Question 1
1. Discuss the ethical issues in counselling practice with reference to:
• The right to informed consent
• The dimensions of confidentiality
Ethical Issues in Counselling Practice: Informed Consent and Confidentiality
Ethical practice is foundational to counselling, encompassing far more than adherence to rules and
prohibitions. As Corey et al. (2021, p. 36) explain, "being an ethical practitioner is far more complex
than a set of rules." Ethical counsellors must navigate mandatory ethics (minimum professional
standards), aspirational ethics (doing what is in the best interests of clients), and positive ethics
(striving to do one's best rather than merely avoiding trouble) (Corey et al., 2021, p. 36).
The Right to Informed Consent
Informed consent is a fundamental ethical and legal requirement in counselling, integral to the
therapeutic process regardless of theoretical orientation. Corey et al. (2021, p. 39) define informed
consent as "the right of clients to be informed about their therapy and to make autonomous decisions
relating to it." It establishes the foundation for a collaborative working alliance between client and
therapist, empowering clients and building trust.
Informed consent encompasses several essential components. According to Corey et al. (2021, p. 39),
these include "the general goals of counselling, the responsibilities of the counsellor toward the client,
the responsibilities of clients, limitations of confidentiality and exceptions to confidentiality, legal
and ethical issues that could define the relationship, the qualifications and background of the
practitioner, the fees involved, the services the client can expect, and the approximate length of the
therapeutic process." Additionally, it covers the benefits and risks of counselling and the possibility
that the client's case may be discussed with supervisors or colleagues.
A crucial aspect of informed consent is that it is not merely a one-time event involving a signature on
a form. Rather, it is an ongoing process that begins with the first counselling session and continues
throughout therapy. Corey et al. (2021, p. 39) emphasise that "educating the client begins with the
first counselling session, and this process will continue for the rest of the counselling." The challenge
lies in striking a balance between providing too much information (which may overwhelm clients)
and too little (which may leave them uninformed). For instance, it is too late to inform minors about
parental consultation after they have disclosed considering an abortion; young clients have the right
to know about confidentiality limitations before making such personal disclosures (Corey et al., 2021,
p. 39).
Informed consent can be provided in written form, orally, or a combination of both. When done
orally, therapists must document the nature and extent of informed consent in the client's clinical
record (Corey et al., 2021, p. 39). Written consent is particularly preferred in contexts involving
conflict, family disputes, or forensic settings, where high emotional investment may lead to litigious
engagement. Corey et al. (2021, p. 39) note that "informed written consent (and assent, in the case of
children) is essential to safeguard all the relevant parties."