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Brief Contents

Chapter    1 Professional Identity: Ethics, Values, and Self-Awareness  1

Chapter    2 Cultural Intelligence  44

Chapter    3 The Process, Skills, and Pitfalls of Counselling  88

Chapter    4 Relationship: The Foundation for Change  123

Chapter    5 Listening and Responding: The Beginning of Understanding  156

Chapter    6 Asking Questions: The Search for Meaning  191

Chapter    7 Empathic Connections  227

Chapter    8 Supporting Empowerment and Change  263

Chapter    9 Engaging with Hard-to-Reach Clients  310

Chapter 10 Mental Health and Substance Misuse  347

Chapter 11 Neuroscience and Counselling  393

iii
Contents
Preface xi 2 Cultural Intelligence 44
Acknowledgments xxiii
LEARNING OBJECTIVES 44
1 Professional Identity: Ethics, Values, and The Elements of Cultural Intelligence 44
Self-Awareness 1 The Importance of Multicultural Involvement 46
LEARNING OBJECTIVES 1 Canadian Diversity 46
Creating Safety for Change 2 BRAIN BYTE Cultural Neuroscience 47
Canadian Immigration 48
The Counselling Community 2 Challenges Faced by Immigrants and Refugees 50
Values: Doing What’s Important and Worthy 5 Sociopolitical Realities 52
BRAIN BYTE Intergenerational Trauma 52
Belief in the Dignity and Worth of People 5
Client Self-Determination 6 Culture and Diversity: Key Elements 54
CONVERSATION 1.1 Gallows Humour 8 Worldview 54
Rights of Children 8 Individualism versus Collectivism 56
BRAIN BYTE Culture and the Pleasure Centre 57
Ethics: Doing What’s Right 8
BRAIN BYTE Culture and the Brain 58
Dual Relationships 10 Communication Style 59
Professional Boundaries 10 Relationship Expectations 61
Confidentiality 11 Time Orientation 62
BRAIN BYTE Ethical and Moral Decision Making 14
Counselling Immigrants and Multicultural Clients 63
Ethical Dilemmas: Tough Decisions 14
Barriers to Culturally Intelligent Practice 63
Types of Ethical Dilemmas 14 Controlling the Tendency to Stereotype 64
Resolving Ethical Dilemmas 15 Respecting Diversity and Individual Differences 65
BRAIN BYTE Ethics and Neuroscience 16 Learning from Clients 65
Multicultural Ethical Issues 19 Seniors 66
Counsellor Self-Awareness 67
Ethical Engagement with Indigenous Peoples 20
Ethical Engagement with the LGBTQ Indigenous Clients 68
Community 21 Indigenous Demographics 69
CONVERSATION 1.2 Values and Ethics Conflict 22 Indigenous Values and Worldviews 70
Objectivity 23 Traditional Healing Practices 73
CONVERSATION 1.3 Personal Feelings Get in the Way 23 CONVERSATION 2.1 Ideas for Working with Indigenous
CONVERSATION 1.4 Personal Involvement with Clients 25 Peoples 74
The Competent Counsellor 25 LGBTQ Communities 74
CONVERSATION 1.5 I’m Just a Beginner 27 BRAIN BYTE LGBTQ Thinking and Behaviour 76
Strengths and Defining Features of LGBTQ
Self-Awareness 27
Communities 76
The Importance of Self-Awareness 27 Prejudice and Discrimination 77
Increasing Self-Awareness 28 Mental Health 79
Understanding How Bias Can Affect Spirituality and Religion 79
Counselling 29 Youth 80
Privilege and Bias 31 Counsellor Competence (Working with
Who Am I? How Do Others See Me? 33 LGBTQ Clients) 81
Personal Needs 34
Spirituality and Counselling 82
Personal and Cultural Values 36
BRAIN BYTE Spiritual Neuroscience 83
Professional Survival 38 CONVERSATION 2.2 Praying with Clients 85
Summary 39 Summary 85
Exercises 40 Exercises 86
Weblinks 43 Weblinks 87

v
3 The Process, Skills, and Pitfalls of Anticipatory Contracts 137
Counselling 88 Work Contracts 137
INTERVIEW 4.1 Contracting 140
LEARNING OBJECTIVES 88 Engaging with Seniors 142
What Is Counselling? 88 Sustaining the Counselling Relationship 143
BRAIN BYTE Counselling and the Brain 89 Immediacy 143
CONVERSATION 3.1 Counselling and Psychotherapy 91 INTERVIEW 4.2 Immediacy 145
Choices: The Need for Versatility 91 Transference and Countertransference 146
BRAIN BYTE Transference 147
BRAIN BYTE Music 93
BRAIN BYTE Childhood Abuse and Intimate Relationships 148
Brief Encounters 94
CONVERSATION 4.3 Counsellor Self-Disclosure 148
Trauma-Informed Practice 94
Ending the Counselling Relationship 148
BRAIN BYTE Trauma 95
BRAIN BYTE Endings 149
BRAIN BYTE Strengths-Based Counselling 96
Dealing with Endings 150
Relationship Issues 96
CONVERSATION 4.4 Boundaries 151
Counselling Skills and Strategies 97 INTERVIEW 4.3 Endings 152
Relationship-Building Skills 99 Summary 153
Exploring and Probing Skills 101 Exercises 153
Empowering Skills 102 Weblinks 155
Promoting Change Skills and Strategies 103
The Phases of Counselling 104 5 Listening and Responding: The Beginning
The Preliminary Phase 107 of Understanding 156
CONVERSATION 3.2 Helpful Friends and Counsellors 107 LEARNING OBJECTIVES 156
The Beginning Phase 109
CONVERSATION 3.3 Should I Read the File? 110 Listening: a Pathway to Learning 156
The Action Phase 112 The Power of Listening 158
The Ending Phase 113
Listening Barriers 159
Counselling Pitfalls: Barriers to Success 114 BRAIN BYTE Listening 159
Client Issues 115 Overcoming Listening Barriers 161
Counsellor Issues 115 BRAIN BYTE The Auditory Alarm System 161
Common Mistakes 116 BRAIN BYTE The Right Ear Advantage 164
CONVERSATION 3.4 Rescuing and Supporting 120
Active Listening 165
Summary 121
Exercises 121 Attending 166
Weblinks 122 BRAIN BYTE Frame of Reference 167
Selective Attention 168
4 Relationship: The Foundation for Change 123 BRAIN BYTE Multitasking 168
LEARNING OBJECTIVES 123 Nonverbal Communication 170
The Importance of the Relationship 123 Meaning of Nonverbal Communication 171
CONVERSATION 5.1 Problems with Listening and
BRAIN BYTE The Brain on Relationship 125
Responding 172
Definition 126
BRAIN BYTE Nonverbal Processing 173
BRAIN BYTE Oxytocin 127
Working with Nonverbal Communication 175
Relationship and the Phases of Counselling 127
Carl Rogers and the Core Conditions 129 Silence 175

CONVERSATION 4.1 Unconditional Positive Regard 131

Understanding Silence 175
BRAIN BYTE The Benefits of Silence 176
Core Conditions: A Starting Point for
Counsellors 132 Silence in Counselling 176
BRAIN BYTE Silence Triggers Memories 176
CONVERSATION 4.2 Genuineness 133
Nonverbal Cues and Silence 180
Role and Purpose: Counselling Contracts 133 Encouraging Silence 181
Objective of Contracting 133 CONVERSATION 5.2 Learning to Deal with Silence 182
Relationship Contracts 134 CONVERSATION 5.3 Residential Schools 182

vi Contents
 Paraphrasing 182 CONVERSATION 6.2 Note-Taking 222
Paraphrasing and Empathy 183 Connect (Linking) Transitions 223
INTERVIEW 6.1 Interviewing Skills 223
Summarizing 184 Summary 224
CONVERSATION 5.4 Effective Paraphrasing 184 Exercises 225
INTERVIEW 5.1 Listening, Silence, and Summarizing Weblinks 226
Skills 187
Summary 188 7 Empathic Connections 227
Exercises 189 LEARNING OBJECTIVES 227
Weblinks 190
Understanding Emotions 227
6 Asking Questions: The Search BRAIN BYTE Emotional Memories 229
for Meaning 191 BRAIN BYTE Mirror Neurons 230
The Language of Emotion 230
LEARNING OBJECTIVES 191 Individual Differences and Cultural Context 233
The Art of Asking Questions 191 Mixed Feelings/Ambivalence 234
Affect 235
Types of Questions 192
BRAIN BYTE Memory 193 Empathy 236

Reasons for Asking Questions 196 Empathy Defined 236

The Importance of Empathy 237
Questions for Establishing Purpose 196
BRAIN BYTE Location of Empathy in the Brain 238
Questions to Define the Counselling
BRAIN BYTE Selective Empathy 239
Relationship 197
Client Reactions to Empathy 239
Questions for Exploring and Understanding 197
CONVERSATION 7.1 Increasing Empathic Vocabulary 240
Questions for Problem Solving 199
Questions for Evaluating 200 Types of Empathy 241
BRAIN BYTE Questions and the Brain 200 Invitational Empathy 241
Basic Empathy 243
Questioning Pitfalls 201
BRAIN BYTE Empathic Connection and Brain Plasticity 243
Leading (Biased) Questions 201 Inferred Empathy 244
Excessive Questioning 202 BRAIN BYTE Helping Others and Empathic Circuits 244
CONVERSATION 6.1 Alternatives to Questions 203
Preparatory Empathy 246
Multiple Questions 204 CONVERSATION 7.2 When Not to Use Empathy 247
Irrelevant Questions 205
Poorly Timed Questions 205 Four Generalizations about Empathy 247
Why Questions 205 Empathic Response Leads 250
Cross-Cultural Interviewing 206 Why Achieving Empathic Connection
Is So Difficult 251
Special Considerations 207
CONVERSATION 7.3 When to Shift the Focus Away
When Clients Respond Poorly to Questions 207 from Feelings 251
Managing the Rambling Interview 208 Poor Substitutes for Empathy 252
Interviewing Youth 210 INTERVIEW 7.1 Poor Substitutes for Empathy 253
BRAIN BYTE The Adolescent Brain 210 Tough Empathy 255
Interviewing and Counselling Seniors 211 CONVERSATION 7.4 How Can I Be Empathic if I Have Not Had
Senior Abuse 212 the Same Experience? 255
Beyond the Surface: Interviewing for INTERVIEW 7.2 Effective Use of Empathy 256
Concreteness 214 Summary 258
Exercises 258
The Need for Concreteness 214
Weblinks 262
BRAIN BYTE Neural Development and Marginalization 214
Strategies for Achieving Concreteness 217
8 Supporting Empowerment and Change 263
Making Choices 219
LEARNING OBJECTIVES 263
Interview Transitions 220
Natural Transitions 220 Empowerment: Mobilizing Strengths for Change 263
Strategic Transitions 220 Client Empowerment Is an Expected Outcome of
Control Transitions 220 Counselling 264
Phase Transitions 221 Anti-Oppressive Practice 265

Contents vii
 Empowerment: The Strengths Approach 265 CONVERSATION 9.1 Working with “Involuntary” Clients 317
BRAIN BYTE Stress and Crisis 268 INTERVIEW 9.1 Dealing with Resistance 318

Empowerment and Selected Groups 268 Confrontation: Proceed with Caution 319
CONVERSATION 9.2 Saying No 320
Seniors 268
Types of Confrontation 320
LGBTQ Communities 269
The Misuse of Confrontation 321
Indigenous Peoples 271
Principles for Effective Confrontation 322
Crisis Intervention and Empowerment 271
Aggression and Violence 324
Motivational Interviewing (MI) 273 Risk Assessment for Violence 326
Four Key Principles of Motivational Interviewing 275 BRAIN BYTE Neuroscience as a Tool to Predict Violence 326
Violence and Mental Illness 328
1. Express Empathy 275
BRAIN BYTE Head Trauma and Violence 329
2. Develop Discrepancy 275
Violence Risk Assessment: Key Questions 330
3. “Roll with Resistance” 276
Managing Angry and Potentially Violent
4. Support Self-Efficacy 277
Behaviour 330
Stages of Change 277 BRAIN BYTE Aggression 331
Risk Taking 277 BRAIN BYTE Flight or Fight 332
CONVERSATION 8.1 Working with “Lazy” Clients 277 The Phases of Violence 332
Cognitive Behavioural Therapy 281 BRAIN BYTE The Brain on Anger 338
Critical Incident Debriefing 338
Helping Clients Recognize Thinking Patterns 283
INTERVIEW 9.2 Violent Incident Follow-Up 339
Unhelpful Thinking Patterns 284
CONVERSATION 9.3 After an Assault 340
BRAIN BYTE The Emotional Brain 285
Helping Clients Increase Helpful Thinking 286 Counselling Angry and Violent Clients 341
Reframing 289 Prevention 341
BRAIN BYTE Mindfulness 289 Assertiveness Training 341
BRAIN BYTE Creating New Neural Pathways 291 Cognitive Behavioural Counselling (Therapy) 342
BRAIN BYTE Neurons That Fire Together 291 Anger Management 342
INTERVIEW 8.1 Cognitive Behavioural Techniques 292 Substance Misuse Interventions 342
CONVERSATION 8.2 When Buttons Are Pushed 294 Psychiatric Intervention 342
Reduction of Environmental, Social, and Personal
Helping Clients Make Behavioural Changes 294
Stressors 343
Goal Setting 294 Counselling Victims 343
Developing Effective Goal Statements 295 BRAIN BYTE Children and Abuse 344
INTERVIEW 8.2 Goal Setting 298
Summary 345
The Problem-Solving Process 299 Exercises 345
Step 1: Identify Alternatives 300 Weblinks 346
Step 2: Choose an Action Strategy 300
Step 3: Develop and Implement Plans 300
10 Mental Health and Substance Misuse 347
Step 4: Evaluate Outcomes 302 LEARNING OBJECTIVES 347
CONVERSATION 8.3 I’ve Tried Everything 303
Mental Health in Canada 348
Brief Counselling 303 Mental Health Assessment 348
Selected Brief Counselling Techniques 303 The Diagnostic and Statistical Manual of Mental
Summary 308 Disorders (DSM) 351
Exercises 308 Major Mental Disorders 354
Weblinks 309 CONVERSATION 10.1 Paranoia 358
BRAIN BYTE Neurotransmitters and Mental Illness 359
9 Engaging with Hard-to-Reach Clients 310 CONVERSATION 10.2 How to Respond to Hallucinations 360
LEARNING OBJECTIVES 310 BRAIN BYTE Depression 362
BRAIN BYTE Depression and the Brain 363
Resistance 310 BRAIN BYTE Trauma Therapy 364
Signs of Resistance 311 BRAIN BYTE Attention-Deficit/Hyperactivity Disorder
Understanding and Responding to Resistance 312 (ADHD) 367
BRAIN BYTE Resistance 316 Child and Youth Mental Health 367
Resistance and Counsellor Self-Awareness 316 BRAIN BYTE Adolescent Marijuana Use 368

viii Contents
 BRAIN BYTE Adolescent Drug Use 369 Hemispheres 409
Counselling and Working with People Who Have Brain Lobes 410
Mental Disorders 370 BRAIN BYTE Right Brain/Left Brain 410
BRAIN BYTE Psychotropic Medication 372 BRAIN BYTE Broca’s and Wernicke’s Areas 412
CONVERSATION 10.3 When Clients Don’t Take Their Brain Lobes and Counselling 412
Medication 373 The Limbic System 413
Substance Misuse 374 CONVERSATION 11.2 Male and Female Brains 414
BRAIN BYTE The Importance of Social Contact 415
Counselling People with Substance Misuse
BRAIN BYTE Psychopathic Brains 416
Problems 374
Cranial Nerves 416
Many Canadians Use 374
The Endocrine System 416
Withdrawal from Drugs: Detoxification 376
BRAIN BYTE Endocrine System versus Nervous System 416
BRAIN BYTE Korsakoff’s Syndrome 379
Substance Use Disorders and the DSM 379 Neurons: The Brain’s Information System 417
Brain Plasticity and Addiction 379 Major Neurotransmitters 421
Supporting Recovery from Addiction 379 BRAIN BYTE Endorphins 421
BRAIN BYTE Pleasure Pathway 380 BRAIN BYTE Dopamine 422
Co-occurring Disorders 382 Mirror Neurons 424
Suicide Counselling 383 Glial Cells 425
Reward Pathway 425
Warning Signs and Risk Assessment 384
Brain Problems 426
Selected Groups 388
Mental Disorders 426
Indigenous Peoples 388
Meningitis 426
LGBTQ Community 389
Encephalitis 426
Seniors 389
Brain Tumours 427
Summary 390
Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s
Exercises 391
Disease) 427
Weblinks 392
Cerebral Palsy 427
Epilepsy 427
11 Neuroscience and Counselling 393 Huntington’s Disease 427
LEARNING OBJECTIVES 393 Multiple Sclerosis (MS) 427
The Remarkable and Mysterious Brain 393 Parkinson’s Disease 428
Tourette Syndrome 428
BRAIN BYTE The Non stop Brain 394
Dementia 428
BRAIN BYTE The Amazing Brain 395
BRAIN BYTE Sundowning 430
Neuroscience: An Emerging Force in Counselling 395 BRAIN BYTE Is It Normal or Dementia? 431
CONVERSATION 11.1 Mind and Brain 395 CONVERSATION 11.3 Counselling People with Dementia 431
Six Key Forces in Counselling 396 Stroke 431
Why Neuroscience is Important for Counsellors 397 Traumatic Brain Injury (TBI) and Acquired
Brain Injuries (ABI) 433
Neuroscience Endorses Counselling 397
Summary 434
Discovering the Secrets of the Brain 401 Exercises 435
Brain Imaging 402 Weblinks 436
A Look Ahead 403
BRAIN BYTE Types of Depression 404 Glossary 437
Neuroplasticity: An Empowering Discovery 404 References 445
Tables, Figures, Conversations, Interviews,
Harnessing the Power of Neuroplasticity 405
and Brain Bytes Index 465
Structure of the Brain 406 Author Index 468
INTERVIEW 11.1 Helping Clients Use Neuroplasticity to Make Subject Index 472
Positive Changes 407 Credits 480

Contents ix
PEARSON’S COMMITMENT TO DIVERSITY, EQUITY,
AND INCLUSION
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Preface

“Sometimes people just need to talk. They need to be heard. They need
the validation of my time, my silence, my unspoken compassion. They
don’t need advice, sympathy or counselling. They need to hear the sound
of their own voices speaking their own truths, articulating their own
feelings, as those may be at a particular moment. Then, when they’re
finished, they simply need a nod of the head, a pat on the shoulder or a
hug. I’m learning that sometimes silence really is golden . . .
—Richard Wagamese, Embers: One Ojibway’s Meditations

Don’t skip the Preface. If you are a student you may be anxious to get to the stuff that
will be on the exam. Don’t do it. The Preface will help you understand how the book
is laid out as well as the essential philosophy and assumptions that are the base for
chapter content. It will also assist you with some ideas and tips on how to improve
your learning. As an added bonus—it may even help you on the exam.
Choices is always a work in progress. Each edition has evolved based on user feed-
back, emergent research, practice experience, and peer review. In this edition, all chap-
ters have been rewritten to improve clarity, add new content, and reflect current
research and practice experience with updated references and weblinks. This edition
continues my commitment to producing a readable and practical text. As much as
possible, I have avoided the use of unnecessary jargon, and I have tried to be transpar-
ent and explicit regarding my assumptions, a practice that parallels my approach to
counselling.
This edition was written in the middle of the COVID-19 pandemic. During the
pandemic, counsellors often found themselves dealing with the same psychological,
physical, and financial stressors as their clients. Counsellors, like most other profes-
sionals, soon discovered that they needed to adapt and change in order to work in this
new pandemic-dominated world, including the following:
■■ With face-to-face meetings with clients no longer viable in many settings, counsel-
lors needed to become proficient using on-line technology.
■■ Finding ways to protect confidentiality during on-line meetings when family and
roommates were sharing the same space.
■■ Managing increasing demands for counselling services as many more people were
dealing with anxiety, depression, financial stress, and unemployment.
■■ Developing health safety protocols within agency settings and to protect workers
and clients during necessary off-site in-person meetings, including home visits.
■■ Responding to the needs of marginalized clients, including seniors and Indigenous
peoples, who faced significantly higher risks during the pandemic, a task that is
particularly difficult when dealing with clients who live in settings where physical
distancing is not possible (e.g., long-term care homes, group homes, prisons, etc.).
■■ Addressing escalating problems related to substance misuse, suicide, spousal and
child abuse.
■■ Supporting clients to make informed decisions regarding personal health safety
and vaccination.

xi
 As the COVID-19 pandemic resolves, counsellors have a unique opportunity to
support communities and individuals to deal with the aftermath. Counsellors are
trained to focus on strengths, foster empowerment, and instill hope, skills that will be
needed and valued in a post-pandemic world.

Digital Content Delivery

As the world shifts to a greater reliance on digital media, it is appropriate that this
resource evolves as well. This eighth edition of Choices is the first available in digital
and print formats. Instructors and students will find that, although the medium has
changed, the content is fully consistent with prior editions.

WHAT’S NEW
The eighth edition retains the same basic format with a number of changes and
enhancements, including:
1. Significant new content:
a. working with Indigenous peoples
b. theory and skills for engagement with LGBTQ community
c. enhanced material on endings
d. exploration of listening barriers
e. increased attention to the skills of establishing and maintaining counselling
relationships
f. implications of the COVID-19 pandemic
g. paranoia
h. understanding emotions and how they are expressed
i. exploration of how and when to shift interview focus from the emotional
domain to the behavioural or cognitive domain
2. Updated references and content in all chapters
3. New and/or updated Success Tips
4. New and/or revised conversations, and BRAIN BYTES
5. Many new graphics to illustrate concepts
6. Cultural intelligence which has now repositioned as Chapter 2, with increased
attention to cultural identity
The Truth and Reconciliation Commission (TRC) has alerted all of us to the need to
deal with the traumas caused by the residential school system. Chronicling over
100 years of abuse of Indigenous children—who were forcibly removed from their
families to residential schools, where they suffered physical and sexual abuse and sup-
pression of their cultural identity—the TRC found Canada guilty of cultural genocide.
Now, we have a responsibility to right those wrongs. As counsellors, we need to under-
stand the direct link between the horrors of the residential schools and challenges still
prevalent in Indigenous communities today. As counsellors, we need to acknowledge
and address the harms done by our profession to Indigenous communities. The “sixties
scoop,” which resulted in the removal of Indigenous children from their homes and
communities is but one example. Counsellors must understand this legacy of trauma
if they hope to work effectively with Indigenous peoples. With Indigenous issues in
the foreground, we have an opportunity to avoid repeating the mistakes of the past.

xii Preface
This is our collective responsibility. My hope is that increased attention to Indigenous
issues in this eighth edition will be one small step in the right direction
Choices has found a home in a wide variety of professional training programs in
social work, criminology, nursing, child and youth care, addictions, and psychology as
well as training for professionals and volunteers in other professions whose work
involves interviewing and counselling. A continuing best seller in Canada, Choices is
designed as a textbook and practice reference guide for students and practitioners that
combines theory, practice examples with sample interviews, and challenging self-aware-
ness exercises in a comprehensive yet readable format. The book includes illustrative
practice examples and challenging exercises that promote skill development, concep-
tual understanding, and self-awareness. Throughout the book, I have included neuro-
science concepts that have particular relevance for counsellors. Although framed in the
Canadian ethical and cultural context, the content of the book is designed to appeal to
a broad international audience of professionals.

THEORY AND PHILOSOPHY

Choices promotes an eclectic approach that encourages counsellors to use techniques
and ideas from various theoretical models depending on the specific needs of the client
and situation, not the comfort level of the counsellor. Counselling is a complex blend
of skill, attitude, and creativity, with the work based on best-practice techniques that
are supported by research. Core skills can be learned and practised, but they are not
recipes. There is also an “art” to counselling.
Based on individual client need and context, high-level professionals create, adapt,
and customize skills and strategies, thus avoiding any “one-size-fits-all” approach.
Among the models that have heavily influenced this book’s content are the following:
■■ Person-centred counselling, pioneered by Carl Rogers
■■ Trauma-informed practice
■■ Cognitive behavioural therapy/counselling (CBT)
■■ Motivational interviewing
■■ Short-term and solution-focused counselling
■■ Emergent insights from neuroscience
The term “cognitive reserve” describes the brain’s capacity to creatively find ways to
cope with life’s challenges. Social workers and other counsellors who have high level of
cognitive reserve can “switch gears” when one way of solving a problem does not
work. Put simply, they have choices and they are not discouraged or defeated when one
approach to working with clients fails. They can vary their approach to meet the unique
needs of different clients, cultures, and situations. Over a lifetime of a professional
career, through reflection, education and practice experience that builds on success and
learns from failure, they can grow their counselling skills and cognitive reserve.
Every interview requires an intelligent choice of skills and strategies. To make wise
choices, counsellors need to develop a wide range of practice skills based on supported
theory (science) and proven practice (evidence-based best practice). When counsellors
have a repertoire of skills, they can make knowledgeable choices based on the unique
needs of clients and situations, rather than their own personal comfort levels or estab-
lished routines. In simplest terms, the more choices counsellors have, the greater their
ability to match their work to the needs and wants of their clients, and the less their
need to repeatedly use the same skill. Effective counsellors are wise enough to know
when to–and when not to–use particular skills. Similarly, the goal of counselling is to
help clients achieve versatility in their capacity to solve problems and achieve goals.

Preface xiii
 Skill and technique can be impressive, but alone they are insufficient. Compassion,
caring, empathy, an ability to suspend judgment, objectivity, professionalism, self-
awareness, and sufficient psychological health are some of the personal qualities and
commitments that must operate in tandem with knowledge and skill. Counsellors need
to be genuine, maintain warm and caring regard for their clients, and recognize the inher-
ent worth of people. Kadushin (1990) discusses the important mix of skill and feeling:

Many might say that if they had to choose between feeling and technique they
would choose feeling as the more important prerequisite. Perhaps so, but if one has
to make a choice between these qualifications, an injustice has already been done to
the client. It should be possible to offer the client an interviewer who is both attitu-
dinally correct and technically proficient. (p. xii)

Respect for Diversity and Culture

Diversity includes differences in such major variables as race, religion, age, sex, sexual
orientation, physical and mental ability, economic capacity, language, culture, values,
beliefs, preferences, and ways of thinking and behaving. The diversity of today’s coun-
selling caseloads requires that counsellors develop a range of interviewing and counsel-
ling skills. Competent counsellors are able to vary their style depending on the unique
culture and worldviews of their clients.
Choices emphasizes cultural competence. Since everyone is unique, each with his
or her own mix of values and beliefs, culture is a variable for work with all clients.
When working with clients from visible minorities and those who are marginalized by
poverty or discrimination, counsellors must examine the sociopolitical realities that
frame the clients’ circumstances. They also need to develop sufficient self-awareness to
escape or manage any tendency to be culture-bound—the assumption that all clients
share their values, perspectives, and ambitions or, worse still, that client differences
represent deficiencies. By sustaining a multicultural perspective that recognizes and
prizes diversity, counsellors can avoid the pitfalls of ethnocentrism (the belief that
one’s own views and culture are superior). Culturally competent counsellors view cul-
tural differences as opportunities to widen their horizons and deepen their versatility.
They remember to be humble enough to learn from their clients.

Phases of Counselling
This book divides the counselling relationship into four phases: preliminary, begin-
ning, action, and ending. Each phase involves common as well as unique tasks and
skills. For example, the beginning phase focuses on relationship development and
problem exploration. Predictably, skills for developing relationships, like active listen-
ing, are most useful in the beginning phase, whereas skills such as confrontation are
not recommended. But the subsequent action phase focuses on helping clients develop
new perspectives, set goals, and implement change strategies; thus, skills such as refram-
ing and confronting are used extensively in this phase.
The four phases are developmental, with success at one phase dependent in part
on success at previous phases. For example, clients are more willing to accept confron-
tation in the action phase if a solid relationship or trust has already been established in
the beginning phase. In general, reference to the four-phase model allows counsellors
to make some predictions about the climate of the interview and to determine which
skills and tasks will be needed. However, practitioners must be cautious in applying the
model too rigorously to every counselling interview because there are always circum-
stances for which the sequence of events will differ sharply from the model.

xiv Preface
Values and Ethics
Ethics are principles of acceptable conduct. Professional associations such as the Canadian
Association of Social Workers and the Canadian Counselling and Psychotherapy Asso-
ciation have formal statements that define ethics and standards of practice for their mem-
bers. Similarly, values are ideas and principles that individuals and groups consider
important or worthwhile. In counselling, certain core values are of particular importance:
1. Belief in the dignity and worth of people
2. Respect for the client’s right to self-determination (i.e., for freedom of choice and
the right to control one’s own life)
3. Commitment to work for social justice

The Counselling Relationship

All editions, including this one, have prioritized the importance of the client–counsel-
lor relationship as a major determinant of success. The counselling relationship is
something very special. It’s negotiated. It’s non-reciprocal. It has a purpose. It is
designed to recognize and mobilize strengths. It requires counsellors to abandon their
biases and suspend any tendency to give advice in order to listen and respond in a man-
ner that creates the conditions for trust, growth, and change.
Counselling should empower clients and strengthen their self-esteem. It has very
little to do with giving “good advice,” but it might involve providing information and
assisting clients to evaluate alternatives in order to support them to make informed and
self-determined choices. Best-practice counselling draws on the expertise of clients to
participate in decisions related to the goals and process of counselling. For this reason,
counsellors should demystify their work through open discussion of their methodolo-
gies, assumptions, and intentions. Moreover, commitment to client self-determination
restrains counsellors from abuse of power or control. In promoting client self-
determination, counsellors use a strengths approach that empowers clients by assum-
ing their capacity to cope and change.
The counselling relationship creates the conditions for change to occur and the
motivation for change to proceed. The counselling relationship nurtures the natural
need that everyone has to grow and change. The cornerstone of this is empathy, a
unique and powerful way of listening that alone is sufficient to help many people. It
is not a technique that we activate when counselling, but rather an empathic approach
to life that Rogers describes as a “way of being.”

Counsellor Self-Awareness
Effective counsellors are self-aware, open to feedback, and willing to learn. As counsel-
lors become deeply involved in a relationship with their clients, they need to control
their own biases, and constantly monitor their feelings and thoughts so that they are
able to separate their experiences and feelings from those of their clients.
Knowledge of self, including consciousness of one’s values and beliefs and the
impact of one’s behaviour on others, is a prerequisite for effective counselling. Coun-
sellors who lack self-awareness may confuse their clients’ feelings with their own.
When counsellors are unaware of their own needs, including those that are unmet,
they risk unconsciously using their counselling relationships to meet personal goals
instead of client goals. In addition, without self-awareness, counsellors will be ignorant
of those areas of practice in which they are competent and those in which it will be
difficult for them to work with objectivity.

Preface xv
 Competent professionals know themselves, and they ensure that their values and
beliefs do not become a burden to their clients. They accept that exploring and reflect-
ing on one’s competence and the limits of one’s role and expertise are fundamental to
professional practice. For counsellors, this process of self-examination continues
throughout their careers.

Neuroscience and Counselling

In recent years, neuroscience has emerged as an important new force in counselling.
Since the 1990s, new technologies have spawned an explosive interest in the brain.
These imaging technologies have resulted in enormous progress in our understanding
of the brain. One of the most relevant and exciting findings is the discovery that our
brains are “plastic” and in a constant state of change. Life experience, adversity, trauma,
risk taking, and learning shape and reshape the brain in ways that help us cope with the
challenges in our lives. Or, alternatively, they may drive us to depression, anxiety, and
substance abuse.
A growing body of neuroscience research has confirmed the validity of counsel-
ling by demonstrating in dramatic ways how counselling changes the brain. Counsel-
ling works! Now we have the science to prove it. We have learned how counselling
basics such as listening, empathy, asking questions, and the establishment of relation-
ship counselling harness brain plasticity and promote positive brain growth. It’s already
exciting, even though we are still at the beginning stages of what is certain to be an
avalanche of profound developments in coming years. Neuroscience is providing
answers to the question, “How can counselling help create conditions that promote
positive, empowering brain growth or repair?” As a result, I think that in the near
future college and university counselling programs will require courses on the brain
and neuroscience.

Social Justice and Advocacy

Although the topic is beyond the scope of this text, counsellors should also consider
their responsibility to extend beyond their role as counsellors to social and political
action. As advocates for social justice, they should strive to reduce gender, cultural,
and other forms of discrimination. They should also promote changes in social policy
as well as modification in the functioning of formal organizations and institutions to
meet the needs of clients.

STRUCTURE OF THE BOOK

The book is divided into 11 chapters.
Chapter 1 explores professional identity and introduces readers to the basic con-
cepts of ethics, values, and self-awareness.
Chapter 2 discusses important concepts and issues related to counselling clients
from different cultures. This chapter includes a discussion of spirituality and counsel-
ling, reflecting a growing interest in and acceptance of spiritual issues in counselling. In
this chapter, multicultural competencies for Canadian counsellors are introduced.
Chapter 3 explores the basic nature of counselling skills and strategies. In this
chapter, four major skill clusters are introduced: relationship building, exploring/probing,
empowering, and challenging. The four-phase model of counselling (preliminary, begin-
ning, action, and ending) is proposed as a model for understanding the evolution of
the counselling relationship. As well, the important components of a trauma-informed
approach are introduced and discussed.

xvi Preface
 Chapter 4 examines the helping relationship and considers the core conditions of
effective counselling. Sessional and relationship contracting are featured in this chapter.
Chapters 5, 6, and 7 explore the active listening skills of attending, silence, para-
phrasing, and summarizing (Chapter 4), questioning (Chapter 5), and empathy
(Chapter 6). Specific ideas for interviewing and working with youth are discussed in
these chapters.
Chapter 8 is concerned with action-phase skills that motivate clients to think dif-
ferently and make changes in their lives. Two important theoretical models, cognitive
behavioural counselling and motivational interviewing, are featured.
Chapter 9 presents information on working in difficult situations, such as when
clients are resistant or potentially violent.
Chapter 10 looks at concepts for working with various populations, including
those who are dealing with mental disorders, contemplating suicide, or who have
addictions.
Chapter 11 explores issues related to neuroscience and counselling, including a
discussion of brain problems. An adapted version of this chapter was published in the
journal The Neuropsychotherapist (2017).

Features in the Eighth Edition

People learn in different ways, so this book includes a range of features designed to
assist learners in understanding at the cognitive, emotional, and behavioural levels.
Each chapter contains the following elements:
■■ Learning Objectives: key concepts that will be addressed in the chapter
■■ Summary: a short review at the end of each chapter that summarizes important ideas
■■ Conversations: a unique feature presenting teacher–student dialogues about fre-
quently asked questions
■■ Sample Interviews: annotated interview excerpts that illustrate and explain chap-
ter concepts
■■ Success Tips: short, practical ideas for counselling success
■■ Illustrative Figures: diagrams that support or embellish chapter concepts
■■ Brain Bytes: short links to interesting and relevant neuroscience
■■ Exercises: end-of-chapter reflective questions to give readers practice developing
self-awareness, practice skills, and conceptual knowledge
■■ Weblinks: links to websites related to the chapter’s material
■■ Glossary: definitions of key terms

Instructors
Please note that instructor’s resources are available. Contact your local Pearsoned rep-
resentative for details.

FEATURES
Pearson eText
Affordable and easy to use, Pearson eText helps students keep on learning no matter
where their day takes them. The mobile app lets students read and study, even when
they are offline. They can also add highlights, bookmarks, and notes in their Pearson
eText to study how they like.

Preface xvii
 Students can purchase Pearson eText on their own from Pearson, or you can invite
them to join a Pearson eText course. Creating a course allows you to personalize your
Pearson eText so students see the connection between their reading and what they
learn in class—motivating them to keep reading and keep learning.
Benefits of creating an instructor-led Pearson eText course include:
■■ Share highlights and notes with students—Add your personal teaching style to
important topics, call out need-to-know information, or clarify difficult concepts
directly in the eText.
■■ Access reading analytics—Use the dashboard to gain insight into how students are
working in their eText to plan more effective instruction in and out of class.
■■ Customize and schedule readings—Rearrange the Pearson eText table of contents
at both the chapter and section level to match the way you teach. Add due dates so
that students know exactly what to read to come to class prepared.
■■ Integrate with your LMS.

INSTRUCTOR SUPPLEMENTS
Contact your Pearson rep for access information and instructions for obtaining these
supplements.
■■ Instructor’s Resource Manual
■■ The Test Item File (in Word only)
■■ PowerPoint Presentations
■■ Image Library

SUGGESTIONS FOR STUDENTS

If you are studying this book as part of a course on counselling skills, you will proba-
bly have the opportunity to develop skill competence in a number of different ways:
■■ Watching instructor demonstrations
■■ Conducting practice interviews using role-played or (preferably) real-life scenarios
■■ Completing the chapter exercises
■■ Receiving feedback and evaluation from instructors and student colleagues who
observe your work
■■ Using audio and video recordings to understand and assess your verbal and non-
verbal responses
■■ Working with clients in practicum field settings
In most counselling skills courses, learning groups are used to practise skills. Usu-
ally, these learning groups use classroom simulations and practice interviews in which
you assume the roles of client, counsellor, and observer. Each of these roles offers
unique challenges and opportunities for learning.

Practice Interviewing: When You Are the Client

The client’s role offers a powerful opportunity for you to understand client feelings
and expectations. You may find that your reactions are similar to those that clients you
will work with in the field experience:
■■ Ambivalence about sharing feelings or details about personal issues
■■ Feelings of vulnerability and fear of being judged, embarrassed, or ridiculed

xviii Preface
 As a client, it will be up to you to control how much you wish to disclose; how-
ever, by taking reasonable risks, you can enhance your learning opportunities and
insights. However, you should remember that a training environment does not provide
the time or setting to address complex problems.

Practice Interviewing: When You Are the Counsellor

When you are asked to practise your newly learned skills as a counsellor, you may feel
clumsy and insecure as you take risks to change established communication patterns
or experiment with new skills and strategies. As a student with limited training, you
may be reluctant to ask questions that seem to invade the privacy of your colleagues.
Moreover, when dealing with sensitive issues you may fear that your lack of experi-
ence will damage your clients. You may also fear that your colleagues will judge you as
inept. As well, when you are being observed by others, the intense focus on your
work can be unsettling and anxiety-provoking. But all these reactions are common,
and you will probably find that your colleagues feel the same way. Most professional
counsellors take many years of practice and study to become competent and comfort-
able using a full range of skills. What is important is that you persist and avoid the
natural temptation to stick with familiar patterns of communicating. Skills that are
awkward in the beginning will, with practice, become part of your natural and pre-
ferred style.

SUCCESS TIP
If you create the right conditions, others will help you with feedback that will support the
development of your skills and self-awareness.

Practice Interviewing: When You Are the Observer

Student observers are responsible for watching the interview and providing feedback
to student colleagues who are practising their counselling skills. At first, you may be
reluctant to offer feedback, perhaps worrying that your remarks will generate anger or
hurt feelings. But keep in mind that the observer’s role gives you an excellent opportu-
nity to develop the skill of giving feedback and practise this skill.
Helpful feedback is energizing and does not detract from another person’s self-
esteem. As people learn and practise interviewing and counselling skills, they may feel
vulnerable and awkward. Hence, it is important to remain sensitive to their emotional
and psychological needs, while balancing their needs for information and correction.
Observer feedback may be of two types: supportive or corrective.
■■ Supportive feedback recognizes strengths. Consider how you respond differently
when your strengths are acknowledged rather than when your weaknesses are tar-
geted. Yet despite how obvious this idea seems, many students and professional
counsellors are very problem-oriented and fail to acknowledge client or colleague
strengths. Supportive feedback must be genuine (true) and delivered without res-
cuing or patronizing. If you lie to others to avoid hurting them, your credibility as
a source of feedback will diminish.
■■ Corrective feedback challenges others to examine or change behaviour. But
before giving corrective feedback, consider your relationship with the other per-
son. If your relationship is based on trust and caring, corrective feedback has the
potential to be effective. However, if your relationship has unresolved conflict,
corrective feedback is more likely to be perceived as an attack. If people think

Preface xix
 your feedback is harsh, demanding, or controlling, there is a higher probability
that they will resist. Here are some general feedback guidelines:
■■ Be specific. Avoid generalities such as, “Your interview was great.” Anchor
your assessment by identifying the specific behaviours and responses that you
observed that contributed to the success of the interview.
■■ Don’t use corrective feedback as a means to control, impress, or punish. Pay
attention to your tone of voice and other nonverbal behaviour. Make sure that
you avoid lecturing and pointing fingers.
■■ Timing and pacing are important variables. Supportive feedback is more use-
ful when self-esteem is low. In addition, feedback is most effective when given
as soon as possible, but ensure that you protect personal privacy.
■■ Avoid overwhelming student counsellors by providing too much feedback.
Watch for nonverbal cues or ask them to let you know when they would like
to stop the process.
■■ Ask people to self-evaluate before offering your opinions. You may be sur-
prised to find that they already have insight into the problem areas; thereby
reducing the number of areas in which you have to provide direct feedback.
■■ Feedback has the most potential for success if it is invited or targeted to per-
ceived areas of need. Contract with others to deliver feedback. Ask questions
such as “Would you like me to offer my ideas on what happened?” or “Are
there specific issues that you’re concerned about?”
■■ Everyone is different. Some people prefer feedback to be direct and to the
point. Others may prefer it “sandwiched” between positives. Others need
time to reflect before responding, or they may profit from visual and written
illustrations. Discuss preferences with student counsellors, then respond
accordingly.
Some people have an immediate reaction to feedback that will differ from their reac-
tion once they have had time to ponder what you have said. For example, a person who
responds defensively or even with anger may, on reflection, come to accept your input
and see things differently. The opposite can also be true—people who react favourably
may later develop other feelings, such as resentment or confusion. Checking back dur-
ing future encounters is one strategy for keeping abreast of others’ reactions.
Remember that giving helpful and caring feedback is one way of developing and
strengthening relationships. If you are honest and supportive with others, you greatly
increase the probability they will be honest and supportive with you when you ask for
their helpful feedback.

Developing an Effective Learning Group

When you work with student colleagues in each of the three roles, discuss your fears
as well as your expectations of one another. You will need to work to develop a con-
tract or agreement on how you will work together. Practice interviews are powerful
learning opportunities when they are based on real rather than role-played feelings and
issues. Consequently, it will be important to establish a climate of safety, where confi-
dentiality will be respected. Some important principles to remember include these:
■■ Colleagues who are in the client’s role are disclosing personal issues and feelings,
so it is essential to respect their dignity and right to privacy.
■■ Everyone has different capacities for intimacy. Do not expect that all members of
a learning group will disclose at the same level. Accept individual differences.

xx Preface
■■ Learning the skills of counselling requires a willingness to give up familiar pat-
terns of communication and attempt new approaches. Expand your limits by tak-
ing appropriate risks to try new skills and be tolerant of colleagues who are
engaged in similar risk taking.
■■ Feedback from others is an important part of learning. Therefore, try to make it
easy for others to give you feedback by consistently responding nondefensively.
Help others give specific feedback by asking targeted questions.

SUCCESS TIP
Expect that the process of learning and experimenting with new skills will result in a period
of awkwardness and self-consciousness. For a time, it may seem as though your capacity
to counsel others is regressing.

Keeping a Personal Journal

A personal “for your eyes only” journal can be a significant adjunct to your learning.
The journal is a tool for introspection that provides a private means for documenting
and exploring your thoughts and feelings related to the development of your counsel-
ling skills. There are no rules for journal writing other than the need to make entries on
a regular basis and to try to avoid self-censorship.

Using This Book

If you are using this book as part of a course on counselling, your instructor will pro-
pose a suggested reading schedule that structures your reading over the semester, and
he or she will assign or adapt the chapter exercises to fit your learning needs. Another
way to use the book is on an “as you need it” basis, using the index or chapter headings
to locate specific content. As well, you are encouraged to use other books, journals,
and tools, such as Internet research, to supplement your learning. However, you should
read this book (or any book) critically and seek to understand and explore the ideas
and try them out.

Counselling Skills as a Way of Life

You may be surprised to discover that the skills of counselling are also the skills of
effective everyday communication, and that the process of developing your counsel-
ling competence may begin to influence your personal relationships. As counselling
skills become part of your style, you may find yourself becoming a little more inquisi-
tive and more sensitive to the feelings of others. However, you may find that others in
your life do not welcome the changes in your manner and style. When you change,
others around you have to accommodate your changes. If you become more probing in
your questions, they must be forthcoming with their answers. When you become more
empathic, their feelings become more transparent. These changes move the relation-
ship to a deeper level of intimacy, which may be frightening for some, particularly if
the pace is too fast for their comfort level.

Preface xxi
Acknowledgments

It is always a pleasure to work with the very competent publishing team at Pearson
Canada. I’m grateful for their help in guiding me through the many steps to final
publication.
Cathleen Sullivan, Executive Portfolio Manager
Gurpreet Sohal, Associate Content Developer
Steve Lee & Dipika Rungta, Project Managers
Kamilah Reid-Burrell & Madhu Ranadive, Content Managers
Meaghan Goldmintz, Permissions Project Manager
All editions of this book have benefited from the feedback provided by reviewers,
readers, colleagues, clients, and students. Over the years, students from Douglas College
have offered candid and helpful feedback, and professional colleagues have contributed
ideas and suggestions that have assisted me. Thanks to John Fox, Andrew Buntin,
Barbara Picton, Irene Carter, Jason Carter, Michelle Gibbs, Winnie Benton, Irene
Carter, Susan Davis, Karen Marr, Sheri McConnell, Sara Menzel, Karen Moreau, Neil
Madu, Robert Owens, Alyson Quinn, Melissa Medjuck, Doug Estergaard, Bruce
Hardy, Lawrence Becker, Elizabeth Jones, Colleen Murphy, and Tabitha Brown.
Each edition of Choices has included reviews from professionals in the field. The
eighth edition reviewers offered many helpful suggestions. One common theme was to
move the Cultural Intelligence chapter to the beginning of the book so that this impor-
tant theme could be addressed early. Thank you to the following reviewers:
■■ Kirstin Parry, Fleming College
■■ Brian Dwyer, Humber College
■■ Carol Feddema Spivak, Fanshawe College
■■ Hai Luo, University of Manitoba
■■ Dr. Jessica Van Vliet, University of Alberta
■■ Lori Bailey, Bow Valley College
■■ Lori Gauthier, Cambrian College
I wish to thank Rod McCormick, Faculty of Education and Social Work at Thompson
Rivers University, and Sandra Bandura, Research Associate at Thompson Rivers
University, for their assistance and feedback on content related to Indigenous issues.
As well, I am grateful to Bob Martel, a Toronto-based social worker and educator, for
his consultation on LGBTQ content.
As always, a special thanks to my wife, Joyce Shebib, who continues to offer sup-
port and helpful critical comments.
Reader comments and feedback are always welcomed. Please email me at
shebib@telus.net
Bob Shebib
Faculty Emeritus
Douglas College
New Westminster, BC

Customized workshops and staff training based on this book are available. Contact the
author at shebib@telus.net for details.

xxiii
Chapter 1
Professional Identity: Ethics, Values,
and Self-Awareness

LEARNING OBJECTIVES
■■ Understand how ethics and values are an integral part of competent
practice.
■■ Identify the Canadian professionals who provide counselling services.
■■ Identify how counsellors can work within the limits of their competence.
■■ List and describe the core values of counselling.
■■ Define and describe professional ethics, including standards related to
dual relationships and confidentiality.
■■ Identify principles for understanding and resolving ethical dilemmas.
■■ Know the ethical principles for counselling across cultures.
■■ Grasp the importance of counsellor objectivity and self-awareness.
■■ Understand and manage personal needs and values in counselling.
■■ Recognize and address burnout and vicarious trauma as workplace hazards.

1
 CREATING SAFETY FOR CHANGE
Client expectations of counselling are varied. Some clients have high hopes even to the
point of expecting a short-term miracle of change. Others are convinced it’s a waste of
time and they predict imminent failure. Many have no idea of what to expect, their
vision of counselling based only on unrealistic and distorted television images. Some
will share heartbreaking histories of trauma, abuse, and hardship. Others come with a
long history of involvement with the social service and health care delivery systems. A
few have had their psychological safety violated by workers who judged, lectured,
shamed, imposed unnecessary rules, made arbitrary decisions, and exhibited callous
attitudes. Others have also found support and healing from caring and competent
workers who ensured through their attitudes and actions that they were not mistreated
by the very systems developed to offer help.
Frequently, clients seek help in a time of crisis, desperate and overwhelmed,
exhausted by their troubles. Compassionate, warm, and empathic counsellors can help
clients to transform such crises into opportunities for change and growth, and to use
counselling as a way to harness resilience and strength.
Adherence to professional ethical standards and values is the entry point for com-
petent practice. Ethical standards guide practitioners to conduct their work in the best
interests of their clients. Professional values define what is important; ethics guide
what is right and proper. Applied skills drawn from best practice research and a
philosophy of “do no harm” help to ensure that the work is effective.
The centrepiece for creating safety for client change is the counselling relationship,
now universally accepted as essential for successful counselling work. An empathic,
strengths-based counselling relationship grounded by the values and ethics of the pro-
fession offers clients safety, incentive, and freedom to reveal, explore, and ultimately
manage problems and feelings. Counselling skills and techniques are important, but
they are ineffective without the support of a strong counselling relationship. Even so,
skills can’t be applied as rules. Instead, counsellors customize skills with flexibility and
creativity, adjusting their approach to meet the unique needs of each client and situa-
tion. This is the art of counselling.

THE COUNSELLING COMMUNITY

Professional counsellors have unique qualities that distinguish their work. Like profes-
sionals from any discipline, they acquire and use evidence-based skills that have dem-
onstrated effectiveness. This is a lifetime commitment that includes formal training at a
post-secondary institute; regular attendance at seminars, courses, and professional
workshops; and keeping abreast of emergent research by reviewing journals and books.
An important piece of this is multicultural awareness.
Professional counsellors are required to adhere to the respective values and ethics
of their profession. Typically, ethical codes feature the importance of valuing clients’
rights to make their own decisions (self-determination) and the importance of relating
to clients nonjudgmentally. A crucial component of this is counsellor self-awareness,
including recognition of one’s own biases, including sensitivity to issues of power and
privilege that may, if unrecognized and addressed, have dramatic negative effects on
the relationship and counselling outcomes.
Many professionals, such as social workers, child and youth care workers, psycholo-
gists, psychiatrists, nurses, and psychiatric nurses, do counselling work. Most are mem-
bers of professional associations like the Canadian Association of Social Workers
(CASW) and the Canadian Counselling and Psychotherapy Association (CCPA).
Table 1.1 lists Canadian associations whose members are subject to codes of ethics

2 Chapter 1
 TABLE 1.1 Professional Associations in Canada
Canadian Addiction Counsellors Certification Federation www.caccf.ca
Canadian Art Therapy Association www.canadianarttherapy.org
Canadian Association of Music Therapists www.musictherapy.ca
Vocational Rehabilitation Association of Canada www.vracanada.com
Canadian Association of Social Workers www.casw-acts.ca
Canadian Counselling and Psychotherapy Association www.ccpa-accp.ca
Canadian Criminal Justice Association www.ccja-acjp.ca
Canadian Indigenous Nurses Association https://indigenousnurses.ca
Canadian Nurses Association www.cna-aiic.ca
Canadian Psychiatric Association www.cpa-apc.org
Canadian Psychological Association www.cpa.ca
Canadian Therapeutic Recreation Association https://canadian-tr.org
Council of Canadian Child and Youth Care Associations https://cyc-canada.org
Psychosocial Rehabilitation Canada www.psrrpscanada.ca

governing acceptable professional behaviour. Membership in these associations usually

requires a university degree and, in some cases, a master’s degree or Ph.D. Often coun-
selling professionals work collaboratively as members of a multidisciplinary team, so it
is imperative that they understand the roles and limitations of each member of the team.
Some titles are protected by law so only qualified members are allowed to use titles such
as social worker, art therapist, psychologist, or psychiatrist. This ensures potential cli-
ents that they have a right to ethical and professional service. However, there is no restric-
tion on the use of other terms such as counsellor, mental health therapist, lifestyle
counsellor, and a host of other titles. These individuals, although they may be skilled
and effective, are not under the jurisdiction of any professional body that has the power
to define minimal levels of education and to apply sanctions for unethical practice.
Counselling psychologists are usually qualified at the Ph.D. level, but some juris- counselling psychologists: Profes-
dictions allow registration for those with a master’s degree. Many specialize in the diag- sionals who use psychological principles
to provide education and treatment to
nosis and treatment of mental disorders, but they may also work as counsellors or may individuals dealing with stress and other
specialize in other areas, such as in administering and interpreting psychological tests. mental health issues.
Psychologists are often employed in private practice, but they may also work in settings
such as prisons, hospitals, schools, and private industry.
Psychiatrists are medical doctors with advanced training in psychiatry. They are spe- psychiatrists: Physicians with
cialists in the treatment of people with mental disorders. Psychiatrists are the only coun- advanced training in the diagnosis and
treatment of mental disorders.
selling professionals licensed to prescribe medication. Psychiatric nurses generally have
two to four years of training. Historically, they worked in psychiatric hospitals and wards,
but today, increasingly, they are working in community-based mental health settings.
The nonprofit social service sector also uses volunteers to deliver services in set-
tings such as crisis phone lines, where people in distress call for assistance or referral.
In addition, the professional counselling community is often supported or replaced by
an array of self-help support groups, such as Alcoholics Anonymous (AA) or Narcotics
Anonymous (NA).
Social workers generally have university training with a bachelor’s degree in social social workers: Professionals who
work (BSW) or a master’s degree in social work (MSW). In addition, they may have provide a broad range of educational,
advocacy, and counselling services to
specialized training in areas such as family therapy or group work. Social workers might individuals, groups, and communities.
work in private practice or be employed in hospitals, prisons, schools, or community
social service agencies. Many social workers also work for government agencies inves-
tigating incidents of child abuse and neglect. Social workers are the largest professional

Professional Identity: Ethics, Values, and Self-Awareness 3

 group providing support and counselling to people with psychiatric disorders. Increas-
ingly, with the aging of the Canadian population, social workers are deployed to work
with seniors. Social workers are governed by provincial laws, which limit the use of the
title “social worker” to those who are registered social workers (RSW)
Social service or community social service workers are community college gradu-
ates with one to two years of college training who also provide counselling services in
settings such as transition homes, addiction centres, employment counselling agencies,
and community mental health. They are an important and indispensable part of the
social welfare system.
Anti-Oppressive Practice Like others in the helping professions, social workers coun-
sel clients to help them develop insight, solve problems, deal with emotional pain, and
enhance relationships. They may also support clients by providing information, social
skills training, or resources. One special feature that distinguishes social work counsel-
ling from that performed by other professionals is its dual focus on working with indi-
viduals as well as their social environment (Dale et al., 2009). Social workers realize that
social determinants (e.g., policies, culture, income, education, age, access to resources)
can dramatically limit their clients’ potential for success. As a result, social workers, in
addition to their counselling work, often actively engage in initiatives to foster sys-
temic changes to policies and situations that result in inequities.
Social workers have an important professional responsibility to promote social
justice or “fairness and moral rightness in how social institutions such as government,
corporations, and powerful groups recognize and support the basic human rights of all
people” (Sheafor & Horejsi, 2008, p. 6). Social justice commitment involves advocacy
to promote human rights and more equitable income redistribution, political action to
change oppressive legislation or policy, public education to shape public opinion, and
efforts to build community (see Figure 1.1). Social workers recognize that social prob-
lems arise, at least in part, from ineffective social systems. The Code of Ethics of the
Canadian Association of Social Workers (2005) outlines the obligations of social
workers to advocate for social change and social justice:
. . . social workers believe in the obligation of people, individually and collectively, to
provide resources, services and opportunities for the overall benefit of humanity and
to afford them protection from harm. Social workers promote social fairness and the
equitable distribution of resources, and take action to reduce barriers and expand
choice for all persons, with special regard for those who are marginalized, disadvan-
taged, vulnerable, and/or have exceptional needs. Social workers oppose prejudice and
discrimination against any person or group of persons on any grounds, and specifically
challenge views and actions that stereotype particular persons or groups. (p. 5)

• Challenging discrimination
• Promoting unity and respect
for diversity
• Advocating for fair distribution
Social of resources
Justice • Working to change repressive
or restrictive laws and
procedures
• Reducing barriers caused by
social determinants of health

Figure 1.1 Promoting Social Justice

4 Chapter 1
 SUCCESS TIP
Effective assessment and counselling intervention must include consideration of the social
determinants of health (SDOH) defined as the social and economic variables that affect a
person’s well-being. Variables such as income, education, housing, general living condi-
tions, access to health care, diet, gender, culture, and others have been shown to be the
leading predictor of a person’s health, well-being, and quality of life. (Raphael, 2016).
Frequently, this will lead to the inescapable conclusion that advocacy to remediate restric-
tive SDOH conditions is a necessary adjunct to personal counselling.

VALUES: DOING WHAT’S IMPORTANT

AND WORTHY
Values are principles or qualities that individuals and groups consider important or values: What individuals and groups
worthwhile. Ethics are derived from values. Values represent beliefs about what is consider important or worthwhile.
desirable and good. Personal values describe what individuals consider desirable and
what they believe is right and wrong. Professional values describe fundamental beliefs
that the profession holds about people and ways the work of the profession ought to
be conducted. Clearly, professional values (as reflected in ethical codes of conduct) and
personal values have a major impact on shaping the practice of counselling profession-
als. Two key values of counselling are belief in the dignity and worth of people and the
client’s right to self-determination.

Belief in the Dignity and Worth of People

Belief in the dignity and worth of people is the core value of counselling. This value
commits counsellors to ensuring that their clients are treated with regard for their
rights. It obligates counsellors to demonstrate acceptance of the individual and to
uphold confidentiality. Counsellors who value the dignity of their clients appreciate
diversity and reject stereotyping, labelling, and other dehumanizing practices.
Counsellors must treat clients fairly, regardless of personal feelings toward them.
For example, counsellors must resist the natural temptation to spend more time with
clients they favour and less time with those whom they find difficult. Counsellors are
expected to apply their skills and knowledge at an optimum level for each client,
regardless of their personal reaction toward any client. Clients may have behaved in
ways that counsellors perceive to be offensive, but this belief does not give counsellors
licence to be disrespectful or to withhold services. Discriminatory practices are strictly
prohibited by both major codes:
■■ Counsellors/therapists actively invest in the continued development and refine-
ment of their awareness, sensitivity, and competence with respect to diversity
(between groups) and difference (within groups). They seek awareness and under-
standing of client identities, identification, and historical and current contexts.
Counsellors/therapists demonstrate respect for client diversity and difference and
do not condone or engage in discrimination (CCPA, 2020, p.11).
■■ Social workers recognize and respect the diversity of Canadian society, taking into
account the breadth of differences that exist among individuals, families, groups,
and communities (CASW, 2005, p. 4).
These ethical guidelines underscore the need for professionals to learn about other
cultures. Such learning increases sensitivity and awareness of how values, beliefs, and
worldview define one’s behaviour and thinking. This topic will be explored in more
depth in upcoming chapters.

Professional Identity: Ethics, Values, and Self-Awareness 5


self-determination: The principle that
promotes the rights of clients to have
autonomy and freedom of choice.
6 Chapter 1
Counsellors, especially those who work with high-risk clients (such as those with
chronic addiction problems) need to be careful that their view of, and attitudes toward,
clients do not become jaded. Jaded counsellors often have a cynical and pessimistic
perspective on the willingness and capacity of their clients to change and grow. Coun-
sellors who believe that clients are incapable of growth are likely to invest less energy in
supporting change. Moreover, they may be more prone to using controlling responses
because of their expectation that the “clients cannot do it on their own.” What would
you predict to be the likely outcome of a counselling session when the counsellor
labels the client “a hopeless alcoholic?” Conversely, belief in the dignity and worth of
people is expressed through positive practices:
■■ Involving clients in decision making, goal setting, and problem solving
■■ Adopting a strengths approach
■■ Maintaining an optimistic view of human nature, including the belief that people
are capable of change and growth
Client Self-Determination
Self-determination is the principle that clients have a right to autonomy and freedom
of choice to make their own decisions, insofar as is possible. Counsellors have a duty
to respect and promote this right even when they disagree with the decisions of their
clients. Moreover, choice is an integral part of client self-determination. When clients
have no choices, or believe that they have none, self-determination is not possible;
however, adherence to the principle does not prevent counsellors from helping clients
understand how their actions might violate the rights of others. Nor does it prevent
counsellors from helping clients appreciate the potential consequences of their actions.
Some clients, such as people with mental disabilities and young children, may be unable
to make competent choices. If so, counsellors may need to prevent them from acting in
ways that are potentially harmful to themselves or others.
SUCCESS TIP
Self-determination also applies to cultures. In this sense, Indigenous peoples have asserted
their right to control their own political and cultural development, a right that is in sharp
contrast to the aims of colonialism, which instituted harsh methods to force assimilation.
Novice counsellors are often misinformed about the nature of counselling. They
believe that their role is to listen to their clients’ problems and then offer helpful advice
or solutions. The principle of self-determination obligates counsellors to avoid behav-
iours that control and manipulate clients. Instead, they must employ strategies that
empower clients to make independent and informed decisions. However, counsellors
should be cautious that they do not promote individual decision making at the expense
of ignoring or potentially damaging relationships with family and community. This is
particularly important when working with clients whose cultures are more collective
(family and community focused) than individualistic. Self-determination does not
mean people act selfishly to assert their personal rights without regard to others. It is
about choice, and that includes the choice to sacrifice for the good of other people or
one’s community. Counsellors who subscribe to a strong individualistic value that pri-
oritizes independence need to be careful that they do not impose this value on clients.
The counsellor’s expertise lies not in knowing what is best for the client, but in
being able to manage the process through which problems are solved, feelings are man-
aged, or decisions are made. Empowerment is the process of assisting clients to dis-
cover personal strengths and capacities. In other words, through empowerment,
 Freedom to
Choose

Control
Knowledge &
& Informed
Information
Consent

Involvement in
Access to
Decision
Resources
Making

Figure 1.2 Essential Elements of Self-Determination

counsellors seek to help clients take control of their lives and realize that they can
improve their situation through their actions. (See Figure 1.2 and Table 1.2.)
Effective counsellors accept that clients have a right to be involved in counselling
decision making. They have the right to be treated as active partners in the counselling
process and to participate in decisions affecting their lives. This right is underscored in
the CCPA’s Code of Ethics (2020):
Clients’ Rights and Informed Consent. When counselling/therapy is initiated, and
throughout the counselling/therapy process as necessary, counsellors/therapists inform
clients of the purposes, goals, techniques, procedures, limitations, potential risks and
benefits of services to be performed, and other such pertinent information that sup-
ports the informed decision-making process. Counsellors/therapists make sure that cli-
ents understand the implications of diagnosis, fees and fee collection arrangements,
record-keeping, and limits of confidentiality. Clients have the right to collaborate in the
development and evolution of the counselling/therapy plan. Clients have the right to
seek a second opinion or consultation, to refuse any recommended services, and to be
advised of the consequences of such refusal. (p. 9)

TABLE 1.2 Choices for Supporting Client Self-Determination

• Use advocacy skills to help clients access resources or remove barriers to existing options.
• Avoid prescriptive advice and other controlling responses.
• Use appropriate silence as a way to create space for clients to think and formulate responses.
• Help clients identify, access, and explore options.
• Encourage clients to make their own decisions based on informed choices of the costs and benefits of any course of action.
• Assist clients in evaluating the consequences of their actions for others.
• Fully inform clients about counselling strategies and the potential risks. Promote collaborative decision making on goals.
Whenever possible, provide access to records.
• Invite clients to evaluate the progress of counselling and the counselling relationship.
• When under court order or similar nonvoluntary conditions, provide information on the client’s right to decline service, as well
as the possible consequences of such denial. Whenever possible, empower clients with choices.
• Adopt a mindset that recognizes the client as the “expert” on his or her own problems, feelings, and preferred solutions.
• Avoid dependency-promoting behaviours, such as doing for clients what they can do for themselves, excessive involvement,
and indiscriminate advice giving.
• Encourage optimism and foster a relationship of safety to help clients take risks.
• Honour client lifestyle choices.
• Initiate discussion with clients about the importance of self-determination.
• Encourage clients to act as self-advocates.

Professional Identity: Ethics, Values, and Self-Awareness 7

❯❯❭❯ CONVERSATION 1.1 Gallows Humour
STUDENT: I have just started my field placement, and I am
disturbed by what is happening. When the team goes for
coffee, everyone jokes and makes fun of the clients. If they
knew how their counsellors talked about them, they would
never come back. I did not know that professionals could be
so cold-hearted. Is their behaviour unethical?
TEACHER: Just before his execution by hanging, a con-
demned man is offered a cigarette. “No thanks,” he says, “I’m
trying to quit.” Such “gallows humour” is one of the ways
many people deal with the enormous stress of their jobs.
Jokes about tragic events or client misfortunes help counsel-
lors sustain their emotional well-being. It does not mean that
they have become hardened or uncaring toward their clients;
rather it is a way of unwinding and relieving constant pressure.
As you’ve discovered, one of the dangers of gallows humour is
that others will overhear it and draw conclusions about the
person’s attitudes. Is it unethical? What do you think?

Rights of Children
As a rule, “capable” children are entitled to confidentiality unless there is a reason to
suspect that the child might harm himself or herself or others. As well, situations
involving child abuse or neglect must be reported. In this respect, a child can receive
medical treatment or consultation on issues such as birth control/abortion, mental
health problems, and addictions counselling (Justice Education Society, 2015).
In 1991, Canada signed the United Nations Declaration of the Rights of the
Child, which obligates it to enforce children’s rights as outlined in the Declaration.
Nevertheless, United Nations officials have criticized the country for its failure to
adequately address the needs of Aboriginal, disabled, and immigrant children as
well as those living in poverty (Scoffield, 2008). For example, the “sixties scoop”
resulted in the wholesale removal of children from their Indigenous families without
consent of the family and without band involvement. These children were often
placed in non-Indigenous families who had little knowledge or interest in preserving
their cultural identity. The residential school system is a further example of how
colonization practices have discriminated against children and caused trauma. The
effect was captured in a highly critical review report on Indigenous child removal
practices:

An abysmal lack of sensitivity to children and families was revealed. Families

approached agencies for help and found that what was described as being in the child’s
“best interest” resulted in their families being torn asunder and siblings separated.
Social workers grappled with cultural patterns far different than their own with no
preparation and no opportunity to gain understanding. (Kimelman, 1983)

Although the need for reform continues, there is now wide consensus that Indige-
nous child welfare issues are best handled by Indigenous communities. They are in the
best position to ensure that care honours traditional values, considers historical
trauma, and recognizes the strengths and benefits of an Indigenous approach to the
care of children.

ETHICS: DOING WHAT’S RIGHT

ethics: Guidelines that define the limits Ethics are the principles and rules of acceptable or proper conduct. All profes-
of permissible behaviour. sions have ethical guidelines, designed to protect both clients and members. Ethical
codes define the limits of permissible behaviour and the sanctions or remedies for

8 Chapter 1
member violations of ethical standards. Codes of ethics serve the following broad
purposes:
■■ Professionals can use their codes to assist them with decision making and as a ref-
erence for their practice.
■■ Ethical codes help shelter clients from incompetent and unethical practice by
members of the profession. Ethical codes recognize that clients may be vulnerable
and subject to manipulation and abuse of power by professionals, so they con-
strain professionals from taking advantage of clients.
■■ Ethical codes also provide guidance on how counsellors can deal fairly with col-
leagues and their employers, including the responsibility to address the unethical
conduct of colleagues.
■■ Codes outline the philosophical and value principles of the profession. For exam-
ple, the code of the Canadian Association of Social Workers has six core social
work values:
Value 1: Respect for the Inherent Dignity and Worth of Persons
Value 2: Pursuit of Social Justice
Value 3: Service to Humanity
Value 4: Integrity of Professional Practice
Value 5: Confidentiality in Professional Practice
Value 6: Competence in Professional Practice (CASW, 2005, p. 4)
These ideals are echoed by the Canadian Counselling and Psychotherapy
Association, who list the following fundamental principles as the basis for ethical
conduct:
a. Beneficence: being proactive in promoting the best interests of clients.
b. Fidelity: honouring commitments to clients and maintaining integrity in coun-
selling relationships.
c. Nonmaleficence: refraining from actions that risk harm and not willfully harm-
ing clients.
d. Autonomy: respecting the rights of clients to agency and self-determination.
e. Justice: Respecting the dignity of all persons and honouring their right to just
treatment.
f. Societal interest: upholding responsibility to act in the best interests of society.
(CCPA, 2020, p. 2)
Unethical behaviour typically arises from issues related to one or more of the fol-
lowing: breaking confidentiality; misrepresenting or working beyond one’s level of
expertise; entering into improper relationships (sexual, business, or social) in which
there is an obvious conflict of interest and a high risk of losing objectivity. Serious
instances of unethical behaviour may result in sanctions, including expulsion from
one’s professional association. When unethical behaviour involves criminal acts such
as selling drugs to a client, counsellors are subject to both professional and legal action.
Professional associations are responsible for monitoring their own policies and for
investigating and resolving violations of ethical conduct. The CASW and CCPA are
examples of professional bodies that can formally discipline members who violate
their codes of ethics. Counsellors and volunteers who are not members of profes-
sional associations will often work with agencies that provide guidelines for ethical
behaviour and decision making. For them, unethical behaviour would be resolved as
an employment issue.

Professional Identity: Ethics, Values, and Self-Awareness 9


dual relationship: A relationship in
which there is both a counselling relation-
ship and another type of relationship, such
as friendship or sexual intimacy.
10
Legislation defines and restricts the use of certain titles, such as social worker, psy-
chologist, and psychiatrist, to those who have the appropriate degree or training. The
clients of these professionals can report misconduct or concerns to the appropriate
professional association; however, there may be no legislation preventing people from
offering counselling services under a wide range of other titles, such as counsellor, per-
sonal therapist, family and marital counsellor, and personal growth consultant. These
practitioners may not have had formal preparation or training, and clients should be
cautious when seeking their services.
All professional associations have codes of ethics to which members must adhere.
Typically, counselling and social work association codes outline the values and ethics
that govern professional behaviour and decision making. In practice, counsellors also
consider relevant theory, research, laws, regulations, and agency policy. When faced
with ethical dilemmas, they should consider consultation with colleagues, supervisors,
professional associations, and legal counsel. In addition, the CCPA has published an
ethics casebook (Shulz, 2000) designed to assist counsellors in clarifying ethics and
standards of practice, and the CASW has published Guidelines for Ethical Practice
(2005) as a reference point for social workers on ethical practice.
Dual Relationships
A dual relationship is one in which there is both a counselling relationship and another
type of relationship, such as a business relationship, a friendship, or one of sexual inti-
macy. The essential purpose of counselling is to meet the needs of clients, but dual rela-
tionships lead to the risk that counsellors could misuse (or be perceived to be misusing)
their professional relationships for personal gain. In dual relationships, the counsellor has
a personal interest that may conflict with the client’s interests. This may lead to intended
or unintended exploitation, harm, manipulation, or coercion of clients. To prevent these
problems and any conflict of interest, dual relationships must be avoided because of
their potential harm to clients and the risk of damage to the image of the profession.
Not surprisingly, the codes of ethics for the various counselling professions strictly
prohibit certain types of dual relationships, especially those of sexual involvement.
Generally, they also prohibit sexual intimacies with former clients for a specified period
after terminating the counselling relationship. For example, the CCPA (2020) requires
a three-year period. However, this injunction may extend indefinitely “if the client is
clearly vulnerable, by reason of emotional or cognitive disorder, to exploitative influ-
ence by the counsellor” (CCPA, 2020, p. 11).
Professional Boundaries
Despite ethical guidelines, boundary violations and abuses do occur. Reviewing the avail-
able research, Thoreson and colleagues (1993) found that the incidence of sexual contact
between counsellors and clients ranges from 3.6 to 12.1 percent. Conducting their own
study, the researchers found, after surveying 1000 randomly selected male members of the
American Counseling Association (ACA), that 1.7 percent of the respondents reported
engaging in sexual contact with a client during a professional relationship and 7 percent
reported engaging in sexual contact after a professional relationship (Thoreson et al., 1993).
Physical Contact The CASW’s Guidelines for Ethical Practice (2005) offers this
guidance on the issue of physical contact with clients:
Social workers avoid engaging in physical contact with clients when there is a possibil-
ity of harm to the client as a result of the contact. Social workers who engage in appro-
priate physical contact with clients are responsible for setting clear, appropriate and
culturally sensitive boundaries to govern such contact. (p. 12)
Chapter 1
 While the CASW guidelines do not define appropriate physical contact, com-
mon sense needs to prevail. Fear of the implications and repercussions of touching
has led some settings to become “no touch” environments; however, this practice
may negate the needs of some clients, particularly children who need physical con-
tact. In an editorial on the importance of touching in child and youth care settings,
Tom Garfat (2008) emphasized the importance of touch when working with youth,
but he also stressed that workers need to learn when not to touch. He distinguishes
“between those who would touch youth in the most normal and healthy of ways; a
pat on the back, a touch on the shoulder, a comforting hug when the world is a diffi-
cult place, a hand held in a moment of crisis, and those who use the opportunity to
touch a young person as an opportunity to satisfy their own needs and desires”
(p. iii). Garfat strongly endorses the elimination of inappropriate touching, but urges
us to remember that “touch is part of human nature, touch is developmentally neces-
sary, touch is part of healing, touch is a form of communication, and touch builds
bridges” (p. x).
While sexual intimacy is clearly unethical, the appropriate boundaries of other
relationships may be less clear. As Reamer (2002) observes,
Other dual and multiple relationships are more ambiguous and require careful analysis
and consultation. Examples include social workers in rural communities who cannot
avoid contact with clients in social settings, social workers who are invited by clients to
attend an important life event, social workers’ relationships with former clients, and
social workers’ unanticipated encounters with clients at an Alcoholics Anonymous
meeting when both parties are in recovery. (p. 66)

Miller (2007) discusses the challenges that professionals who work in rural or
small towns face when applying and interpreting ethical standards such as “the need to
maintain professional boundaries and at the same time achieve a sense of personal
belonging in the community” (p. 168). She also notes the vulnerability that workers
feel, due to their high visibility, when their actions are scrutinized by members of the
community.
Pierce and Schmidt (2012) suggest that rural dynamics and culture affect how pro-
fessional boundaries are defined:
For example, over time, the professional may be invited to community events, a wed-
ding, or a celebration for which attendance is viewed as significant by the community.
Not attending may cause disharmony or barriers between the practitioner and the
community. (p. 248)

Confidentiality
The rules regarding confidentiality are integral to every code of ethics. Ethical guide-
lines stress that the confidentiality of clients must be protected. Indeed, most clients
enter counselling with an expectation that what they say will be kept private. For the
most part, counsellors can assure clients that they will keep their disclosures confiden-
tial; however, often it is not so simple. Absolute confidentiality means that client dis- absolute confidentiality: An assur-
closures are not shared with anyone. Relative confidentiality means that information ance that client disclosures are not shared
with anyone.
is shared within the agency with supervisors or colleagues, outside the agency with the
client’s permission, or in courts of law owing to legal requirements, such as child abuse relative confidentiality: The assump-
tion that client disclosures may be shared
legislation. Usually, clients can be assured only of relative confidentiality. within the agency with supervisors or col-
To provide optimum service to clients, counsellors must share information about leagues, outside the agency with client
them within the agency. To monitor the quality of work and help counsellors improve permission, or with others because of legal
requirements, such as those contained
their skills, supervisors need to review client files or consult with counsellors by
within child abuse legislation.
reviewing audio and video recordings of their interviews. Other counsellors within the
agency also have access to files.

Professional Identity: Ethics, Values, and Self-Awareness 11


duty to warn: The professional respon-
sibility that counsellors have to inform
people whom they believe a client may
harm.
12
Many people believe that counsellors and other professionals enjoy “privileged
communication”; that is, they are legally protected from having to share information
that they have obtained while exercising their professional duties. However, the courts
can subpoena counsellors’ records because Canada has no legislative protection for
licensed or unlicensed psychotherapists.
There are valid reasons, including some legal requirements, for sharing information.
For example, all jurisdictions in Canada have legislation that requires counsellors to
report suspicions of child abuse and neglect to the appropriate authorities. Similarly,
counsellors might have to break confidentiality when they believe that clients might harm
themselves or others. Counsellors need to become familiar with the precise wording of
relevant statutes in their area, since laws may vary significantly among jurisdictions.
One often-quoted legal precedent is the 1976 Tarasoff case, in which the client told
his counsellor of his intent to kill his girlfriend, Tatiana Tarasoff. The counsellor told
the campus police of the threat, but he did not warn his client’s girlfriend or her fam-
ily. The client, a student at the school, subsequently carried out his threat and killed
the young woman. The young woman’s parents brought a successful lawsuit against the
counsellor and the university. This litigation established that, when counsellors believe
that a client represents “a serious danger of violence to another,” they have a duty to
warn potential victims (cited in Nesbitt, 2017).
SUCCESS TIP
Become familiar with the legislation in your area that requires you to report suspected
cases of child abuse or neglect, but remember it is not your job to conduct an investigation
unless you are legally assigned this role.
Since the Tarasoff decision, there have been numerous Canadian applications and
legal precedents that address the duty to warn issue. The CASW’s Guidelines for Ethical
Practice (2005) allows for disclosure when “necessary to prevent serious, foreseeable,
and imminent harm to a client or others” (p. 6). The guidelines also obligate social
workers in such circumstances to notify “both the person who may be at risk (if pos-
sible) as well as the police” (p. 8). The CCPA Code of Ethics (2020) has a similar duty to
warn obligation that requires counsellors to “use reasonable care to give threatened
persons such warnings as are essential to avert foreseeable dangers” (p. 9).
Clients have a right to be fully informed regarding the limits of confidentiality,
including any legal or ethical responsibilities that require counsellors to share informa-
tion. Through discussions regarding confidentiality, counsellors can reassure clients
that computer and file records are safe.
Counsellors can take a number of steps to protect client confidentiality. They
should discipline themselves not to discuss clients in public places and at parties or
other social events. Counselling work is demanding, and an important part of dealing
with the stress of the job is to unwind by talking about difficult cases and personal
reactions with colleagues and supervisors. This is a healthy and necessary component
of professional wellness. Unfortunately, time pressures and large caseloads may leave
little or no time for this process during the working day, so it is easy to fall into the trap
of discussing clients over lunch or in other settings where confidentiality cannot be
ensured. The obvious risk is that the conversation will be overheard. Even when names
are not used, accidental listeners may think that they know the person being discussed.
In addition, they may decide that they will never go for counselling because what they
say would soon be spread all over town.
Although it is tempting for counsellors to discuss clients with family and friends
because they are available as supportive listeners, they should avoid doing so. Family
Chapter 1
and friends are not bound by the same ethics as counselling professionals. They could
easily disclose what they have heard, perhaps with a seemingly innocent observation or
comment.
Sometimes counsellors breach confidentiality by failing to take simple precau-
tions. For example, taking phone calls during a counselling session can lead to careless
breaches of confidentiality and suggest to clients that the counsellor treats their private
matters casually. In addition, counsellors should remove all case records, phone mes-
sages, and notes from their desk. This prevents clients from seeing the names of other
clients and reinforces the fact that the counsellor will not leave private records in pub-
lic places. Table 1.3 lists some other essential confidentiality guidelines.

SUCCESS TIP
When leaving phone messages for clients, give just your first name and say nothing about
the nature of the call. Clients may not have informed roommates or family members that
they are seeing a counsellor.

The interview itself should be conducted in private, not where other staff or cli-
ents may overhear. When greeting a client in the waiting room, counsellors should
refrain from using surnames; however, they need to be sensitive to the fact that many
seniors and people from some cultures are insulted by the casual use of their first
names.
Sometimes counsellors meet clients by chance in public places. When this hap-
pens, counsellors should ensure that they maintain confidentiality, even when the cli-
ent appears unconcerned. They should gently shift the conversation to a neutral topic
or suggest a private time and place to continue the discussion. At that time, counsel-
lors can explain why they avoided a public discussion.

TABLE 1.3 Confidentiality Guidelines

• Review professional guidelines such as the CASW’s Guidelines for Ethical Practice and the
CCPA’s Code of Ethics.
• Involve clients. Keep them informed and seek their permission to release information.
Remember that freedom of information statutes may give clients the right to access your
files.
• Become familiar with relevant legal statutes (e.g., child abuse or mental health legislation)
that define and limit confidentiality. Disclose only the information that is required.
• Protect client records with secure filing systems. Do not leave files, notes, or phone
messages about clients out where they may be read by others. Ensure that electronically
stored data is protected.
• Ensure that consultations with others concerning clients are legitimate and conducted in
a private and professional manner. This precludes conversations about clients at social
gatherings or in public places such as restaurants.
• Ensure that interviews are private and free from interruptions.
• Discuss clients only with supervisors and use only support staff for processing necessary
paperwork and documentation.
• Never use client names, initials, or identifying data in emails or text messages.
• Exceptions to the rules may, and sometimes must, be made when there are suspicions of
child abuse or neglect, when required by law (such as a subpoena), and when there is a
risk to self or others (suicide threat or threat of violence).
• Never use social media to discuss clients, even if you change names and identifying
information.

Professional Identity: Ethics, Values, and Self-Awareness 13

❯❯❭❯ BRAIN BYTE Ethical and Moral Decision Making
Functional magnetic resonance imaging (fMRI) has enabled Another study reported by Riddle (2013) in Scientific American
researchers to identify areas of the brain that are active concluded that “our professed moral principles can be
when people address moral and ethical dilemmas. The shifted by subtle differences in mood and how a question is
results showed that areas of the brain associated with emo- posed.” These findings underscore the value of counsellors
tions tend to predominate, particularly when there is a more consulting with others and avoiding impulsive actions when
personal involvement in the dilemma (Science Daily, 2001). confronted with difficult ethical decisions.

ETHICAL DILEMMAS: TOUGH DECISIONS

ethical dilemma: A situation involving
competing or conflicting values or principles.
An ethical dilemma exists when a choice must be made between competing values and
potential courses of action. On the one hand, a decision to remove a child from a
home where there is obvious and significant abuse is not an ethical dilemma, since the
gravity of the situation gives no room for choice. On the other hand, removing a child
when the home situation is marginal requires weighing the risks of potential abuse
against the drawbacks of separating a child from his or her parents.
By virtue of their role, counsellors may have simultaneous obligations to different
people and groups, including the agency that employs them, their clients, the commu-
nity at large, and the legal system. When obligations conflict, an ethical dilemma is
created with risks and benefits to each potential solution.
While ethical codes that are based on the values of the profession attempt to define
acceptable behaviour, they usually do not offer answers about specific situations that
arise for counselling professionals. Even though they do not provide precise guidelines
for resolving all dilemmas, codes are an important reference aid for decision making.

Types of Ethical Dilemmas

1. Distribution of scarce resources (time, money, and opportunity to participate
in a program)
■■ An agency has limited funds available to assist clients with retraining. Who

should get the money—the client with the greatest potential for success or the
client who needs it most?
2. Professional competence and ethical behaviour of colleagues
■■ A student on internship (field placement) becomes aware that her supervisor is

attending an AA meeting with one of her clients.

■■ One of the staff informs you of his intention to phone in sick to extend his

vacation a few more days.

■■ A colleague is steering clients to a business run by his sister.

■■ At a social gathering you run into a colleague who is with his client.

■■ A colleague who has no formal training in hypnosis is using it with clients.

3. Policies and procedures of the agency setting that appear oppressive or insensi-
tive to the cultural/diversity needs of the clients it serves
■■ A worker has information about a client that, if made known to the agency,

would make her ineligible for services that she badly needs.
■■ You become aware that your client, a single mother on welfare struggling to care

for her four children on a meagre budget, received a cheque from her mother to
help with expenses. Legally, she is obligated to declare this income, which will
be fully deducted from her next welfare payment, thus depriving her and her
children of much-needed assistance.

14 Chapter 1
 4. Behaviour of clients
■■ A 17-year-old girl asks for your help to obtain an abortion without involving

her parents.
■■ Your client informs you that he has tested positive for human immunodefi-

ciency virus (HIV), but he hasn’t informed his partner.

■■ A 16-year-old boy tells you that he is working as a prostitute.

■■ Your client casually mentions that he robbed a bank several months ago but was

not caught.
■■ A client asks for a hug.

■■ Your client hints that he is going to get revenge on his ex-wife.

5. Competing values, needs, procedures, or legal requirements

■■ A 15-year-old girl discloses that her father has been abusive, but in recent weeks,

he seems to have changed. She asks that you do not make a report to the author-
ities. She says she knows her father will retaliate if he finds out that she has told
anyone.
■■ A 16-year-old Jehovah’s Witness asserts her belief that she should not be given

a blood transfusion to deal with a terminal illness.

■■ An abused child says he will not cooperate with removal from his parents and

that he will run away from any foster home.

■■ An Indigenous client offers you a gift.

Resolving Ethical Dilemmas

Erford (2010) and the CCPA (2020) identify ethical rules or principles that can be used
to help guide ethical behaviour and resolve ethical dilemmas (Figure 1.3):
1. Autonomy: Honour clients’ self-determination and their freedom to make their
own decisions.
2. Beneficence: Pursue the welfare and benefit of others.
3. Nonmaleficence: In simple terms, do no harm to others.
4. Justice: Strive for an equal distribution of resources and equitable effort among
participants.
5. Fidelity: Be loyal and honest and keep promises.
6. Societal interest: Considering and acting in the best interests of society.
Under ideal conditions, counsellors can honour all six principles, but ethical
dilemmas by nature entangle competing principles, and each choice involves unique

Non-
Justice
maleficence

Beneficence Fidelity

Ethical Societal
Autonomy
Principles Interest

Figure 1.3 Ethical Principles

Professional Identity: Ethics, Values, and Self-Awareness 15

 consequences. Ethical decision making involves identifying and weighing which of the
principles ought to take priority in any given situation.
The application of any model for ethical decision making does not mean that reso-
lution of ethical dilemmas will be easy. When values and ethics compete, deciding
which one should have priority can be painfully difficult. Consider a case in which an
individual in remission from cancer stipulates that if his cancer returns, he does not
want further surgery or other invasive treatment. Suppose years later, he develops
dementia and his cancer returns. He now asserts that he wants treatment. Which “per-
son’s” wishes should a caregiver honour, the one with sound mind from the past or the
current one with diminished capacity (adapted from Locke, 2014)?
Intimate knowledge of ethical principles and legal guidelines can make the decision-
making process clearer, albeit no less difficult. For example, a client’s right to confiden-
tiality and self-determination must be given up when that client discloses child abuse,
and the duty to warn principle means that professionals must break confidentiality to
warn potential victims. However, it is not always clear when a client’s behaviour consti-
tutes danger to the safety of others.
The principle of self-determination protects the right of people to make errors
and carry out actions that others might consider wrong. Counsellors must consider
when the application of this principle must be abandoned because the individual’s
behaviour might result in death, such as when a client threatens suicide. While coun-
sellors have a clear legal and ethical responsibility to intervene to prevent suicide, their
responsibilities are not as clear for other challenges. For example, the lifestyles of
homeless persons may reach the point where their hygiene, living, and eating habits
become dangerous for them. The point at which their right to self-determination
should yield to their right to health and well-being is not easy to establish.
Counsellors can take seven steps to resolve ethical dilemmas (see Figure 1.4).
Step 1: Gather Facts During this stage, it is important to control any tendency to
act impulsively. Remember that assumptions and hearsay are not the same as facts.
Most ethical codes require that professionals seek resolution with colleagues before
proceeding. For example, the CCPA code advises a counsellor who has concerns about
the ethical behaviour of another counsellor “to seek an informal resolution with the
counsellor, when feasible and appropriate” (2020, p. 7). In many cases, frank discussion
with colleagues reveals additional information or results in a satisfactory solution.
Step 2: Identify Ethical Issues and Potential Violations At this point, refer to
the appropriate code of ethics (CASW, CCPA, etc.) to identify whether the matter
under question is addressed in the code. If the person in question is not governed by
a professional code, then agency policies and procedures or local legislation may pro-
vide important reference points. For example, matters of discrimination in Canada
are addressed under the Canadian Human Rights Act (1985). At this stage, it will be
helpful to identify which ethical principles are important and how they might be in
conflict, such as a client’s right to confidentiality versus the duty to inform others of
potential harm.

❯❯❭❯ BRAIN BYTE Ethics and Neuroscience

Current and emerging neuroimaging techniques raise the already being used. This raises important ethical questions:
possibility that one day these tools could be used to read To what extent might neuroscience be used in legal settings
minds, perhaps to determine if a person is lying or harbour- to determine guilt or whether or not a person should be
ing prejudicial views. In fact, rudimentary tools to do this are granted parole (Smith, 2013)?

16 Chapter 1
 Gather
Facts

List ethical
Take
and values
Action
issues

Identify
Consult options for
action

Evaluate
Consider
potential
cultural
gains and
context
losses

Figure 1.4 Model for Resolving Ethical Dilemmas

Step 3: Identify and Evaluate Options and Strategies Here the goal is to list
the potential action strategies. Where appropriate, consulting with colleagues, profes-
sional organizations, and supervisors can assist in generating alternatives.

Step 4: Evaluate Potential Gains and Losses Reflective questions help you
consider the merits and ramifications of any action plan. Here are some sample
questions:
■■ What are the advantages and disadvantages of not taking action?
■■ What are the advantages and disadvantages of taking action?
■■ What are the potential consequences (short-term and long-term) of action or
inaction?
■■ Who might gain or lose?
■■ What other individuals or organizations are likely to be affected?
■■ To what extent might other factors be influencing my judgment (e.g., unresolved
relationship problems, bias, and hidden agendas)?
■■ What values and principles have priority? Boyle and colleagues (2006) suggest a
rank order of ethical principles (see Figure 1.5). They identify seven ethical prin-
ciples, giving the highest priority to protection of life, which supersedes all of the
other rights. The equality and inequality principle entitles people to be treated
equally, and this right supersedes an individual’s right to autonomy and freedom.
The least harm principle aims to minimize the adverse consequences of any course
of action. The quality of life principle suggests that counsellors should choose
alternatives that enhance quality of life over those that diminish it. Privacy and
confidentiality, while important, are given lesser priority than those rights higher
on the hierarchy. Similarly, truthfulness and full disclosure are important ethical
principles, but they may be compromised if overridden by other, higher-rated
principles.

Professional Identity: Ethics, Values, and Self-Awareness 17

 Protection of Life

Equality & Inequality

Autonomy & Freedom

Least Harm

Quality of Life

Privacy & Confidentiality

Truthfulness & Full Disclosure

Figure 1.5 Ethical Principles Hierarchy

SOURCE: Adapted from Boyle et al., 2006, p. 97.

Step 5: Consider Cultural Context An important part of ethical decision making

is reflecting on the cultural implications of a given course of action. Responsible ethi-
cal action compels us to explore how our actions might adversely affect a community.
Some areas in which a multicultural interpretation might lead to different perspectives
and strategies are gift giving, relationship boundaries, and confidentiality.

Step 6: Consult Consultation can and should take place at any point as counsellors
work to resolve ethical dilemmas. Resolving ethical problems is a complex and some-
times emotionally taxing endeavour. Consulting with colleagues, supervisors, and
sometimes lawyers can add fresh perspectives and ease the stress associated with the
presenting dilemma. Involving supervisors ensures that we will have support during
and after the decision-making process.
A matrix chart, such as that illustrated in Figure 1.6, can be used as a tool to com-
pile and compare the benefits and risks of the alternatives. A separate analysis should
be done for each choice. Entries should consider both the short- and long-term costs
and benefits of a given course of action as well as the cultural implications of a given
choice. Consult with experts and others when completing this task.

Predicted Potential Potential Cultural

Outcome Gains Losses Implications

Taking This
Action
Choice

Not Taking
This Action
Choice

Figure 1.6 Matrix Decision-Making Chart for Resolving Ethical Dilemmas

18 Chapter 1
Step 7: Take Action A good action plan should include details of the intended out-
come, a list of the people who need to be involved, required resources (e.g., information,
meeting space, and external facilitator), and the sequence of events that must be accom-
plished. A concrete timetable with clearly defined steps ensures that you will not lose time
wondering what to do next. The action plan should also anticipate obstacles and identify
strategies for addressing them. For example, if you are confronting a colleague on a breach
of ethical behaviour, it would be wise to consider what you might do if the colleague
■■ launches a counterattack.
■■ reacts with feelings such as anger, remorse, or shame.
■■ denies that the behaviour occurred.
■■ asks that you keep your knowledge of the breach confidential between the two of you.

SUCCESS TIP
Resolution of ethical dilemmas is intellectually challenging and emotionally taxing. Seek
appropriate consultation and supervision for planning and debriefing.

MULTICULTURAL ETHICAL ISSUES

Ethical codes only provide general guidelines, which may not offer sufficient direction
or flexibility for multicultural counselling. When counselling across cultures, counsel-
lors should remember certain principles:
■■ Considerable diversity may exist within cultures and even between people in the
same family group.
■■ Counselling strategies and skills that are appropriate with one group may be inap-
propriate with another. Western approaches to counselling encourage exploration
and sharing of feelings, but some cultures prefer to keep emotions private. Some
cultures favour the collective good over individual needs, where self-interest is sec-
ondary. Many clients favour the use of alternative health measures, including the
use of traditional healers.
■■ Relationship boundaries may be much more fluid than is generally permitted by
ethical codes.
■■ Privilege can be a major issue when counsellors are part of the dominant Canadian
culture and their clients are visible minorities and/or face other barriers to a level
playing field within Canada.
■■ Counsellors need to develop the ability to assess and make judgments in a way that
recognizes that their clients’ perspectives may be culturally very different. They
need to make sure that ethical decision making doesn’t give priority to dominant
culture values while ignoring or discounting minority values.
Sheppard emphasized the importance of understanding client values and perspec-
tives that may be very different from Western views that have inspired ethical codes
such as the CCA (Canadian Counselling Association) Code:
. . . a counsellor’s failure to demonstrate respect for diversity may infringe on the client’s
cultural autonomy and thereby constitute an unethical practice under the CCA Code of
Ethics. Counsellors who hold stereotypical beliefs about racial and ethnic minority clients
or who practice without an awareness of the unique cultural realities of their clients may
cause harm to these clients. The failure to demonstrate sensitivity to the culture of clients
may violate several of the fundamental ethical principles of the profession, such as respect
for the dignity of persons, not harming others and responsible caring. (Sheppard, 2020)

Professional Identity: Ethics, Values, and Self-Awareness 19

 These sentiments are echoed by McCormick (1998), who noted:

Although development of ethical codes is desirable, it is important to note that such

guidelines are the product of the culture that created them. The guidelines, through
necessity, reflect the beliefs and values of that culture. An ethics code’s cultural base
becomes problematic when members of one culture are asked to evaluate the behav-
iours of members of another culture. . . . Although there may be practical reasons
for such efforts, it is not always possible to evaluate the behaviour of others in the
cultural context in which that behaviour was learned. In examining ethical guide-
lines, it is important to be aware that both the client and counsellor who are from
different cultural backgrounds are likely to have a different way of seeing the world.
(pp. 284–297)

Ethical Engagement with Indigenous Peoples

The revised CCPA Code of Ethics integrates Indigenous wisdom into its guide for ethi-
cal decision making:

Counsellors/therapists are encouraged to approach all ways of knowing when engag-

ing in decision-making. Using Etuaptmumk2 (two-eyed seeing) is of immense assis-
tance. This way of perceiving situations refers to “learning to see from one eye with
the strengths of Indigenous knowledges and ways of knowing and from the other eye
with the strength of Western knowledges and ways of knowing . . . and learning to
use both eyes together for the benefit of all.” (Marshall, 2004)

The “wise practices lens” model of decision-making (Wesley-Esquimaux & Snowball,

2010, p. 230) is a decision-making strategy that practitioners may find helpful. The
model uses teachings from the seven sacred values that include courage, honesty, humil-
ity, respect, truth, love, and wisdom (Baskin, 2007). (CCPA, 2020, p. 5)

Shouldice (2015) presented several ideas from an ethical perspective when working
with Indigenous communities. She emphasized the importance of being involved in
the community by attending gatherings, ceremonies, and powwows. She also cautions
that ethical positions forbidding hugging and gift giving between counsellors and cli-
ents do not apply, as hugging is frequent and gift giving (usually handmade items) is
common. This perspective is endorsed by the CCPA (2020), who note:

Counsellors/therapists understand the distinct cultural and ethical differences of dual

relationships, multiple relationships, gifting, and Traditional Knowledge keeping.
Cross-cultural contexts take priority over rule-based contexts in these cases. (p. 32)

The Truth and Reconciliation Commission (TRC) was formed in 2008 to docu-
ment the history of the Canadian Indian residential school system and the damages it
caused to Indigenous peoples. In 2015, the TRC issued its findings, which included 94
“calls to action.” A number of these calls to action have significant implications for
counsellor practice and ethical behaviour, including making sure that social workers
and others who conduct child welfare investigations receive education and training
about the
■■ history and impacts of residential schools on children and their families.
■■ potential for Aboriginal communities and families to provide more appropriate
solutions to family healing.
■■ right of Aboriginal governments to establish and maintain their own child welfare
agencies.
■■ importance of considering the residential school legacy in their decision making.
■■ priority of placing Aboriginal children into culturally appropriate care.

20 Chapter 1
 The report also emphasized the importance of
Respecting Indigenous peoples’ right to self-determination in spiritual matters, includ-
ing the right to practise, develop, and teach their own spiritual and religious traditions,
customs, and ceremonies, consistent with Article 12:1 of the United Nations Declara-
tion on the Rights of Indigenous Peoples. (TRC, Calls to Action, 2015, p. 5)

Ethical Engagement with the LGBTQ Community

Counsellors who work with LGBTQ (lesbian, gay, bisexual, transgender, and question-
ing or queer) clients need to be mindful of their responsibility to keep professional eth-
ics front and centre. Codes of ethics for the various helping professions provide broad
and important guidelines for practice. In addition, work with LGBTQ clients needs to
consider and feature other unique variables. First, counsellors need to acquire and sus-
tain multicultural competence for working with the population. Second, they need to
be familiar with the fact that many LGBTQ clients have endured ongoing trauma, preju-
dice, and discrimination throughout their lives, a reality that may impede their ability to
trust others, including counsellors. Consequently, counsellors have a responsibility to
create counselling environments that are inclusive and welcoming. Third, counsellors
must not engage in practices that have been deemed harmful and unethical, in particu-
lar, conversion therapy. They need to know that there is no intervention that will change
a person’s sexual orientation. Fourth, counsellors must avoid the trap of assuming that
sexual orientation and gender identification are binary concepts (male or female). Gen-
der identity may differ from the sex acquired at birth. Fifth, culturally competent coun-
sellors recognize the importance of self-awareness with respect to their own sexual
orientation and reactions in order to monitor and control countertransference reac-
tions of attraction or repulsion. An important component of this is the ability to com-
fortably engage in dialogue with their clients who need to talk about their sexuality.
Confidentiality While counsellors are required by their ethical codes to maintain
confidentiality, the duty to warn principle may supersede this code requirement. Con-
sider, for example, a situation in which a client is HIV positive but has not disclosed
this fact to his wife, who is unaware that he is having sex with other men. In Canada,
criminal law requires a person to disclose HIV-positive status before sexual activity
that poses a realistic possibility of transmission. However, the Supreme Court of Canada
has also ruled that the requirement to disclose may not apply if the person has a low or
undetectable viral count and a condom was used (Department of Justice, 2017). In the
situation example, the counsellor has a complex ethical dilemma—that is, whether the
duty to warn principle applies or the client’s right to confidentiality prevails.
Working with LGBTQ youth may present some special challenges. Consider, for
example, a youth age 15 who discloses that he thinks he may have “picked up some-
thing” from a sexual encounter with a classmate. He says his parents, who don’t know
he is gay, would not be supportive.
Not all LGBTQ people are “out” and they have a right to privacy regarding their
decision to keep their sexual orientation private. Counsellors need to be especially
vigilant to ensure that they do not accidently “out” their clients, a mistake that could
easily destroy the counselling relationship. Outing can also have far-reaching impacts
on employment and family relationships as well the potential for embarrassment,
harassment, and physical harm. Service providers need to ensure that electronic stor-
age and/or sharing of information regarding clients has a very high level of security.

SUCCESS TIP
Seek permission and guidance from Indigenous traditional healers and knowledge holders
before using Indigenous healing practices.

Professional Identity: Ethics, Values, and Self-Awareness 21

 Conversion Therapy Conversion or reparative therapy refers to practices that claim
to change a person’s sexual orientation. It may utilize various approaches, including the
use of electric shocks to curb impulses (aversion therapy), medication, talk therapy,
group pressure or counselling, and prayer/religious rites. The Community-Based
Research Centre (CBRC, 2020), a Vancouver-based LGBTQ2 support organization,
conducted research on conversion therapy and found that as many as 20 percent of
sexual minority men have experienced conversion therapy.
The Canadian Psychological Association (CPA, 2015) reviewed the scientific litera-
ture and concluded the following:
Scientific research does not support the efficacy of conversion or reparative therapy.
Conversion or reparative therapy can result in negative outcomes such as distress, anx-
iety, depression, negative self-image, a feeling of personal failure, difficulty sustaining
relationships, and sexual dysfunction. There is no evidence that the negative effects of
conversion or reparative therapy counterbalance any distress caused by the social
stigma and prejudice these individuals may experience.

It is considered unethical by every major medical and counselling professional

organization in Canada and the United States. For example, the CPA strongly asserted
that it “opposes any therapy with the goal of repairing or converting an individual’s
sexual orientation, regardless of age” (2015). In 2018, the CASW endorsed and
reprinted the CPA policy statement.
In March 2020, the Canadian government introduced a bill to ban conversion
therapy that will make it a criminal offense to use conversion therapy on a minor,
including taking the minor abroad for that purpose, making a profit from conversion
therapy, forcing a person to undergo it, and advertising to promote it.

❯❯❭❯ CONVERSATION 1.2 Values and Ethics Conflict

STUDENT: Homosexuality is not accepted by my religion. clients by being culturally sensitive to diverse lifestyles. As a
What should I do if I am asked to work with clients who are rule, counsellors are expected to be able to offer service to
LGBTQ? all clients.

COUNSELLOR: First, tell me your thoughts. STUDENT: I can’t change what I believe!

STUDENT: Well, I know that I can’t impose my views, but I
don’t want to feel that I am betraying my religious values.
COUNSELLOR: You’re right. There are many times when our
values and ability to work objectively might be tested, such
as issues related to abortion, euthanasia, sexual relations
outside marriage, or the role of women who live in cultures
with norms and beliefs radically different from our own.
From time to time I get tested. I think you are exercising
professional responsibility by recognizing that this is poten-
tially problematic for you and especially for your LGBTQ cli-
ents. Such self-awareness is an important dimension of
competence.
STUDENT: So how do I respond appropriately?
COUNSELLOR: As you know, codes of ethics for all profes-
sional counsellors require members to be nonjudgmental, to
support self-determination, and to not impose their values or
lifestyles on their clients in direct or indirect ways. Your pri-
mary responsibility is to respect the dignity and welfare of
COUNSELLOR: You are entitled to your personal views. When
they conflict with those of your LGBTQ clients, you are
expected to closely monitor your actions to ensure that they
do not adversely affect your professional behaviour or judg-
ment. This may require supervisory assistance, further train-
ing, or personal counselling. Supervision can be used as an
opportunity to increase self-awareness and to explore how
your beliefs and actions might be subverting client self-
determination or communicating judgment. If you are unable
to keep your personal views separate, then it is preferable
that you refer your client to another counsellor. However, be
mindful that your clients may experience referral as rejec-
tion. In small communities, there may not be alternative
counsellors or services available. A more difficult, but some-
times necessary, choice is to consider whether to remain in
the counselling profession.
STUDENT: Here’s a question to think about. Suppose your
sexual orientation and views are the same as your client’s?
What are the issues and risks?

22 Chapter 1
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of
Mirrors of Moscow
 This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: Mirrors of Moscow

Author: Louise Stevens Bryant

Illustrator: Oscar Edward Cesare

Release date: July 3, 2022 [eBook #68451]

Language: English

Original publication: United States: Thomas Seltzer, 1923

Credits: Tim Lindell, Martin Pettit Northern State University and

the Online Distributed Proofreading Team at
https://www.pgdp.net (This book was produced from
images made available by the HathiTrust Digital
Library.)

*** START OF THE PROJECT GUTENBERG EBOOK MIRRORS

OF MOSCOW ***
MIRRORS OF MOSCOW
 MIRRORS OF MOSCOW

BY

LOUISE BRYANT

With five illustrations by

CÉSARE

New York
THOMAS SELTZER
1923

Copyright, 1923, by
THOMAS SELTZER, Inc.
———
All rights reserved

PRINTED IN THE UNITED STATES OF AMERICA

TO THREE WISE EDITORS—

M. KOENIGSBERG
BRADFORD MERRILL
PHILLIP FRANCIS
 CONTENTS
PAGE
Foreword xi
Lenin and His Subordinates 1
Jacob Peters, Fedore S. Dzerzhinsky and
43
the Extraordinary Commission
Anatol Vassilievitch Lunacharsky and
69
Russian Culture
Michael Ivanovitch Kalinin and the Peasants 85
Madame Alexandra Kollontai and the
109
Woman’s Movement
Leon Trotsky, Soviet War Lord 129
Enver Pasha and the Mohammedans 147
Tikon and the Russian Church 165
Tchicherin, Commissar for Foreign Affairs,
179
and His Subordinates
Maxim Litvinov, Assistant Commissar,
197
Leonid Krassin and Subordinates
ILLUSTRATIONS
Facing Page
Lenin 2
Kalinin 86
Kollontai 110
Trotsky 130
Enver Pasha 148
 FOREWORD
Revolution! The air is filled with flames and fumes. The shapes of
men, seen through the smoke, become distorted and unreal.
Promethean supermen, they seem, giants in sin or virtue, Satans or
saviours. But, in truth, behind the screen of smoke and flame they
are like other men: no larger and no smaller, no better and no worse:
all creatures of the same incessant passions, hungers, vanities and
fears.
So it is in Russia. And in this book I have tried to show the leaders of
the revolution as they really are, as I know them in their homes,
where the red glare does not penetrate and they live as other men.
Great events make great men. For to be strong enough even to
maintain one’s self amid great events is to be great. Without the
event the strength is nothing. Had the revolt of 1917 failed, like the
revolt of 1905, Lenin would have worked his life out in an attic in
Geneva, Trotsky would have lived and died in a New York garret,
Kalinin would have remained a disappointed, debt-burdened
peasant, Tchicherin a futile ex-diplomatist in exile. The world would
not have known their names: just as the world would not have known
Napoleon or Danton or Marat or Robespierre had Louis XVI been a
trifle less desperately dull. But the revolt of 1917 became a
revolution and its colossal drive and heave flung up the exiles to
greatness. As men it did not change them.
They differ from the political leaders one meets in Washington,
London and Paris, largely because they are able to be franker and
more themselves. Public opinion, which is the boon of politicians and
the bane of statesmen, does not drive them to drab conformity or
high-sounding platitude. The public they have to satisfy is small and
sophisticated—the trade unions of the larger cities. And these
workingmen demand, above all else, frankness and the unpowdered
truth. An address by Lenin is, therefore, as direct, unsentimental and
full of facts as a statement to a board of directors by an executive of
an American corporation. The slow, strong wants of the peasants
have to be heeded, too; but they are simple wants, land and free
trade, and do not yet touch intricate things, remote from the daily life
of the farm, like foreign affairs and higher economics. In the end the
peasants will rule Russia, but to-day public opinion is the opinion of
the class-conscious workingmen of the cities. Therefore, the leaders
of Russia can afford to be frank.
In the western democracies, politics is the art of seeming frank while
not being so. Only three types of politicians ever emerge in the
highest places. First, the statesman of brilliant intellectual
understanding, like Lloyd George, who always knows what he ought
to do, and never does it—until the public also comes to understand,
usually some months, or years, later. Second, the sentimentalist,
who is always able to muddle an inconvenient understanding of facts
and muffle his conscience with high-sounding principles that endear
him to the public heart. Third, the kindly blockhead, who discovers
what ought to be done just a little later than the public. These types
do not exist in Russia. The trade unions compel the Russian
politician to be a stark realist, talking frankly, acting on the best
information he can obtain and giving that information fully to his
public. The leaders pictured in this book will seem, therefore, franker
and more direct than the leaders of the western world.
They will also seem more desperate; not because it is their natural
character to be desperate but because they face as desperate a
problem as ever strained the human brain. They have been caught,
from the first, on the horns of the revolutionary dilemma. The same
intolerable breakdown of economic life, which alone makes
revolution possible, also predestines revolution to almost certain
failure. That dull beast, the public, will move to revolution only when
life has become unbearable, only when the established order has
broken down so completely that ruins alone remain. Revolution does
not come before ruin. And to build on ruins a new and fairer life is a
task almost beyond the powers of men. So much of the exhausted
energy of the nation must be consumed in re-establishing the mere
fundamentals of life—food, shelter, clothing and security from fear—
that little remains to attack the task of remoulding life in a shape that
is closer to the heart’s desire. But to this task the leaders of Russia
have dedicated their lives. And if they succeed or if they fail, they will
be remembered always for their courage in following an ideal
through destruction, famine, death and the hatred of the world.
Here, then, they are: the Russians of to-day: close to the Tartar and
the Cossack of the plain, children of serfs and Norsemen and
Mongols—close to the earth and striving for the stars.
Louise Bryant.
LENIN AND HIS SUBORDINATES
NIKOLAI LENIN
CHRISTIAN RAKOVSKY
ABRAHAM KRASNICHAKOV
LEO KAMINEV AND GREGORY ZINOVIEV
PETER STOOTCHKA
ALIEXIEV IVANOVITCH RYKOV
LENIN
 LENIN AND HIS SUBORDINATES
NIKOLAI LENIN
Lenin became an active revolutionist through the spiritual motives
that have moved all great reformers—not because he himself was
hungry and an outcast, but because he could not stand by unmoved
in a world where other men were hungry and outcast. Such
characters are predestined internationalists; the very quality that lifts
them above materialism places them above borders and points of
geography; they strive for the universal good. Lenin believes that the
only thing worth living for is the next generation. Communism is his
formula for saving the next generation from the injustices and
inequalities of the present.
When I think of Lenin and his place in the Russian revolution I am
reminded of a statue which, until the late Fall of the year 1918,
adorned the busy square before the entrance to the Nikoliavski
station in Petrograd. It represented one of the former rulers of Russia
astride a huge stallion. One could not fail to be struck by the
tremendous strength of the animal and the frailty of the rider. The
contrast was intentional; the titled sculptor meant to warn his
sovereign of the dangers threatening the throne. Russia was the wild
horse, fierce, untamed, powerful, a force as yet unaroused but which
might wake up any moment and cast off its royal burden.
When Lenin took the reins of state, he was in exactly the same
position as a man riding a runaway horse. The utmost his
constituents could have expected was that he would guide Russia
away from complete destruction. They could hold him responsible for
immediate situations but not for ultimate results. To what goal those
vast urges and desires which caused the revolution would carry
Russia, was beyond him or any man to command. His heart and his
mind wished to direct it toward the crimson portals of socialism.
Russia, however, in its stampede seems to have slowed up
dangerously near the old, familiar gates of capitalism. Nevertheless,
she will never be the same; Lenin is responsible for it that Russia
has forever gained the larger fruits of the revolution.
Legends spring up around every famous man, manufactured largely
by his enemies, who spread tales of his lavish extravagance, his
vices, his affairs with women. It is important to know such facts about
a man’s life. His personal relationships mean a great deal; if he fails
in these, he eventually fails in all ways. The life of the leader of a
great world movement must harmonize with his doctrines; his
conduct must be as austere or as lax as his doctrines dictate. That is
why we have a natural antipathy to dissolute priests and none at all
to dissolute poets and Bacchanalians. So it is worthy of note that
even the narrowest moralist could not pick a flaw in Lenin’s personal
conduct I am convinced that if he had lived in any other way than he
has, he could not have maintained his remarkable poise.
Whatever inward storms arose he was impressive because of his
outward serenity, because of his calm, majestic as a Chinese
Buddha’s. Without any fuss he took power, faced world opposition,
civil war, disease, defeat and even success. Without fuss he retired
for a space, and without fuss he has returned again. His quiet
authoritativeness inspired more confidence than could any amount of
pomp. I know of no character in history capable, as he was through
such distressing days, of such complete, aristocratic composure.
Every normal man is pushed forward or back to some degree by
women. It is my theory that Lenin’s amazing stability was
substantially strengthened by the women who meant most to him.
Those women were: his mother, his wife, his sister and his lifelong
friend and, in late years, chief secretary, Fotiva.
During all the years since the Bolshevik uprising, Fotiva has been his
assistant. On days when he was ill or away in the country she
actually had charge of the office. She is a highly efficient woman of
forty, tall, dark, healthy and full of enthusiasm. She is quiet, also, and
cheerful, and creates a pleasant atmosphere about her.
Lenin’s office, with Fotiva managing all the under-secretaries, is an
agreeable office to enter. You never feel like an intruder, nor, at the
same time, that it is a place to loaf in, which means that she knows
how to preserve a happy balance. In all one’s dealings with Fotiva,
one finds her a woman of her word. She has the very un-Russian
quality of always being on time for appointments and never going
back on her promises. She is a Communist of old standing and
occasionally contributes articles to newspapers and magazines.
As for Madame Lenin, no one could be disturbed in her presence.
How different the state of the Soviet Premier’s temper might have
been on occasions were his wife the sort of woman who would weep
because her apartment in the Kremlin was small, or would quarrel
with the other Commissars’ wives, or would be jealous of Fotiva. The
truth is, she admires Fotiva and is entirely glad of her existence.
Madame Lenin, whose real name is Nadezhda Konstantinova
Krupskaya Ulianova, acted for many years as Lenin’s secretary. Only
ill health prevented her from continuing the work.
When Lenin was editor of Iskra in Switzerland, she was the secretary
of the whole Iskra organization, which not only had charge of
publishing a newspaper but carried on vast party activities. All the
correspondence was in her hands. At one time she was in
communication with every revolutionist in Russia.
That is one reason why she is so well known from one end of the
country to the other and why people still continue to call her by her
revolutionary name.
Under the Tsar, Lenin was twice exiled and Krupskaya always
shared his fate. Together they passed hard years in Switzerland,
England and especially Paris, where for two years Lenin spent
almost his entire time studying in the national library. His only means
of existence was by his writings, and he wrote solely for and about
the revolution—by no means a remunerative occupation. The entire
period of exile extended over ten long years. In that time the Lenins
never knew a day of ease or luxury. They had become accustomed
to privations long before the revolution, had lived in the meanest
quarters of every city they visited, occupying, as a rule, only one
room, where they ate, slept, studied and carried on their
revolutionary work.
It does not seem mere romance to infer that Krupskaya has had a
good deal to do with keeping Lenin’s nerves steady.
There were moments when Trotsky lost his head, when the
Extraordinary Commission gave way to doubts, when Tchicherin
hesitated—but never Lenin. Without doubt the secret of his power is
that he is the only man in Russia, of any political group, whose
purpose always remained clear and whose hand never trembled.
He made all manner of blunders. That he was able to admit his
mistakes emphasizes his quality of mind. It is a scientific mind: a
mind so well disciplined that he is able to face every fact, failure as
well as success. Moreover, he has a way of grasping a situation
almost by instinct; at least he grasps it at a stroke.
Nikolai Lenin strives for two great things—to westernize Russia and
to keep alive the fountainhead of the Socialist State.
He told me that he did not want to grant a single foreign concession,
whether a factory, a mine or a forest concession, unless he could
establish a similar Russian institution alongside of it so that the
Russians might continually see before their eyes the superiority of
the American or the English way of doing things.
He is more interested in America than in any other country.
I remember one afternoon just before I went up to interview him, an
official in the Foreign Office told me that if America did not hurry and
start trade negotiations with Russia, Russia would be forced to make
a trade alliance with Japan. I mentioned this to Lenin and he said:
“Nonsense! Even if we could trust Japan, which we cannot, what
could she give us? We need thousands of tractors, railway engines,
cars, things like that. We must get such things from America, we
must make friends with America.”
I think he feels in closer contact with the United States, too, because
of the number of former exiles who once fled to our shores and who
returned after the revolution and now hold office under the Soviet
Government. He likes the way they have been trained here.
It has given him the idea of working concessions in the manner I
have described. He also feels gratitude toward Raymond Robins and
always asks about him, considers William C. Bullitt a man of honor,
while John Reed was as near to his heart as was ever any Russian.
He is continually reading American papers, books and magazines.
When I came home I sent him the “Mirrors of Washington,” and I
know how he will chuckle over it as he used to chuckle over William
Hard’s articles in the New Republic.
He admires American energy so much that he comes very near
understanding an American reporter’s need for on-the-minute news,
which no other Soviet official appreciates, except Trotsky.
I will never forget the day during the blackest time of the blockade
when I went to Lenin and asked permission to go to the Middle East
after the Foreign Office had flatly refused me this permission. He
simply looked up from his work and smiled.
“I am glad to see there is someone in Russia,” he said, “with enough
energy to go exploring. You might get killed down there, but you will
have the most remarkable experience of your life; it is worth taking
chances for.”
In two days I was on my way, with every necessary probsk to ride on
any train or stop in any government hotel. I carried a personal letter
from Lenin and had two soldiers for escort! Any other official in
Russia would have considered me an infernal nuisance even to
suggest such an adventure in the middle of a revolution.
Lenin has always stood for allowing political enemies to leave
Russia. This shows an unexpected softness in his make-up which
only those who know him well comprehend.
Naturally, the Cheka disagrees with him on this point, holding that
when these people “succeed in getting out of Russia” they are just
as much a part of the war on Russia as the White Army is.
The explanation is that Lenin has by no means a forbidding
personality: revenge never occupies his mind. He will flay an
opponent in a debate and walk out of the hall arm-in-arm with him.
He is extraordinarily human and good-natured and wishes to see
everyone happy.
In the beginning of the revolution he imagined that he could maintain
a free press, free speech and be liberal toward his enemies. But he
found himself faced by a situation where iron discipline was the only
method capable of saving the day.
There were times when he rather ruthlessly suppressed the
Anarchists, but only because they threatened violence at every step.
The supreme test of his power to forgive came during the Social
Revolutionary trial, which took place in the summer of this year. He
was lying ill in the country from the effects of an operation to remove
an assassin’s bullet from his neck. The people responsible for the
bullet were duly sentenced to death after a long and illuminating trial,
in which the absolute evidence of their guilt was established. It was
through the irrepressible influence of Lenin that their sentences were
all commuted.
Lenin never scorns a deep affection or a personal sentiment. At the
time of Kropotkin’s death, the widow and daughter sent a telegram to
Lenin asking that the Anarchist leaders then imprisoned in Moscow
be allowed to attend the funeral. Lenin let them go “on their honor”
without guards for three days.
The Cheka objected, the Foreign Office objected and the Moscow
Soviet objected, but Lenin’s will, as usual, prevailed. This generosity
toward his enemies costs Lenin nothing and helps him to maintain
his astonishing equilibrium.
Every man in Lenin’s cabinet, with the exception of Trotsky and
Tchicherin, has been working with him for over twenty years; they