Ethical Issues

in Counseling Practice
GSMAP108 PSYCHOLOGICAL COUNSELING AND PSYCHOTHERAPY
 As counselors we cannot always keep our personal needs
completely separate from our relationships with clients.
Ethically, it is essential that we become aware of our own
needs, areas of unfinished business, potential personal
problems, and especially our sources of
countertransference.
Our professional relationships with our clients exist for

Putting Clients’ their benefit.

A useful question to frequently ask yourself is this:

Needs Before
“Whose needs are being met in this relationship, my client’s
or my own?”
It is not unethical for us to meet our personal needs

Your Own
through our professional work, but it is essential that
these needs be kept in perspective.
An ethical problem exists when we meet our needs, in
either obvious or subtle ways, at the expense of our
clients’ needs. It is crucial that we avoid exploiting or
harming clients.
As helping professionals, we must actively work toward
expanding our self-awareness and learn to recognize our
areas of prejudice and vulnerability.
We must also examine other, less obviously harmful personal needs that
can get in the way of creating growth-producing relationships such as:
the need for control and power
the inordinate need to be nurturing
the need to change others in the direction of our own values
the need for feeling adequate, particularly when it becomes overly
important that the client confirm our competence
the need to be respected and appreciated
 In practice, you will have to apply the ethics codes of your
profession to the many practical problems you face.
Professionals are expected to exercise prudent judgment
when it comes to interpreting and applying ethical
principles to specific situations.
Learn about the resources available to you
Consult with colleagues

Ethical Decision Keep yourself informed about laws affecting your

practice

Making
Keep up to date in your specialty field
Stay abreast of developments in ethical practice
Reflect on the impact your values have on your
practice
Be willing to engage in honest self-examination
You should also be aware of the consequences of
practicing in ways that are not sanctioned by
organizations of which you are a member or the state in
which you are licensed to practice.
 The Role of Ethics Codes as a Catalyst for
Improving Practice

Professional codes of ethics serve a number of purposes:

(1) They educate counselling practitioners and the
general public about the responsibilities of the
profession.
(2) They provide a basis for accountability, and

Ethical Decision protect clients from unethical practices.

Ethics codes provide a basis for reflecting on and

Making
improving your professional practice.
Self-monitoring is a better route for professionals to take
than being policed by an outside agency.
It makes sense to be aware of the legal aspects of
practice and to know and practice risk-management
strategies, but we should not lose sight of what is best for
our clients.
One of the best ways to prevent being sued for
malpractice is to demonstrate respect for clients, keep
client welfare as a central concern, and practice within
the framework of professional codes.
Some Steps in Making Ethical Decisions

Identify the problem or dilemma. Gather information that will shed light on the
nature of the problem. This will help you decide whether the problem is mainly
ethical, legal, professional, clinical, or moral.
Identify the potential issues. Evaluate the rights, responsibilities, and welfare of
all those who are involved in the situation.
Look at the relevant ethics codes for general guidance on the matter. Consider
whether your own values and ethics are consistent with or in conflict with the
relevant guidelines.
Consider the applicable laws and regulations, and determine how they may have a
bearing on an ethical dilemma.
Seek consultation from more than one source to obtain various perspectives on
the dilemma, and document in the client’s record the suggestions you received
from this consultation.
Brainstorm various possible courses of action. Continue discussing options with
other professionals. Include the client in this process of considering options for
action. Again, document the nature of this discussion with your client.
Enumerate the consequences of various decisions, and reflect on the
implications of each course of action for your client.
Decide on what appears to be the best possible course of action. Once the course
of action has been implemented, follow up to evaluate the outcomes and to
determine whether further action is necessary. Document the reasons for the
actions you took as well as your evaluation measures.
Because ethics codes do not make decisions for you, it is a good practice
to demonstrate a willingness to explore various aspects of a problem,
raise questions, discuss ethical concerns with others, and continually
clarify your values and examine your motivations.
To the degree that it is possible, include the client in all phases of the
ethical decision-making process.
It is essential to document how you included your client as well as the
steps you took to ensure ethical practice.
 Regardless of your theoretical framework, informed
consent is an ethical and legal requirement that is an
integral part of the therapeutic process.
It also establishes a basic foundation for creating a

The Right of working alliance and a collaborative partnership between

the client and the therapist.

Informed
Informed consent involves the right of clients to be
informed about their therapy and to make autonomous
decisions pertaining to it.

Consent
By educating your clients about their rights and
responsibilities, you are both empowering them and
building a trusting relationship with them.
It is a positive approach that helps clients become active
partners and true collaborators in their therapy.
Some aspects of the informed consent process include the following:
the general goals of counseling
the responsibilities of the counselor toward the client
the responsibilities of clients
limitations of and exceptions to confidentiality
legal and ethical parameters that could define the relationship
the qualifications and background of the practitioner
the fees involved
the services the client can expect
the approximate length of the therapeutic process.
As a part of the informed consent process, it is wise to discuss the
potential privacy problems of using a wide range of technology and to
take preventive measures to protect both you and your clients.
The challenge of fulfilling the spirit of informed consent is to strike a
balance between giving clients too much information and giving them too
little.
Informed consent in counseling can be provided in written form, orally, or
some combination of both.
 Confidentiality is an ethical concept, and in most states it
is the legal duty of therapists not to disclose information
about a client.
Privileged communication is a legal concept that protects
clients from having their confidential communications
revealed in court without their permission (Herlihy &
Corey, 2015a).

Dimensions of
The legal concept of privileged communication does not
apply to group counseling, couples counseling, family
therapy, child and adolescent therapy, or whenever there

Confidentiality are more than two people in the room.

Confidentiality is central to developing a trusting and
productive client–therapist relationship.
Counselors have an ethical and legal responsibility to
discuss the nature and purpose of confidentiality with
their clients early in the counseling process.
Clients have a right to know that their therapist may be
discussing certain details of the relationship with a
supervisor or a colleague.
 Ethical Concerns with the Use of Technology

Issues pertaining to confidentiality and privacy can

become more complicated when technology is involved.

Exceptions to Confidentiality and Privileged

Communication
Dimensions of In determining when to breach confidentiality, therapists

Confidentiality
must consider the requirements of the law, the institution
in which they work, and the clientele they serve.
Whenever counselors are not clear about their obligations
regarding confidentiality or privileged communication, it
is critical to seek consultation and to document these
discussions.
There is a legal requirement to break confidentiality in
cases involving child abuse, abuse of the elderly, abuse of
dependent adults, and danger to self or others.
Here are some other circumstances in which information must
legally be reported by counselors:
When the therapist believes a client under the age of 16 is
the victim of incest, rape, child abuse, or some other crime.
When the therapist determines that the client needs
hospitalization.
When information is made an issue in a court action.
When clients request that their records be released to them
or to a third party.
The counselor’s primary obligation is to protect client disclosures
as a vital part of the therapeutic relationship. Informing clients
about the limits of confidentiality does not necessarily inhibit
successful counseling.
 Are Current Theories Adequate in Working
With Culturally Diverse Populations?

For traditional theories to be relevant in a multicultural and

diverse society, they must incorporate an interactive
person-in-the-environment focus.

Ethical Issues
It is essential for therapists to create therapeutic strategies
that are congruent with the range of values and behaviors
that are characteristic of a pluralistic society.

From a Is Counseling Culture-Bound?

Multicultural Cultural diversity is a fact of life in our world. To the extent

that counselors are focused on the values of the dominant

Perspective culture and insensitive to variations among groups and

individuals, they are at risk for practicing unethically
(Barnett & Johnson, 2015).
Counselors need to understand and accept clients who have
a different set of assumptions about life, and they need to
be alert to the possibility of imposing their own worldview.
In working with clients from different cultural backgrounds
and life experiences, it is important that counselors resist
making value judgments for them.
 Focusing on Both Individual and
Environmental Factors

A theoretical orientation provides practitioners with a

Ethical Issues map to guide them in a productive direction with their

clients. It is hoped that the theory orients them but does

From a
not control what they attend to in the therapeutic
venture.
Counselors who operate from a multicultural framework

Multicultural
also have certain assumptions and a focus that guides
their practice. They view individuals in the context of the
family and the culture, and their aim is to facilitate social

Perspective action that will lead to change within the client’s

community rather than merely increasing the individual’s
insight.
An adequate theory of counseling does deal with the
social and cultural factors of an individual’s problems.
However, there is something to be said for helping clients
deal with their response to environmental realities.
 The Role of Assessment and Diagnosis in
Counseling

Ethical Issues Assessment and diagnosis are integrally related to the

practice of counseling and psychotherapy, and both
are often viewed as essential for planning treatment.

in the The rationale is that specific counseling goals cannot

be formulated and appropriate treatment strategies

Assessment
cannot be designed until a client’s past and present
functioning is understood.
Regardless of their theoretical orientation, therapists

Process
need to engage in assessment, which is generally an
ongoing part of the therapeutic process.
This assessment may be subject to revision as the
clinician gathers further data during therapy sessions.
Some practitioners consider assessment as a part of
the process that leads to a formal diagnosis.
Assessment Diagnosis
Consists of evaluating the relevant Is sometimes part of the assessment process,
factors in a client’s life to identify themes consists of identifying a specific mental disorder
for further exploration in the counseling based on a pattern of symptoms.
process. Diagnosis may include an explanation of the causes
Both assessment and diagnosis can of the client’s difficulties, an account of how these
be understood as providing direction problems developed over time, a classification of
for the treatment process. any disorders, a specification of preferred
treatment procedure, and an estimate of the
chances for a successful resolution.
The purpose of diagnosis in counseling and
psychotherapy is to identify disruptions in a client’s
present behavior and lifestyle.
A diagnosis provides a working hypothesis that
guides the practitioner in understanding the client.
The therapy sessions provide useful clues about
the nature of the client’s problems. Thus diagnosis
begins with the intake interview and continues
throughout the duration of therapy.
The classic book for guiding practitioners in making diagnostic
assessments is the fifth edition of the American Psychiatric
Association’s (2013) Diagnostic and Statistical Manual of Mental
Disorders (also known as the DSM-5).
Clinicians who work in community mental health agencies, private
practice, and other human service settings are generally expected
to assess client problems within this framework.
This manual advises practitioners that it represents only an initial
step in a comprehensive evaluation and that it is necessary to gain
information about the person being evaluated beyond that required
for a DSM-5 diagnosis.
 Considering Ethnic and Cultural Factors in
Assessment and Diagnosis

A danger of the diagnostic approach is the possible

failure of counselors to consider ethnic and cultural

Ethical Issues factors in certain patterns of behavior.

The DSM-5 emphasizes the importance of being aware of
unintentional bias and keeping an open mind to the

in the presence of distinctive ethnic and cultural patterns that

could influence the diagnostic process.

Assessment
The DSM-5 is based on a medical model of mental illness
that defines problems as residing with the individual
rather than in society. It does not take into account the

Process
political, economic, social, and cultural factors in the
lives of clients, which may play a significant role in the
problems of clients.
Barnett and Johnson (2015) suggest that practitioners
give careful consideration before rendering a diagnosis
and take into consideration the realities of
discrimination, oppression, and racism in society and in
the mental health disciplines.
 Assessment and Diagnosis From Various
Theoretical Perspectives

Ethical Issues The theory from which you operate influences your
thinking about the use of a diagnostic framework in your

in the
therapeutic practice.
The rationale is that specific therapy goals cannot be
designed until a clear picture emerges of the client’s past

Assessment
and present functioning.
In addition, progress, change, improvement, or success
may be difficult to evaluate without an initial assessment.

Process Regardless of the particular theory espoused by a

therapist, both clinical and ethical issues are associated
with the use of assessment procedures and possibly a
diagnosis as part of a treatment plan.
 Evidence-based practice (EBP)
“the integration of the best available research with clinical

Ethical
expertise in the context of patient characteristics, culture,
and preferences”
(APA Presidential Task Force on Evidence-based Practice,

Aspects of
2006, p. 273).
Norcross, Hogan, and Koocher (2008) advocate for
inclusive evidence-based practices that incorporate the

Evidence- three pillars of EBP:

(1) looking for the best available research
(2) relying on clinical expertise

Based Practice (3) taking into consideration the client’s

characteristics, culture, and preferences
The central aim of evidence-based practice is to require
psychotherapists to base their practice on techniques that
have empirical evidence to support their efficacy.
 Dual or multiple relationships, either sexual or nonsexual,
occur when counselors assume two or more roles
simultaneously or sequentially with a client.

Managing
When clinicians blend their professional relationship with
another kind of relationship with a client, ethical concerns
must be considered.

Multiple
Many forms of nonprofessional interactions or nonsexual
multiple relationships pose a challenge to practitioners.
Some examples of nonsexual dual or multiple relationships

Relationships are combining the roles of teacher and therapist or of

supervisor and therapist.
The ACA Code of Ethics (ACA, 2014) makes it clear that

in Counseling counseling professionals must learn how to manage

multiple roles and responsibilities in an ethical way.
Although multiple relationships do carry inherent risks, it is

Practice a mistake to conclude that these relationships are always

unethical and necessarily lead to harm and exploitation.
Some of these relationships can be beneficial to clients if
they are implemented thoughtfully and with integrity (Zur,
2007).
 Perspectives on Multiple Relationships

Herlihy and Corey (2015b) contend that some of the problematic

aspects of engaging in multiple relationships are:
they are pervasive

Managing they can be difficult to recognize

they are unavoidable at times
they are potentially harmful, but not necessarily always

Multiple harmful
they can be beneficial
they are the subject of conflicting advice from various

Relationships experts
Some of the codes of the professional organizations advise against
forming multiple relationships, mainly because of the potential for

in Counseling misusing power, exploiting the client, and impairing objectivity.

When multiple relationships exploit clients, or have significant
potential to harm clients, they are unethical.

Practice The current focus of ethics codes is to remain alert to the

possibilities of harm to clients and to develop safeguard to protect
clients.
It bears repeating that multiple relationship issues cannot be
resolved with ethics codes alone; counselors must think through all
of the ethical and clinical dimensions involved in a wide range of
boundary concerns.
 Ways of Minimizing Risk

In determining whether to proceed with a multiple

Managing relationship, it is critical to consider whether the potential

benefit to the client of such a relationship outweighs its

Multiple
potential harm.
Herlihy and Corey (2015b) identify the following guidelines:
Set healthy boundaries early in the therapeutic

Relationships
relationship. Informed consent is essential from the
beginning and throughout the therapy process.
Involve clients in ongoing discussions and in the

in Counseling decision-making process, and document your

discussions. Discuss with your clients what you
expect of them and what they can expect of you.

Practice Consult with fellow professionals as a way to

maintain objectivity and identify unanticipated
difficulties. Realize that you don’t need to make a
decision alone.
 When multiple relationships are potentially problematic, or
when the risk for harm is high, it is always wise to work
under supervision. Document the nature of this supervision
and any actions you take in your records.
Self-monitoring is critical throughout the process. Ask
yourself whose needs are being met and examine your
motivations for considering becoming involved in a dual or
multiple relationship.
In working through a multiple relationship concern, it is best to
begin by ascertaining whether such a relationship can be avoided.
Sometimes nonprofessional interactions are avoidable and your
involvement would put the client needlessly at risk.
In other cases multiple relationships are unavoidable.
One way of dealing with any potential problems is to adopt a policy
of completely avoiding any kind of nonprofessional interaction.
Another alternative is to deal with each dilemma as it develops,
making full use of informed consent and at the same time seeking
consultation and supervision in dealing with the situation.
 Establishing Personal and Professional
Boundaries

Managing
Establishing and maintaining consistent yet flexible
boundaries is necessary if you are to effectively counsel
clients.

Multiple
Developing appropriate and effective boundaries in your
counseling practice is the first step to learning how to
manage multiple relationships.

Relationships One important aspect of maintaining appropriate

professional boundaries is to recognize boundary
crossings and prevent them from becoming boundary

in Counseling violations.
A boundary crossing is a departure from a commonly
accepted practice that could potentially benefit a client.

Practice Boundary violation is a serious breach that harms the

client and is therefore unethical.
A boundary violation is a boundary crossing that takes the
practitioner out of the professional role, generally
involves exploitation, and results in harm to a client
(Gutheil & Brodsky, 2008).
 Social Media and Boundaries

Facebook and other social media sites raise many ethical

Managing
concerns for counselors regarding boundaries, dual
relationships, confidentiality, and privacy.
One possibility is to set up two distinct Facebook pages,

Multiple one for professional use and the other for personal use.
Spotts-De Lazzer (2012) believes practitioners will have
to translate and maintain traditional ethics when it comes

Relationships to social media and offers these recommendations:

Limit what is shared online

in Counseling
Include clear and thorough social networking
policies as part of the informed consent process
Regularly update protective settings because

Practice
social media providers often change their privacy
rules
As social media use continues to spread, the ACA Code of
Ethics (2014) emphasizes the need for counselors to
develop a social media policy and to include that in their
informed consent discussions.
 Knowing and following your profession’s code of ethics is
part of being an ethical practitioner, but these codes do
not make decisions for you.
As you become involved in counseling, you will find that
interpreting the ethical guidelines of your professional

Becoming an
organization and applying them to particular situations
demand the utmost ethical sensitivity.
In your professional work you will deal with questions that

Ethical do not always have obvious answers. You will have to

assume responsibility for deciding how to act in ways that
will further the best interests of your clients.

Counselor Throughout your professional life, seek consultation from

trusted colleagues and supervisors whenever you face an
ethical dilemma.
Ethical decision making is an evolutionary process that
requires you to be continually open and self-reflective.
Becoming an ethical practitioner is not a final destination
but a journey that will continue throughout your career.
 Source
Corey, G. (2017). Theory and Practice of Counseling and Psychotherapy (10th edition). United States of

America: Cengage Learning.