In this paper I will discuss Counselor Ethics and Responsibilities; to include my own personal thoughts and values concerning abortion and extramarital affairs and how I would personally provide ethical counseling to a client’s struggling with abortion and or extramarital affair issues. Next I will discuss client’s right to autonomy, nonmaleficence, beneficence, justice and fidelity in ethical counseling. Then I will cover the factors that must be considered in “duty to warn” and also “duty to protect” obligations as a counselor. Finally, I will discuss client record keeping; a client’s right to a professional standard of care, and counselor liability.
From my own personal experience and beliefs, abortion is wrong with few exceptions. My personal belief is that if a female is raped or there is danger to the mother abortion is acceptable to me. What I mean by acceptable is that it creates dissonance with my current operating beliefs of abortion being wrong to take the life of an unborn fetus. I have a 16 year old daughter whom was gang raped which resulted in a pregnancy not at the will or choice of my daughter. My belief says no abortion, but my rational side asks many questions like; is the mother ready to care for a child? Can she physically and monetarily care for a child? How will this affect her life in the long run? What about school? Are the any issues that might arise if the mother carries to full term? Am I ready in every fashion to become a grandparent? To me each answer was no and my daughter continued and had the abortion.
In an article by Wagaman (2013), he point s out that Americans today are more tolerant to premature sex, divorce and gay relationships which was once considered taboo. He continues by saying “but there’s one exception: We condemn adultery like it is 1642.” (WAGAMAN, 2013) I follow suite and believe if you marry another person that is the one person you have devoted yourself to and should at any cost stick by their side no matter what and an extramarital affair is a deal breaker. I ask myself why I should punish my partner by going outside of the marriage seeking the puzzle piece that is missing, when my wife has already given me the key to her heart. In society today people have more control and freedom to explore premature sex and entering and leaving a relationship or marriage. But, with all this freedom and control there comes accountability and lying is the one vice most consider wrong. (WAGAMAN, 2013)
Describe how you would counsel the client in each situation. In counseling a client in both cases of abortion and extramarital affairs I quote the ACA (2014) section A; A.1.a, Primary Responsibility, “The primary responsibility of counselors is to respect the dignity and promote the welfare of clients.” It is not uncommon for the counselor and client to have different values and beliefs at all. (2014 ACA Code of Ethics, 2014) First off, I will have to step back and look at my own personal area or areas of expertise. According to the NBCC Code of Ethics (2012), “NCCs (Nationally Certified Counselor’s) shall perform only those professional services for which they are qualified by education and supervised experience (NATIONAL BOARD FOR CERTIFIED COUNSELORS (NBCC), 2012) .”
Addiction specialist shall seek out new/effective approaches which enhance their professional abilities such as; continuing education research and activities with professional in different disciplines. (The Association for Addiction Professionals, 2013) Some client’s many have already dealt with an abortion or affair and may be seemingly ok, but not in-line with my values. As the primary counselor in these cases it is my responsibility to avoid causing harm or imposing my values on to my client.
As a counselor I must act accordingly to avoid harming my client or abate or remedy unavoidable or unforeseen harm. Counselors must be aware of their own values, attitudes, beliefs and behaviors and avoid imposing them on their client. For example, if I’m opposed to both abortion and affairs these are my own personal beliefs and not those of the client. My client may have had an affair and became pregnant by someone other than their partner and had an abortion to hide it from their significant other. So if I were to voice my values to my client this could cause harm to the counselor-client relationship where the client shuts down and it causes irreversible damage due to me imposing my own values on my client. According to the NBCC (2012), from the point of view of an addiction counselor, the professional counselor refrains from using methods which seems coercive like threats, negative labeling or any means which causes shame or humiliation. In the case of abortion or having an affair, either could provoke shame and humiliation in the client based on counselor vs client values.
Incorporating autonomy in its simplest form is supporting the clients’ right to make their own decisions and addresses the concept of independence. In order to support a clients’ autonomy, this means not imposing goals, agendas or values on a client. As a counselor I must understand, embrace and work with the client’s experiences; culturally, socioeconomically, this is supported in counseling through person centered style of counseling and communication. (Ryan, 2011)
Incorporating nonmaleficence is supported by the number one rule in counseling, the concept of causing no harm to others our clients. This practice is tied with a clients’ autonomy and their right to independence and making their own choices. Implementing this means living by the laws of your state and follow the ACA, NAADAC or NBCC codes of ethics. (Davis, 1996)
Beneficence is simply doing what is good for the client, this is the counselors’ responsibility to be proactive and contribute to the overall health and welfare of their client’s. This means doing treatment planning with the client and listening to the clients’ input in the planning process. (Ryan, 2011)
According to Kitchner (1984), Justice is not doing what is right for the client, but treating equals equally and unequals unequally. This means identify such things as ethnic background, socioenomic background, race and numerous others. (Kitchner, 1984)
Incorporating fidelity is me being loyal to my client, because clients’ must must have faith and trust in their counselor in the therapeutic relationship in order for growth to occur. This means being faithful and meeting obligations and commitments and not leaving with of these unfulfilled. (Ryan, 2011) Discuss the informed consent process and how it protects client rights including: Informed consent is an on-going process throughout the counseling process; it lets the client know that first they have the freedom to engage in or decline entrance into a therapeutic relationship and gives them sufficient information concerning the theraputic process and the therapist.
Informed consent is an obligation placed on the counselor, which is reviewed both written and orally explaining the rights and responsibilities of the counselor as well as the client. Therapists explain to their clients the nature of all services, goals, purposes, techniques, limits, procedures, benefits and potential risk of services; counselor credentials and qualifications, relevant experience and counseling approach. Counselor explain fee and billing arrangements including non-payment of fees. Clients also receive rights and limits of confidentiality, information concerning records, refusal of services and consequences of refusal. (Gerald Corey, 2104)
When creating costs for counseling services, the counselor should take consideration the client’s locality and financial status so that the normal fees do not create an undue hardship on the client. Counselor may assist clients in finding comparable and affordable services or adjust fees when legally permissible.
Right to Privacy
As a counselor, each and every client has a right to privacy whether a prospective or existing client. Therapists only request confidential information from clients when it is determined advantageous to the therapeutic process. Counselor protect the privacy of clients and only disclose information with consent to release information or with sound legal/ethical confirmation. At the initiation and throughout the therapeutic process counselors inform clients of confidentiality limitations and identify situations situation in which confidentiality must be broken; such as when disclosure is required to protect clients or keep others from serious foreseeable harm or when legal requirements require release. HIPPA compliance and Compliance with credentialing board requirements for incorporating informed consent into practice
As a professional counselor we are bound by HIPPA to provide documentation to potential clients how the practice and you will handle the release of confidential information. This document describes how mental/medical information about you may be disclosed and used and how the client may get access to this information. This document must have a compliance date on it and includes information pertaining to; treatment, health care operations, payment and other disclosures and uses without the clients consent. (Association, Meeting HIPAA Requirements, Notice of Privacy Practices and Client Rights Document, 2014)
Responsibility to Warn and Protect
Duty to warm and protect refers to the responsibility of the therapist or counselor to breach confidentiality if a client or other identifiable person or persons are in clear imminent danger. When duty to warn and protect come into play there must be clear evidence of imminent danger to the client or other persons, then the therapist/counselor must determine the seriousness of the threat and then must notify the person in danger and other persons in a position to protect that person from harm.
The best possible example is the Tarasoff Act, which imposed inherent duty on therapist/counselors to warn potential victims of intended harm by a client, stating confidentiality ends where danger begins. The implications of the Tarasoff Act indicate that only notifying the police is not sufficient action to protect the therapist/counselor from a lawsuit if the client threatens to carry the threat out. (University, 2014) Client Record-Keeping/the counselor from liability
A client’s right to a professional standard of care
Documentation in a client’s record serves many purposes including; clinical/ administrative accountability, and documentation of the counselor’s protection of the clients’ rights. This documentation also provides protection for counselors in helping them refute any and all allegations of incompetence or misconduct by the counselor. A counselors’ responsibility to protect the clients rights is normally documented in a series of forms signed by the client to include; informed/parental consent, fee agreements, treatment forms, treatment plans, signed client rights statement and treatment team staffing notes, and release of information protecting the client’s privacy with specific parameters. Finally, documentation in a client’s record can be used to protect and defend the therapist/counselor from unwarranted allegations of misconduct.
A client record containing a thorough assessment, treatment plan, progress notes consistent with the plan, supervisory notes, billing for services rendered, and documented clients rights represent sound evidence of the counselor’s efforts to practice within their professional scope and standard of care. (University, 2014) In conclusion, the ethical responsibilities of a counselor are both broad and complex. This paper describes and discusses many of the aspect that are at the forefront of client/counselor relationship and protection of rights for both counselor and client. The knowledge required to become an ethical counselor comes with time and practice along with consulting colleges and primary supervision.
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http://www.counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2 NAADAC. (2013). The Association for Addiction Professionals. Retrieved from NAADAC.org: http://www.naadac.org/code-of-ethics#i Ryan, R. M. (2011). Motivation and Autonomy in Counseling. The Counseling Psychologist, 193-260. University, G. C. (2014, November 18). Lecture 4. Retrieved from gcu.edu: https://lc-grad2.gcu.edu/learningPlatform/user/users.html?operation=loggedIn#/learningPlatform/loudBooks/loudbooks.html?viewPage=current&operation=innerPage¤tTopicname=Client Rights, Counselor Responsibilities, and Confidentiality&topicMaterialId=71 WAGAMAN, A. (2013, July 25). Americans grow increasingly intolerant of extramarital affairs. Star Tribune. Retrieved from startribune.com: http://www.startribune.com/lifestyle/relationship/216813271.html