CHAPTER 3: ETHICAL ISSUES
INTRODUCTION
Balancing client’s needs against your own
Making sound ethical decisions
Educating clients about their rights
Confidentiality
Counselling diverse client populations
Diagnosis
Dealing with dual relationships
Need to re-examine ethical issues periodically through professional life.
CLIENT’S NEEDS BEFORE YOUR OWN
“Whose needs are being met in this relationship? Client’s or my own?”
Not unethical to meet our own needs – keep in perspective
Avoid EXPLOITING client
ETHICAL DECISION MAKING
Roles of ETHICS CODES as a catalyst for improving practice
Result in legalistic dimensions – fulfilling minimum legal requirements rather than what
is right for client
Being an ethical practitioner involves more – clients’ welfare as a central concern
Steps in making ethical decisions
1. Identify problem or dilemma – decide if ethical, moral, legal, professional or
clinical
2. Identify potential issues – rights, responsibilities, welfare of those involved
3. Consider applicable laws/regulations
4. Seek consultation – professional maturity implies you are open to questioning
and discussing with colleagues
5. Brainstorm
6. Enumerate consequences
7. Decide on best course of action
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THE RIGHT OF INFORMED CONSENT
Empower clients and built trusting relationship through educating them about their
rights.
Balance between too little and too much info
Have basic info about therapy in document as well as discussing with them - they can
take home and consider
CONFIDENTIALITY
Central to developing trusting relationship
Both ethical and legal issue
Ethical to discuss confidentiality and limitations early in process
Mention discussing with colleague or supervisor
Confidentiality can be broken if client may do serious harm to themselves or others
Legal requirements
Client under age 16 is victim of rape, child abuse, or other crime
Client is in need of hospitalisation
When information is an issue in a court action
When client request their records be released
MULTICULTURAL PERSPECTIVE
Assumptions
With traditional theories, assumptions made about mental health, development, or
nature of pathology and effective treatment may have little relevance in multicultural
setting
Culture-bound
Euro-American culture and core set of values
Emphasis on individualism, separate existence of self, individuation
Other cultures are COLLECTIVIST – primary consideration given to what is
good for the group
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Individual & Environmental factors
Need to view individuals in the context of family and culture
Interventions need to be tailored toward social action aimed at changing the
factors that are creating the client’s problem rather than blaming the client for
his/her condition
Person-in-the-environment perspective acknowledges the interactive reality
ASSESSMENT PROCESS
Diagnosis
Is not a final category but a working hypothesis that guides
Feminist & postmodern approaches say that diagnoses ignore societal contexts
Ethnic & Cultural factors
Ethnic & cultural patterns could influence diagnosis
Behaviours & patterns that are not characteristic of the dominant culture
Assessment & Diagnosis
Consider as a continuous process aiming to understand the client
Collaborative approach involving the client actively
Diagnosis for insurance/medical aid purposes – arbitrarily assigning a
diagnostic classification
Legal and ethical obligation to screen client for bipolar, schizophrenia and
suicidal intent
Essential to asses WHOLE person – mind, body, spirit
DUAL/MULTIPLE RELATIONSHIPS IN COUNCELING PRACTICE
Dual/multiple relationships, either sexual or nonsexual occur when counsellors
assume two or more roles simultaneously or sequentially with a client –
providing therapy to a friend/employee/relative or being teacher & therapist
Emotional or sexual involvement with a current client is unethical and
unprofessional and with former clients – unwise and unethical
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Not considered unethical if multiple relationship would not reasonably be
expected to cause impairment or risk. APA does not prohibit all forms of
multiple relationships in all circumstances – rarely a clear-cut matter
Remain alert to possibility of damaging exploitation and harm to clients
- Set healthy boundaries
- Consult fellow professionals
- When there is risk work under supervision, document nature of supervision
- Self-monitoring is critical
CHAPTER 6: EXISTENTIAL THERAPY
Introduction
Key Figures
Victor Frankl,
Rollo May, &
Irvin Yalom
Theory
Philosophical approach
Reacting against the tendency to view therapy as a system of well-defined
techniques
Emphasise our freedom to choose what to make of our circumstances.
Focus
Focus is on the quality of the person-to-person therapeutic relationship
Get clients to reflect on life, to recognise their range of alternatives
Start on the path of consciously shaping their own lives
Category
EXPERIENTIAL/RELATIONSHIP-ORIENTED: Stresses a concern for what it
means to be fully human – suggesting themes that are part of the human
condition, such as freedom and responsibility, anxiety, guilt, awareness of being
finite, creating meaning in the world, making active choices.
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