapter 13 (5)