Ethical Dillemma in Therapy

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“In my research and at training workshops, I am interested in asking counsellors to identify ethical issues or dilemmas that arise in their work and how they resolve them. It has been my experience that counsellors generally draw upon a selection of six sources. These are: (1) personal ethics, (2) ethics implicit in therapeutic models, (3) agency policy, (4) professional codes, frameworks and guidelines, (5) moral philosophy and (6) law”. (Bond 2010, p40) The purpose of this assignment is to discuss the ethical considerations within the therapeutic relationship by examining a dilemma through which these may best be demonstrated. The therapeutic relationship can be fraught with ethical issues which, if not addressed with care and consideration, could be the cause of great trauma and harm to the client’s emotional as well as physical wellbeing (Sanders, 2002). The responsibility of a counsellor is to behave ethically, and within the confines of any relevant agency policy, the British Association for Counselling and Psychotherapy (BACP) ethical framework guidelines and pertinent law and legislation, while taking into consideration their own ethics and morals, as well as the best interests of the client. Upon further exploration of ethics within a therapeutic context it becomes clear that in addition to making an informed choice based on an assessment of the relevant facts, part of the decision making process is founded on personal choice. The dilemma chosen is based on a story which appeared in the national newspapers in October 2011 (Appendix 1). Person A is a 20 year old male who is attending counselling on a weekly basis. After several sessions he discloses that he is conducting an incestuous relationship with his sister, Person B, who is 17 years old. His parents are unaware of the sibling’s relationship. The BACP provides a clear ethical framework intended to ensure good practice amongst its members (Appendix 2). The ethical principles required are fidelity, autonomy, beneficence, non-maleficence, justice and self-respect. Upon disclosure of this situation, the counsellor in question would be faced with a multitude of dilemmas and would no doubt need to refer to these ethical principles when deciding upon the most appropriate course of action for, primarily, their client but also themselves. The principle of beneficence requires that the

counsellor act in the best interests of the client based on professional assessment, while non-maleficence ensures a commitment to avoiding harm to the client. These principles would be of utmost importance when considering this dilemma, as would those of fidelity and justice which honour confidentiality, and respect the client’s human rights and dignity respectively. In accordance with the BACP ethical framework, the client is also entitled to be afforded the freedom by which to make an autonomous decision. In order to make an informed conclusion with regards to ethical dilemmas it is vital to encompass an examination of the counsellor’s own moral principles and implicit code of ethics as well the BACP ethical framework or other professional frameworks such as those of the UK Council for Psychotherapy (UKCP) or the Health Professions Council (HCP). If working as part of an agency the decision making process would also involve evaluation of relevant agency policy which may have further bearing on a given course of action. Supervision is an important factor in relation to any decision made when considering an ethical dilemma, and is the process of professional consultation with a more experienced counsellor. This person will have received professional BACP accreditation to enable them to hold a supervisory position, and their role is to discuss the client and any issues that have presented themselves which may prove problematic as well as serving to direct the counsellor towards any relevant agency policy and legislation. Supervision is an important tool as it ensures the safety of...
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