Ethical Issues Are Now Just as Much

Ethical issues are now just as much of a concern as they were thirty years or more ago. (Qian, Gao, Yao & Rodriguez) Ethics are a clear set of principles dealing with what is considered appropriate behavior in-group and individual counseling. These standards were created not only to protect clients, but also to protect counselors. As a counselor, a fine line can easily be crossed if the counselor and/or the client do not follow and understand basic rules that are in place regarding ethical interactions between clients and counselors. It is evident that no matter what area of counseling one chooses to go into, there are always concerns and issues with ethical boundaries, and what is and is not acceptable. (Justice & Garland) Every Human interaction involves the interpretation of roles and interpersonal boundaries. These roles dictate what behavior is appropriate and inappropriate professionally and personally. In the current essay, I will discuss two areas of ethical concern that are pertinent to me. The two areas that will be discussed relate to ethical issues with dual relationships with clients, and confidentiality. This essay consists of a review of pertinent articles that address these issues in an attempt to give insight into these issues as well as effective ways of dealing with them.

Calley reiterates that professional ethics are beliefs about behavior and conduct that guide professional practices. In the counseling profession, ethical standards are required to protect clients, guide professional behavior, ensure the autonomy of professionals, increase the status of the profession, enhance the client's and the community's trust in the profession, and articulate collegial conduct between professionals. Ethical codes provide a framework for interpreting specific forms of conduct to regulate the ethical behaviors of the membership of professional organizations, thereby providing guidance to the profession. Furthermore, as individuals commit to upholding ethical standards of practice as a requirement for membership in professional organizations, ethical codes serve as a binding force for the profession, uniting professionals around appropriate conduct.

Ethical decision-making is an ongoing process reports Moleski & Kiselica in their research. The article goes on to discuss that there are no easy shortcut when dealing with ethics and clients. There is a constant need to balance one's life experiences and values with professional codes of ethics. This further affirms that counselors need to have a firm grasp on ethical codes and the consequences that come along with not following them closely. Full knowledge allows a counselor to be able to set clear and concise boundaries. The article does explain that though guidelines are given, perfect answers are not provided for the proper behavior in every situation that a counselor may face. Therefore, sound judgment is necessary to insure the proper handling of each situation. The researchers further reiterate that some of the most challenging ethical issues stem from dual relationships. (Kocet) A code of ethics for most professional organizations is designed to articulate the standards of practice for a group of people. This article explains that a code of ethics is a way to express the collective values of a profession. This code of ethics is also seen as a living document that can assist an individual to know proper protocol and procedures.

There are two central components of a code of ethics for counselors (Kocet): First, a code outlines the prescribed or mandatory professional behaviors by which counselors are expected to govern their conduct, and, second, a code contains aspirational components, which encourage active ethical reflection that fosters clarification of the fundamental ethical beliefs of the profession. No code of ethics can encompass every potential ethical dilemma faced by a professional; however, a code of ethics can serve as a blueprint for laying the foundation necessary to promote the competency and efficacy of counselors. The Code is revised approximately every 7 to 10 years and provides an opportunity for the counseling profession to examine current practices and issues faced by professionals in the roles and settings in which counselors most frequently work (such as mental health agencies, schools, research, clinical practice, supervision, and counselor education). A central focus of the professional code of ethics is to help guide professional practice with clients, students, supervisees, colleagues, and research participants. A code of ethics is designed to protect the well-being of those served by counselors, as well as to advance the work of the profession.

(Younggren & Gottlieb) Professional practice abounds with the potential for multiple relationships, and the circumstances under which these types of relationships occur are quite varied. Although psychologists frequently choose to enter into these types of relationship, many may actually be unavoidable, and in some situations, one can even conceptualize the avoidance of the dual relationship not only as unethical but also as potentially destructive to treatment itself. To avoid all contact with patients in this situation would require the practitioner to lead the life of a virtual hermit. To make matters worse, this type of unusual conduct could raise questions in the minds of other members of the community as to why the practitioner acts in such a manner. A socially isolated practitioner will attract few patients and arguably will serve them less well by failing to integrate himself or herself into the community. Such examples have forced the profession to accept the logical position that not all multiple relationships are unethical per se.

In one of the first articles, that I read it was best explained by saying that, (Shiau) dual relationships are complex and common issues found in the counseling profession. These issues will be experienced regardless of the role that one plays in the counseling field i.e. counseling, educator, supervisor, and practitioners. (Justice & Garland) Social workers also struggle on a regular basis with what is and is not ethical with clients. Regardless, at some point in your career, this inevitable situation will come about and has to be handled accordingly. Researchers continue to express that ethical issues that encircle dual relationships have continued to generate controversy, and are of considerable concern for those counselors in the mental health field (Hollander, Bauer, Herlihy & McCollum). These dual relationships are a violation of the therapeutic boundaries, and consist of a counselor having a relationship with a client outside of the counseling that is being sought after. Counselors, have an obligation to avoid dual relationships, these dual relationships can impair the professional judgment of the counselor, and may be detrimental to the mental well-being of the client.

(Moleski & Kiselica) Dual relationships occur anytime a counselor blends professional and non-professional relationships with a client. The research indicates that usually when there are multiple relationships between a counselor and client, the additional relationship is classified either as sexual or non-sexual. Sexual dual relationships are viewed as abusive; these relationships can be obvious i.e. sexual contact, kissing etc. Or less obvious i.e. sexual gazes and seductiveness. Dual relationships can come about in two ways: by choice and by chance. When dual relationships are formed because of a conscious choice made by the counselor, he or she must examine the potential positive and negative consequences that the secondary relationship might have for the primary counseling relationship. The counselor should choose to enter into the dual relationship only when it is clear that such a relationship is in the client's best interests. However, in some circumstances, the counselor has little choice about engaging in a dual relationship.

Calley discusses that much of the counseling literature has provided a foundation upon which to teach and assist those entering the field to acquire an understanding of ethics. However, application of ethics has been largely limited to general counseling practice rather than to working with specific populations within specific public systems. Additionally, there is little literature that directly addresses making ethical standards explicit in specific counseling practices, such as the child welfare and the criminal justice systems. As counselor may find himself or herself working in a continuously expanding range of work settings, challenges related to the application of specific standards of the Code (ACA, 2005) may increase; therefore, tools that promote a more focused contextual understanding of ethics are needed.

Hollander, Bauer, Herlihy & McCollum conducted research that focused on dual relationships and substance abuse counselors. The research begins by explaining that data suggests that substance abuse counselors are the most at risk and are most often faced with the ethical issue of dual relationships. In the study conducted a random sampling of Board Certified Counselors (BCSACs) throughout 31 states that responded to a request regarding ethical criteria and adherence. 387 surveys were returned and utilized in this study; A demographic questionnaire and a survey "The multiple Relationship Survey for Substance Abuse Counselors (MRSSAC). The questionnaire was given to all participants in an attempt to gather information regarding their beliefs and multiple relationships. Validity of the questionnaire was examined through content and construct validity, this was determined through a review conducted by three experts in substance abuse counseling.

Results of the research (Hollander, Bauer, Herlihy & McCollum) indicated that educations played a role in how inappropriate a counselor felt dual relationships were. Those with graduate degrees reported that dual relationships were problematic, where those with less education did not see these relationships as problematic. Secondly, those counselors that were in recovery saw less issues as problematic ethically than those counselors that were not in recovery. The results indicated that individuals who were currently receiving supervision would find multiple relationship behaviors more problematic than those who were not receiving current supervision suggests that continued supervision may be beneficial for substance abuse counselors.

These findings have implications for mental health counselors. Because substance abuse counseling is a specialization within the broader field, mental health counselors in a variety of settings may work closely with substance abuse counselors as colleagues or fellow members of treatment teams, and may provide them with administrative or clinical supervision. Mental health counselors who are in supervisory or administrative roles can provide opportunities for the counselors in their workplaces to discuss multiple relationships, thus modeling the necessity for thoughtful consideration regarding ethical dilemmas in the workplace. Encouraging practitioners to explore personal issues could be particularly beneficial for employees who are recovering substance abuse counselors and, thus, may have issues similar to those of their clientele. Previous research has emphasized differences among recovering and non-recovering substance abuse counselors (Hollander, Bauer, Herlihy & McCollum).

Justice & Garland make a distinction in their research between what is considered boundary crossing and a violation. It is explained that it can often be unavoidable to not cross boundaries; an example of this in the text discusses a congregational setting as such a boundary crossing. It is however stated that these boundary crossings can easily shift to a violation if not watched carefully. If the client seeks out to have an intimate relationship with the counselor, or even goes beyond to try to have a more personal relationship with the counselor. This relationship or attempt is considered a violation. As stated previously these boundary crossing can be rather problematic, even more in communities were interaction outside of the therapeutic environment is nearly impossible. The research goes further to express that these boundary crossing are often never easily fixed.

Sexual dual relationships appear to be the most destructive dual relationship issues with counselors and patients. Moleski & Kiselica reported that out of over four thousand mental health professionals asked their opinions on which dual relationships they felt were most destructive, ninety-eight percent replied that they believed that sexual activity with a client before termination of therapy was the most destructive. In the studies utilized in the researcher's article it is reported that 12% of male counselors reported having a sexual relationship with their clients, 3% of women claimed to have sexual relationships with current clients. The tragic cost for the patient of such a relationship may include cognitive dysfunction, sexual confusion, ambivalence, suppressed rage, guilt, depression, psychosomatic disorders, and risk of suicide. Sexual relations with former clients do not elicit the same unanimous concern from professionals in the mental health field.

(Erwin) In his research, he discusses that there are four major determinants of moral behavior; there is moral sensitivity, moral judgment, moral motivation, and moral character. Moral sensitivity is the acknowledgment that your behavior can negatively affect others and can be a violation of moral principles. Moral judgment is an individual's determination of which actions are just. Moral motivation refers to an individual's decision either to attend to the moral action or to ignore it for the pursuit of other matters. Moral character refers to one's ability to implement a moral action. The moral sensitivity of counselor supervisors is the focus of the current investigation.

Confidentiality too can be an ethical issue for counselors. (Aoyagi & Portenga) discussed in their writing that Confidentiality could often be misconstrued. It is explained, that clients need to be informed clearly what they can expect to be private information, and what information may be shared with a third party. In sport & Performance Psychology (SPP), this is often an area of issue, since it is the job of the SPP to inform coaches etc. Of the well being and ability of an athlete. One way to insure that there is no room for miss understanding is to; proactively discuss potential confidentiality concerns and how they can be handled between the parties before the issues ever arises.

(Bodenhorn) All professional counselors are required to abide by the ethical standards of their particular professional organization. In the case of school counselors, this adherence is to the American School Counselor Association ethical standards (ASCA, 2004). Ethical standards are established as a guideline to use and refer to in situations that create dilemmas, defined as "problems for which no choice seems completely satisfactory, since there are good, but contradictory reasons to take conflicting and incompatible courses of action." According to the research that Bodenhorn conducted, solutions to Ethical Problems in Schools model was proposed, referring to the ethical code is one of the first steps. This is then followed by, if necessary, considering the students' chronological and developmental levels; considering the setting, parental rights, and minors' rights; applying moral principles of autonomy, beneficence, non-malfeasance, justice, and loyalty; determining potential courses of action and their consequences; evaluating the selected actions; consulting; and implementing the chosen course of action. Currently, little empirical evidence is available on the ethical dilemmas faced by school counselors.

(Ward) This research indicated that in the beginning stages of professional education, social workers are taught to recognize clients' right, as well as basic social work values and ethics. When this topic is discussed, in the literature, the fact that confidentiality is important and that it will come up as being a top priority; the article first defines confidentiality as a principle of ethics according to which the social worker or other professionals may not disclose information without the consent of the client. The information that is included in this confidentiality includes the identity of the client, professional opinions about the client, and materials from the client's records. The Social Work Code of Ethics incorporated the concept of confidentiality as one of its initial standards in the first Code of Ethics. The Code of Ethics also addresses two other areas of confidentiality. The first is with colleagues, and the importance of keeping information shared within the context of the professional relationship confidential and respected. The second is in the area of conducting research; participants must have the assurance of not only confidentiality but anonymity, as well.

Did you know that there exceptions to confidentiality? These exceptions as indicated in research can be the cause for confusion on the part of the client, as well as a possible cause of their ethical lines being crossed unintentionally. (Ward) There are times in the course of the client-worker relationship that the client may voluntarily rescind confidentiality. There are other times where confidentiality is not legally binding on the social worker. These circumstances relate to safety of the client or others. Some social workers may never experience a situation were the need to breach confidentiality occurs; others may face this situation on a regular basis. Important issues related to confidentiality include client consent, duty to warn, and privileged communication. Neukrug & Milliken discuss that what can be a problem is that what is considered ethical one year may not be considered ethical the next. Ethical codes are constantly changing to coincide with the changing values of society. Making good ethical decisions is dependent on knowledge of one's code, familiarity with models of ethical decision-making, the cognitive complexity of the counselor, and knowledge of problematic ethical situations.

(Lazovsky) This article focuses on a discussion of confidentiality in Israeli school counselors' professional judgments regarding the decision to maintain or breach confidentiality in an array of school counseling situations. School counselors in Israel are required to have a graduate degree in order to receive a counseling license, and their work, as well as their ethical standards, is quite similar to that of their colleagues in the United States. The literature shows that dilemmas that school counselors must confront in different countries are similar studies regarding student confidentiality issues with minors have been reported in the articles as well. There is minimal empirical evidence available on the ways school counselors actually make decisions about ethical dilemmas involving confidentiality issues. Therefore, this study can be pertinent to school counselors in different parts of the world, by providing additional empirical data that might assist counselors in the ethical reasoning process needed for resolving dilemmas, thus enlarging the body of knowledge from an international perspective as well as enhancing cross-cultural feedback and collaboration.

Truth is there is no cure all in relation to confidentiality. Ward best put it in the article when he explained that, most social workers will confront the issue of substance abuse and addiction in the scope of their practice. Applying the standard confidentiality rules for basic social work practice is not adequate or acceptable when working with substance abusing clients and may well cause legal and ethical difficulties. Social workers need to be aware of the narrower scope of confidentiality within the substance abuse field. A good guide for all clinical situations is to use the Federal Confidentiality Regulation of Substance Abuse. While many social workers who work primarily with substance abusing clients may be familiar with the Federal confidentiality laws, not all agencies who receive Federal funding and the social workers who provide services for the agencies are aware of their legal obligations. Education regarding the Federal confidentiality law on substance abuse is essential for the social workers who are providing substance abuse counseling regardless of their employment setting.

Balancing confidentiality (Lazovsky) and the duty to warn and to protect in case of danger to self or others is also a challenging ethical and legal issue. Given that in many situations, it is not clear whether there is imminent danger, school counselors must judge if there are circumstances that justify breaching confidentiality. Yet studies indicate that counselors may vary considerably in their perceptions of danger and in their justifications for breaching confidentiality. In the ethical dilemmas related to confidentiality presented in the study discussed by Lazovsky in his research, there was less than 50% agreement among school counselors regarding the correct ethical or legal choice. Another complex issue is sharing information with educators who can be of assistance to students. It is not easy for counselors to find the right path between disclosing only minimal and necessary information and upholding confidentiality, because a culture of open communication regarding student information is quite common among educators in school settings. Counselors are required to be accountable to principals, and in addition, counselors often serve as consultants to other educators.