Module 02 – Counselling Ethics

The term ethics comes from the Greek ethos meaning custom, habit or character. Ethics can be
defined as the principles that are based on well-founded standards of right and wrong, which
prescribe what one ought to do, in terms of rights, obligations and benefits to others.

As a counsellor trained in the principles of psychology, one can no longer afford to be a self-
proclaimed philosopher or an agony-aunt who is ever so liberal when it comes to advice-giving.
A trained counsellor is a professional who is accountable and responsible towards an established
framework of ethical guidelines.

Ethical guidelines are not laws. They are not rules that can be blindly followed. These are merely
guiding principles that are to be interpreted in a responsible, judicious and sensitive manner.
Ethical conflicts and challenges arise repeatedly in the counselling profession and to respond to
these in the most effective manner, a counsellor must be armed with complete knowledge of the
ethical guidelines, a responsible and unbiased attitude and an intention to do what is in the best
interests of the client.

According to the code of ethics given by the ACA (American Counselling Association) there are
six fundamental principles of professional ethical behaviour:

a. Autonomy, which means that the client has the right to control the direction of his own
life.
b. Non-maleficence, which states that the counsellor must avoid actions that can cause any
harm.
c. Beneficence, or working for the good of the individual and society by promoting mental
health and well-being.
d. Justice, i.e., treating clients equitably and fostering fairness and equality.
e. Fidelity, i.e., honouring commitments and fulfilling responsibilities.
f. Veracity which means that the counsellor must deal truthfully with individuals with whom
they come into contact professionally.

While the detailed ethical guidelines given by the APA (American Psychological Association) and
the ACA (American Counselling Association) are always available for consultation, the basic and
most essential ethical issues shall now be discussed.

1) CONFIDENTIALITY
The first issue that we shall be dealing with is CONFIDENTIALITY. Confidentiality is of
utmost importance in any form of psychotherapy. In simple words, confidentiality implies
trust. As a mental health professional, it is the counsellor’s duty to keep in confidence all
the information that a client has shared with him. Only with this trust can a safe
 environment be created, where the counselee can reveal his innermost, complex and
most private aspects of life.
Everything related to the client, i.e., his identity, therapy notes, session records,
assessment records, etc. come under the purview of confidentiality. No client-related
information must be disclosed personally or professionally, without permission from the
client to do so. Avoiding undue invasion of clients’ psychological boundaries is also a
crucial aspect to be kept in mind. A counsellor should ask for only that information from
the client as is required for therapy. A client may consent to answer all questions asked,
but it is the ethical duty of the counsellor to invade the client’s privacy to the least extent
as possible.
Confidentiality, however, is in no manner absolute. There are limits to confidentiality and
the client must be informed of these limits before the counselling process begins. Also,
the client should be informed if his case would be discussed with a peer or supervisor.
Using one’s judgment, a counsellor may breach confidentiality in certain exceptional
cases, for example, when there is a definitive chance of harm to self or others by the
client, in cases of child abuse, court-ordered disclosure, etc. Utmost professional
judgment is to be exercised when deciding whether confidentiality is to be breached or
not. It is the counsellor’s to be aware of the limits of confidentiality that are legally and
ethically prescribed in his region or organisation. Ignorance of such laws is not considered
to be an acceptable defence if matters are taken to a court of law.
It cannot be emphasized enough that confidentiality should be breached only when the
counsellor is absolutely certain of its necessity. Even while doing so, only that much
information must be disclosed as is minimally required. This is referred to as ‘minimal
disclosure’ in legal terms.
A counsellor’s primary obligation is to protect the client’s privacy and to maintain trust
and dignity in the counselling relationship.

2) MULTIPLE ROLES
The second ethical issue to be discussed is the issue of MULTIPLE ROLES. As a counsellor
it is crucial to set strict boundaries and to be completely clear of what is to be expected
from the counsellor-counselee relationship. A counsellor should aim to work with only
those clients with whom he does not share any other relationship. Additionally, once a
counsellor takes on a client, no new relationship must be fostered with the client, be it
personal of professional. Multiple roles can occur in many forms such as combining the
roles of teacher and counsellor, bartering goods or gifts for services, counselling a friend,
relative or colleague, etc.
Having an additional relationship with the counselee, apart from the therapist-client
relationship is detrimental in many ways. First and foremost, when a client approaches
 someone for therapy, they are in a vulnerable state, seeking help from a trained
professional. This directly or indirectly puts the counsellor in a position of authority, a
position of power. Having multiple relationships in such a situation may lead to a
conscious or unconscious misuse of power by the counsellor to fulfil the needs and
demands of the additional relationship, which can amount to abuse as well. It is nearly
impossible to keep the boundaries of a professional relationship intact, when personal
issues are brought in from both sides. Being emotionally involved with a client adversely
affects both the client and the counsellor and can cause serious damage. Hence, trying to
juggle multiple roles is such a situation should be avoided.
However, a global prohibition of multiple roles is not always possible. For example, if as a
counsellor you are providing services in a small town, a lot of the clientele may be known
to you, such as the local doctor, banker, etc. or if you work as a counsellor in a large
corporate organisation, your clients would inadvertently be your co-workers as well. In a
situation where a dual role is unavoidable, the counsellor must make efforts to:
a. deal with the power differential issues,
b. deal with boundary issues and
c. be careful of any possibility of exploitation so as to minimize the risks involved.

Constant self-monitoring is of key importance in such scenarios.

3) COMPETENCE
The third issue we shall delve into is COMPETENCE. The mental health profession is
endowed with a multitude of techniques, therapies, principles and theories. It is
unrealistic to expect a counsellor to be well-trained in all forms of therapy. However,
ethically it is important that a counsellor have full knowledge and training for the services
that he is offering to the client.
As a counsellor, one must also continuously strive towards competence by not only
obtaining expertise but also by updating one’s knowledge base from time to time. This
can be done by staying active in the professional community through workshops,
seminars, peer discussions, research, etc. Professional education is an ongoing process
and must never end.
In situations where the counsellor is aware that he is not competent enough to deal with
the client’s problems, it is unethical to continue counselling and referrals are encouraged
in such scenarios.
4) INFORMED CONSENT
The fourth ethical issue that we shall cover is INFORMED CONSENT. The ethical guidelines
pertaining to this issue are clear about the fact that complete permission or consent must
be taken from the client before engaging in any form of therapy. Most importantly, while
taking consent, the client must be informed of all aspects of the therapeutic plan such as:
 a. the techniques that may be used,
b. the rationale behind it,
c. approximate length and cost of therapy,
d. goals of therapy,
e. legal issues,
f. risks involved,
g. alternative therapies, etc.,

Using language that the client can easily comprehend, so that the client can take an
independent, autonomous and well-informed decision regarding their therapy.

A counsellor must, however, be careful of divulging too much information that may
overwhelm the client. Basic information must be shared that will enable the client to
extract the most from the therapeutic process. The client should also be duly informed of
the counsellor’s qualifications, training, supervision arrangements, etc. The counsellor
must do so verbally as well as in written statement for record keeping, which can be a
safeguard in case a conflict arises. The client is also fully allowed to withdraw consent at
any point of time during the therapeutic process and must be told so at the very beginning
itself.

Taking informed consent additionally benefits by laying the foundation for a collaborative
partnership between the counsellor and counselee. When a client feels he is fully
equipped with all the information regarding his therapeutic journey, he feels empowered,
knows what to expect and cooperates and participates actively in the process. Taking
informed consent is not merely signing a permission form, but it is the education of the
client regarding his rights and responsibilities.

In some situations, taking voluntary informed consent from the recipient of the services
is not possible, such as in the case of minors, incapacitated adults, etc. The counsellor
must take into account the rights of the client and their capacity to give consent while
approaching the parents, family or legal guardian for consent.

5) TERMINATION
The fifth and final issue of today’s lecture is that of appropriate TERMINATION.
Termination of a counselling relationship should happen ideally only when the counsellor
is certain of the fact that the client has reached his therapeutic goal.
However, termination may become necessary before the goal is achieved in some
situations. For example, if the counsellor feels that the client will not benefit from his area
of expertise or if the counsellor is going to be unavailable for a considerable period of
time, etc. In such situations, terminations and referrals should be done in a professional
 and ethical manner so that the client does not feel abandoned or neglected. However, if
the counsellor feels endangered by the client in any manner, he is well within his rights
to terminate the process at any time.

Apart from the above discussed principals, there are some other ethical priorities that a
counsellor must always keep in mind:

a. A counsellor must offer non-judgmental professional service, free from any

discrimination, always honouring the individuality of the client.
b. Counsellors must respect the worth and dignity of all people.
c. At no cost, must value judgments be passed at the client and the counsellor should be
free from any sort of biases or feelings of prejudice regarding the client.
d. A counsellor should be aware of one’s values, attitudes and beliefs and never try to
impose them on the clients.
e. One should always strive to establish a helping relationship in order to maintain the
integrity and empowerment of the client without offering advice. Assisting the client in
making a decision without giving advice is the most important goal of counselling.

For an ethical counsellor, the commitment is to ongoing personal and professional development
i.e., working for larger and more inclusive goals than short-term individual goals.

Dealing with ethical issues is often difficult, complicated and anxiety-inducing. While the
professional ethical codes elaborate on most of the basic issues, it is impossible to document the
solution for every possible ethical dilemma that may arise in the counselling process. Periodic
self-reflection and open-mindedness are key to maintaining an ethical practice as a counsellor.

ETHICAL DECISION MAKING

Mental health professionals are often faced with situations that require sound ethical decision-
making ability. Determining the appropriate course to take when faced with a difficult ethical
dilemma can be a challenge. The answers to ethical dilemmas can rarely be categorized as right
and wrong. In most cases the decision is to be made between choices, that all seem to fall under
grey areas of ethical understanding.

A seven-step ethical decision-making model has been prepared by incorporating the works of
Forester-Miller and Rubenstein (1992), Haas and Malouf (1989), Kitchener (1984), Stadler (1986),
and Van Hoose and Paradise (1979), which can substantially help counsellors from varied fields
when trying to make an ethically correct decision.

Step 1. Identify the problem.

 As the first step, the counsellor must attempt to gather as much information as possible
that will illuminate the situation. In doing so, it is important to be as specific and objective
as possible. The counsellor must try to focus on the facts, separating out innuendos,
assumptions, hypotheses, or suspicions.

Asking oneself questions can be a productive strategy. Such as, is it an ethical, legal,
professional, or clinical problem? Is it a combination of more than one of these? If a legal
question exists, one must seek legal advice. Another example can be: is the issue related
to me and what I am or am not doing? Is it related to a client or the client’s significant
others and what they are or are not doing? Is it related to the institution or agency and
their policies and procedures?

Ethically, a counsellor must look into several perspectives while examining the problem
and not just pick the easiest way out by employing an overly simplistic solution.

Step 2. Apply the ACA Code of Ethics.

After understanding the true nature of the problem, the counsellor must refer to the ACA
Code of Ethics to see if the issue is addressed in a clear manner. One can also look up any
other state or professional codes that may be applicable. If there is a clearly mentioned
specific applicable standard or several standards, following the course of action indicated
should lead to a resolution of the problem.

To be able to accurately apply the ethical standards, it is essential that the counsellor is
well versed with the code and understands its implications. If the problem is more
complex and cannot be resolved by reviewing the ACA Code of Ethics, then the counsellor
should take the time to thoroughly analyse and assess all aspects of the situation and its
potential solutions

Step 3. Determine the nature and dimensions of the dilemma.

The counsellor can follow a few steps to ensure that the problem has been analysed in all
of its various dimensions:

§ First examine the dilemma’s implications for each of the foundational principles:
autonomy, justice, beneficence, non-maleficence, fidelity and veracity. Decide which
of the principles apply to the specific situation, and determine which principle takes
priority in this particular case. Theoretically, each principle is of equal value, and the
counsellor will need to use his professional judgment to determine the priorities
when two or more of them are in conflict.
 § Next, the counsellor must review the relevant professional literature to be appraised
of the most current professional practices and the diversity of issues involved in the
particular situation.
§ Consulting with experienced professional counsellors or supervisors who also abide
by the ACA Code of Ethics is the next advised step. It is often seen that such
discussions help bring to light other issues that are relevant or provide a perspective
that had not been considered or help identify aspects of the dilemma that were not
being viewed objectively.

Step 4. Generate potential courses of action.

In this next step, the counsellor must brainstorm as many potential courses of action as
possible. It is important to be creative and list as many options as possible; even ones that
seem to have a very little chance of being useful. Generating as many potential solutions
as possible is the goal of this step.

Step 5. Consider the potential consequences of all options and determine a course of action.

Now, the counsellor must take into account the information gathered and the priorities
set before evaluating each option, being sure to assess the potential consequences for all
of the parties involved. The implications of each course of action for the client, for others
who will be affected, and for oneself as a counsellor must be carefully considered.

The counsellor can now eliminate the options that clearly do not give the desired results
or that can cause even more problematic consequences. After reviewing the remaining
options, the counsellor must try to determine which option or combination of options
best fits the situation and addresses the priorities that were identified.

Step 6. Evaluate the selected course of action.

In this step, the counsellor should review the selected course of action to see if it
presents any new ethical considerations. In doing so, three simple tests can be applied
to the selected course of action to ensure that it is appropriate: justice, publicity, and
universality (Stadler, 1986).

• First is Justice: In applying the test of justice, the counsellor must assess his own
sense of fairness by determining whether he would treat others the same in this
situation.
• Second is Publicity: For the test of publicity, the counsellor must ask himself whether
he would want this behaviour reported in the press.
 • And the third is Universality: The test of universality asks the counsellor to assess
whether he would recommend the same course of action to another counsellor in
the same situation.

If the answer to these three questions is in the affirmative and the counsellor is satisfied
then the next step is that of implementing this solution.

Step 7. Implement the course of action.

To be able to implement a course of action which should resolve a complex ethical

dilemma, the counsellor must strengthen his resolve and move ahead with full
confidence. Just because it is the right decision does not mean it will be easy to
implement. Taking the appropriate action in an ethical dilemma is often difficult.

After implementing the selected course of action, the counsellor must follow up on the situation
to assess whether the actions had the anticipated effect and consequences. If the course of
action causes any new ethical issues, then the counsellor will need to go back to the beginning
and re-evaluate each step of the process.

As a psychologist it is important to always keep in mind that unless counselling is provided on an

ethical basis, it ceases to serve any useful purpose. Clients will usually seek counselling because
they are troubled or vulnerable and they want to be sure that the primary concern of the
counsellor is to help them to achieve a greater sense of control and well-being in their lives. This
means that counselling, by its very nature, needs to be an ethical relationship.

Counselling is not like a medical procedure that can take place on a passive or anaesthetized
patient. It requires the active participation and engagement of clients made possible by a
relationship of trust. Establishing a high level of trust in the counselling process is considered to
be so fundamental that it is the primary principle in the constructions of counselling ethics. A
counsellor must always strive to achieve the highest possible ethical standards in order to ensure
that the client has received the best mental health care that could be given.