Ethical decision-making is an evolutionary process that requires you to be continually open and self-critical.
Recognizing the potential for countertransference: what are your own needs? Do you have areas of unfinished business? Are there potential personal conflicts that would interfere with helping the client? Do you recognize your own areas of prejudice and vulnerabilities? Counselor impairment often leads to countertransference. The more common characteristics of impairment are: • Fragile self-esteem
• Difficulty establishing intimacy in one’s personal life • Professional isolation
• A need to rescue clients
• A need for reassurance about one’s attractiveness or one’s competence • A substance abuse
Countertransference can show itself in many ways. The following are most common:
1. Being overprotective with a client.
2. Treating clients in benign, superficial ways.
3. Rejecting a client.
4. Needing constant reinforcement and approval.
5. Seeing yourself in you clients.
6. Developing sexual or romantic feelings toward a client. 7. Giving advice compulsively.
8. Desiring a social relationship with a client.
9. Delaying termination
Whose needs are being met in this relationship—my client’s or my own?
Is it unethical to meet our personal needs through our professional work? Don’t we benefit by being nurturing, feeling adequate, displaying competence, being respected and appreciated?
Steps in Ethical Decision-Making
1. Identify the potential problem. Is the problem mainly ethical, legal, professional, clinical, or moral? 2. Identify the potential issues for both you and the client. 3. Review the ethical codes for your profession. Are you own values and ethics consistent with or in conflict with the relevant guidelines? 4. Consider the applicable laws and regulations.
5. Seek consultation from other professionals or from your professional organization. 6. Brainstorm possible courses of action.
7. Evaluate the consequences of possible courses of action. 8. Decide on the best possible course of action.
9. Follow up to evaluate the outcomes
INFORMED CONSENT: clients must be provided with information that they need to made informed choices; their rights and responsibilities must be given to them in paper form and they must sign that they have read and agree with the information. Includes: goals of counseling, the responsibilities of the counselor toward the client, the responsibilities of clients, limitations of and exceptions to confidentiality, legal and ethical parameters of the therapeutic relationship, the qualifications and background of the therapist, the fees involved, the approximate length of the therapeutic process. See handout for model.
CONFIDENTIALITY: information shared in the clinical setting must be kept private, but confidentiality is not an absolute and exceptions must be explained to the client. Confidentiality must be broken when it is clear that the client may do serious harm to either themselves or others. There is a legal requirement to report incidences of child abuse, abuse of the elderly and of dependent adults. Confidentiality must be breached if a client under the age of 16 is a victim of incest, rape, abuse or some other crime; when the client needs hospitalization, when information is made an issue of court action and when the client requests that records be released. Clients must also be informed if the therapist may be discussing details of the relationship with a supervisor or a colleague.
DUAL AND MULTIPLE RELATIONSHIPS: counselors must not assume two or more roles (sexual or non-sexual) simultaneously or sequentially with a client. Examples given include bartering for services, borrowing money from a client, providing therapy to a friend, a...