When providing counseling services to individuals or a group of individuals, one needs to be cautious on his or her approach to everyone’s specific needs. Even though there are a variety of methods to solving a problem, some methods encounter ethical dilemmas. The ethical dilemma is about Jane, a counselor at a community college, who starts a relationship skills group for nine individuals between the ages of 18-25. In her primary course of action, she encounters several ethical dilemmas: she fails to provide sufficient information about the group in an advertisement, encounters ethical problems within the enrollment process, fails to provide an informed consent to the enrollees, and puts the other attendees at risk of harm. By identifying the code of ethics involved and the moral principles within her primary course of action, Jane is able to purpose and evaluate several options that she can properly apply to her final course of action, eliminating the ethical dilemmas.
The Dilemmas of Starting a Relationship Skills Group
Identify the Problem
Jane is a counselor who decides to start an age-restricted “relationship skills” group. In order to promote her new group, she posts an advertisement with minimum information. She orders the counseling center to admit the first nine students who call to enroll, without asking any questions about the enrollees. At the time of the first meeting, the group consists of seven women and two men. Having never met the attendees, Jane tells the students to share the reason why they have decided to join the group. Daryl, one of the men in attendance, describes his situation. He shares that he was just released from jail after serving time for domestic violence. He also expresses that he still contains feelings of anger toward women. Due to Daryl’s confession, five of the seven women in the group do not attend the next group session. In this case, Jane has fails to follow through her duties of ethical decision-making. Failure to provide sufficient information
In Jane’s advertisement for her group, she provides minimal information. She includes information such as the name of the group, date and time of the first meeting, and a contact number. In most states, professionals act unethically if they provide insufficient information about their services. For example, in the State of Georgia Code of Ethics Chapter 135-7-07, Advertising and Professional Representation, “the licensee may provide information that accurately informs the public of the professional services…unprofessional conduct includes, but is not limited to: intentionally misrepresenting the licensee’s professional competence…intentionally providing information that contains false, inaccurate, misleading, partial, out-of-context, or otherwise deceptive statement” (O.C.G.A., 2000). Jane fails to provide clear information about her active role in the group meetings, her level of competence, and, most importantly, she provides misleading information about her group by not providing a clear name of the group.
Enrollment into the group
Jane made an unethical decision by telling the secretary of the counseling center to enlist the first nine students, between the ages of 18-25, who call to enroll into the new group. The receptionist enrolls the nine students without questioning the students about any problems they may have, personal goals, or any previous counseling experience with groups. There are several dilemmas within the enrollment process.
Competence. Before deciding who can enroll into the group, Jane should evaluate each potential enrollee. The evaluation can determine whether Jane is competent to handle the enrollee’s purpose for enrolling. Evaluating a potential enrollee can be a simple, quick task. By allowing an extra few steps to the enrolling process, Jane will not only be protecting herself from harm, but also the client and the others who enroll into the group. Determining her competence level can reduce stress and tension within the group.
Denial of treatment. Limiting the number of people and implementing an age restriction into a group can cause dilemmas. There are several ethical questions about those who wish to receive “relationship skills” but do not meet the criteria to receive aid. Jane is denying treatment to those who do not meet the requirements. Denying treatment to a client is seen as unethical, which can result in a counselor being fined, losing his or her right to practice, or being put on probation.
Lack of an Informed Consent
At the start of the first meeting, never meeting or talking to any of the students, Jane asks the students to share why they have decided to join the group. At the first session between a counselor and a client, the counselor has a duty to provide their clients with an informed consent. The consent shall provide information about the purpose, risks, method(s) of treatment, the professional’s credentials, costs for the service, and confidentiality amongst groups. The counselor bares the duty to make sure the client fully understands the informed consent before any relationship between the two can start.
Putting Others at Risk
One of the students, Daryl, who enrolls in to the group shares that he had had a previous run in with the law for domestic violence. Daryl also shares that he still feels anger towards women. Since Jane fails to evaluate the students before allowing them to enroll into the group, she has put the other students at risk. The counselor has a duty to protect his or her client for any harm or danger. Daryl is seen as a threat to women of the group, which results in five of the women not returning the following week.
ACA Code of Ethics
The mission statement of the American Counseling Association Code of Ethics (2005) “is to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.” Jane fails to comply with the ACA Code of Ethics (2005) when she unsuccessfully informs future participants about the group, determines who can enroll into the group, not provide an informed consent, and fails to protect others from harm.
Advertisement of counseling services should be present to the public in a manner that provides the counselor’s credentials and a description of the services that are not false or misleading according the ACA Code of Ethics (2005) C.3.a. Jane does not provide the students with her credentials. In the advertisement that Jane posts at the campus, she fails to provide sufficient information about the “relationship skills” group. The ACA Code of Ethics (2005) C.3.e., states “…ensure that advertisements concerning products or events are accurate and disclose adequate information for consumers to make informed choices.” Failing to disclosure more information, Jane attracts students to the group who do not belong in the group.
Enrolling Into a Group
The ACA Code of Ethics (2005) makes references about group work and how to approach them in an ethical manner. According to the ACA Code of Ethics (2005) A.8.a., “Counselors screen prospective group counseling/therapy participants. Counselors select members whose needs and goals are compatible with goals of the group…will not impeded the group process…” When Jane decides to start a group, she instructs the secretary to enlist the first nine students who call and enroll. The secretary never questions the future enrollees about how their needs are compatible with those of the group.
Also, there are not questions about their well-being. Another ethical dilemma Jane encounters while determining who can enroll into the group is failing to define her boundaries of competence. ACA Code of Ethics (2005) C.2.a., states that counselors should “practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience.” Jane never determines whether or not she is competent enough to help the students in the group. By not doing so, she is harming herself and the students in the group.
At the start of the first meeting, Jane fails to provide her students with an informed consent. According the ACA Code of Ethics (2005) A.2.a, the students have a right to determine whether or not they wish to stay in the group by evaluating the information about the approach the group is to take and information about the counselor. The ACA Code of Ethics (2005) A.2.a. also states that the counselor has an “obligation to review in writing and verbally with client’s rights and responsibilities of both the counselor and the client.” Jane should explain the purpose of her group, by providing the students information such as purposes, goals, limitations, potential risks, and benefits according to the ACA Code of Ethics (2005)
A.2.b. Duty to Protect
When Jane allows Daryl to share why he is there, he makes references about serving time for domestic violence and expresses his feelings of anger towards women. Throughout the ACA Code of Ethics (2005), several codes address the counselor’s duty to protect his/her clients. The ACA Code of Ethics (2005) A.4.a. states, “Counselors act to avoid harming their clients, trainees, and research participants and to minimize…unavoidable or unanticipated harm.” A.8.b. of the ACA Code of Ethics (2005) also confirms that within a group setting, the counselor should take precautions to protect others from “physical, emotional, or psychological trauma.” Jane fails to protect the five women, who decide not to attend the following group session. They fell threaten by Daryl’s feelings towards women, and decide not to attend.
The Nature and Dimensions of the Dilemma
There are five moral principles: autonomy, nonmaleficence, beneficence, justice, and fidelity (Forester-Miller & Davis, 2006). Four of the five moral principles are encountered in Jane’s situation. Nonmaleficence, “the concept of not causing harm to others,” is violated by Jane when she allows Daryl into the group (Forester-Miller & Davis, 2006). His personal problems are seen as threats to the others in the group. The act of the counselor maintaining responsibility of the client’s welfare is referred to as beneficence. Jane fails to comply with maintaining her responsibility of protecting her client’s welfare. By failing to obtain an assessment on any of the students before the first group session, justice is the third moral dilemma violated in Jane’s case. According to Forester-Miller & Davis (2006), justice is “treating equals equally and unequals unequally…”
Jane, the counselor, should have been able to determine how to approach Daryl’s situation versus the situation of another student. The students in the group are not all there for the same purpose. Fidelity is the last moral principle that is expressed in Jane’s case. In this situation, fidelity is an important one to be cautious about. Fidelity can be described as the counselor expressing “loyalty, faithfulness, and honoring commitments” (Forester-Miller & Davis, 2006). The client needs to feel trust and secure.
Potential Course of Action
According to Forester-Miller & Davis (2006), “there is rarely one right answer to a complex ethical dilemma.” There are a variety of ways to approach the ethical dilemmas Jane faces in creating a group for young adults. When deciding to start a “relationship skills” group, Jane should be more cautious on how to advertise the group. In her advertisement, she should provide more details about who she is, her credentials are, and the purpose of the group. She does well at providing a group name, date and time, and contact information. By putting more information on the advertisement, the students with interest can be more informed about the group and they can better decide if they really want to join. Secondly, Jane needs to be more cautious of how and who she enrolls students into the group. According to the ACA Code of Ethics (2005), Jane should evaluate or question candidates when she decides who is a potential member of the group.
By doing so, she is aware of where each of the students stand in regards to the group. She is not only protecting herself from harm but also protecting the other students from being in danger. Another issue she needs to address is possibly expanding the amount of students in the group. In her current approach she is denying treatment to several other students who may need more attention. Jane also lacks providing the students an informed consent. She has not properly informed them of the process, risk, and who she is to the students. When applying an informed consent to the group, she is informing the students on how she is going to protect their confidentiality, what she expects of them, and the benefits of being in the group. If she does not want to make the group seem official, she can draw up a contract within the group. Lastly, Jane has the duty to protect the students from receiving any harm from the group. If she applies an evaluation and an informed consent to the group, this should minimize any harm to any members of the group.
As with every decision one makes, there are going to be consequences. Jane can encounter minimal ethical dilemmas in applying the potential courses of action. One of the problems she can face in evaluating the students is making the students feel uneasy about joining the group. If the students feel uneasy, they will likely decide not to join. Secondly, by setting a restriction on the amount of students in the group, she can face charges of denying services to a student. Thirdly, if she decides to apply an informed consent to the group instead of a contract, many students can have feelings of commitment to the group. Lastly, if she decides that she wants the group to be liberal, an evaluation and an informed consent can make Jane feel as if she has limits as to what she can do.
Evaluating the Selected Course of Action
Evaluating the selected course of action can be a difficult task if the counselor is focuses on one point of view. Forester-Miller and Davis (2006) recommend that the counselor applies three tests: the test of justice, the test of publicity, and the test of universality. In the potential selected course of action, justice is rightly served. In order to determine if justice is served in including an evaluation process, Jane must put herself in the situation of the student. She questions if she would feel inferior by being questioned about her personal life, personal goals, and previous experience. The test of publicity requires Jane to evaluate how she would feel if her potential “relationship skills” group is exposed to another campus or other professionals in the same field. How much pride and confidence does she have in this group? Lastly, the test of universality suggests that Jane question whether she would recommend another professional to start a similar group with her proposed methods. After applying the three tests, Jane examines for new ethical dilemmas.
Implementation of Selected Course of Action
Jane, a counselor in a community college counseling center, decides to start a “relationship skills” group for young adults between the ages of 18-25. Even though most of the college students do not fall within that specific age group, Jane feels that her competence level is between those ages. When deciding to advertise her group, Jane provides as much information as she can on her advertisement. She includes information about herself, her certification, the name of the group, the purpose and goals of the group, date and time, and a contact number for enrollment and to address any further questions. Jane tells the receptionist at the counseling center to take note of everyone who inquires about the group and schedule them to feel out a questionnaire in regards to their personal history. The questionnaire includes questions that address personal information, any personal problems they have, their personal goals for the group, previous experience with any groups, and any criminal history.
Once the enrollment process is complete, Jane evaluates each of the questionnaires and determines who she is competent enough to have in her group. If the candidate has different purpose than the group’s intended objective, Jane informs them of her level of competence and suggests they seek help with another professional. At the first meeting, Jane immediately discusses and hands out an informed consent for the students to fill out. In the informed consent she addresses the purpose of the group, any risks to the group, her level of competence, issues concerning confidentiality amongst the group, and the name of another professional who they may contact if they have any concerns about the way Jane is addressing the group. By following this course of action, Jane should be able to run a successful group without any problems. After the completion of the group meetings, Jane evaluates the group and determines if any of her actions can possibly result in consequences.
American Counseling Association (2005). ACA code of ethics. Alexandria, VA: American counseling association.
Forester-Miller, H., & Davis, T. (2006). A practitioner’s guide to ethical decision making. Retrieved from http://counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2 O.C.G.A., A. (2000, March 19). Advertising and professional representation. Retrieved from http://rules.sos.state.ga.us/docs/135/7/07.pdf