Ethical and Legal Challenges in Professional Practice
Ethical and Legal Challenges in Professional Practice
The American Counseling Association (ACA) Code of Ethics is available to clarify the ethical responsibilities for professional counselors and future professional counselors. According to the ACA (2005), “the code serves as an ethical guide designed to assist members in constructing a professional course of action that best serves those utilizing counseling services and best promotes the values of the counseling profession.” As a graduate student striving to achieve a Master’s Degree in Counseling, it is crucial, not only to know and understand the ACA Code of Ethics, but also to understand any challenges that I may have in upholding them as well as ways to address these challenges effectively. In this paper I examine a section of the ACA Code of Ethics that I find personally challenging, risk management strategies used to resolve this potential ethical conflict, and a section of the ACA Code of Ethics that will not present a challenge.
Personally Challenging Ethics Code
According to the ACA Code of Ethics (2005), section C.2.g Impairment, counselors are alert to the signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when such impairment is likely to harm a client or others. The ACA Code of Ethics (2005) section C.2.g Impairment also states that counselors seek assistance for problems that reach the level of professional impairment, and, if necessary, they limit, suspend, or terminate their professional responsibilities until such time it is determined that they may safely resume their work.
Personal Relevant History
In 2005, during my senior year of undergraduate school at The University of Arizona, I was on the fast track to law school. I was on a full scholarship, earning a 4.0 grade point average, a resident assistant for the dorms, and a member of a co-ed pre-law fraternity. I had just completed my internship working for senator John McCain and had finished the scary LSAT. This is what my friends and family saw. In the background, I was struggling. During the weekends I was “hosting” parties, or rather people would just show up and throw their own parties at my residence. I was struggling to get out of bed in the morning and often came back home to take naps and miss my next few classes of the day. My grades were slipping and so was my ambition.
I took it upon myself to see a psychiatrist and was prescribed anti-depressants. This medication changed my life for the worst. I did not even notice that things were spinning out of control as I maxed out my credit cards (I would just get new cards later) and making impulsive and risky decisions. I was losing sleep as I was either out socializing or home cleaning like a madwoman, and often had bouts of irritability. My boyfriend at the time (my current husband) called my parents and asked that I come home to Phoenix and receive help.
So I had a medical withdrawal from school, returned home, and was provided with psychiatric help. I was diagnosed with bipolar disorder and informed that by taking antidepressants I was experiencing a manic episode. As stated by Griswold and Pessar (2000, p. 1347) while referring to bipolar disorder, “the use of tricyclic antidepressants should be avoided because of the possibility of inducing rapid cycling of symptoms.” So with a new diagnosis the process of trial and error with psychotropic and mood stabilizing medications and their unavoidable side effects began. Once I was on a stable medication and dosage, I felt like myself again. I got a job at a residential treatment center to work with adolescents that have mood disorders and had gotten into trouble with the law. I found my passion. It was a few years before I could return to school with a purpose. I was graduated from Arizona State University with a Bachelor’s of Science degree in Family Studies and Human Development in May 2011 and the future goal of becoming a therapist.
Future Considerations and Risk Management Strategies
I believe that under the Impairment ethics code, mood disorders are considered a mental or emotional problem that may impair the counselor affecting the way in which a counselor provides treatment to clients. Bipolar disorder does not disappear once one takes the necessary medication. “Medication alone is often inadequate to restore and maintain physical health and quality of life” (Rheineck & Steinkuller, 2009, p. 339). Rheineck and Steinkuller (2009) recommend that those with bipolar disorder participate in therapy in conjunction with taking their effective medication. It would be myopic of me to assume that bipolar disorder will never affect me as a therapist. If I am not aware of my moods while I am having either a depressive or manic episode I may become irritable with or place my own perceptions onto a client. Ethically, to manage the risks involved with being a therapist who has bipolar disorder, I need to do more than take medication and participate in therapy.
According to Biegel, Brown, & Shapiro (2007), a therapist should practice self-care, including self-awareness and self-regulation or coping. I think that when I am practicing, it will be self-awareness that will assist me most in terms of risk management. As an unbiased observation of my inner experience and behavior, self-awareness could also serve as an alarm to signal that I need to take appropriate actions whether to notify my supervisor, limit, or suspend my professional responsibilities. When referring to self-awareness Corey, Corey, & Callanan (2008, p. 44) state that without it “mental health professionals are likely to obstruct the progress of their clients as the focus of therapy shifts from meeting the client’s needs to meeting the needs of the therapist.” To assist with my self-awareness, I plan to utilize mindfulness. Mindfulness, as defined by Campbell and Christopher (2012, p. 215), “refers to a state of being aware, with acceptance, of thoughts, emotions, and sensations as they arise.” I currently practice various mindfulness exercises in therapy to assist with my mood disorder and coping strategies.
To be a positive and healthy professional counselor I will continue with mindfulness exercises throughout my career and my life. I plan on practicing this daily, on my own time, so that I will be able to recognize when I am having moods or episodes that need to be addressed. Mindfulness will be additionally useful, as “counselors need to be immediately cognizant of signs of stress and burnout and address these immediately to practice counseling ethically” (Bradley, Brogan, Brogan, & Hendricks, 2009, p. 358). By being mindful and self-aware I will be able to identify the symptoms of stress and burnout as well as any number of potentially harmful feelings.
Ethics Code that Does Not Present a Challenge
According to the ACA Code of Ethics (2005), section C.2.f Continuing Education, counselors recognize the need for continuing education to acquire and maintain a reasonable level of awareness of current scientific and professional information in their fields of activity. The ACA Code of Ethics (2005) section C.2.f Continuing Education also states that counselors take steps to maintain competence in the skills they use, are open to new procedures, and keep current with the diverse populations and specific populations with whom they work.
Personal Relevant History
In my experience while working in behavioral health, training always has been emphasized and mandated yearly. During the four years that I spent working at a residential treatment center, I had accumulated more than 500 hours of training. While working at a group home for a year, I had gone through more than100 hours of training. In the past year while working as a youth and family specialist I have completed an additional 60 hours of training. Although I found many of the training sessions over the years to be fairly repetitive, there were also several trainings providing completely new knowledge to me and therefore effective to assisting me while working with clients. Examples of recent effective trainings include crisis prevention intervention, compassion fatigue, cognitive behavioral therapy for children and adults, and behavioral health documentation.
According to the ACA Code of Ethics (2005), Preamble, “inherently held values that guide our behaviors or exceed prescribed behaviors are deeply ingrained in the counselor and developed out of personal dedication, rather than the mandatory requirement of an external organization.” To me this statement means that as a professional counselor I will further my education and knowledge of skills because I want to and not because an agency I work at mandates it. I do not believe that when one finishes school, they have completed learning, especially if they work in behavioral health. There are always new diagnoses, methods, and forms of treatment coming out that I want to be learn to better meet the needs of my future clients. In a mail-in survey study of 1000 licensed professional counselors conducted in 2009 pertaining to counseling grief stricken clients, Granello, Ober, & Wheaton (2012) found that the majority of the participants stated they were unprepared when it came to specific skills and lacked knowledge to address those with grief.
“Counselors who received training rated themselves as more competent than those who did not, with more training related to higher levels of self-perceived competence” (Granello et al., 2012, p. 158). Another study conducted by Jameson, Poulton, and Stadter (2007), involved 38 therapists and evaluated the effect of a two-year continuing education program on their knowledge, skills, and application. “The majority (74%) felt the training helped them think clearly and specifically, both about assessment issues and specific interventions” (Jemeson et al., 2007, p. 113).
It is clear when reading these findings that further training can only help a professional to work with more specific needs of their clientele. Although all agencies have mandatory trainings, I have observed that there are hundreds of additional trainings offered yearly for any counselors who want to attend voluntarily. I plan to be a counselor who takes the opportunities offered to further educate myself, in order to improve myself and to provide my clients with a better and more knowledgeable version of me.
In summation, I have examined a potentially personally challenging section of the ACA Code of Ethics, risk management strategies that I plan to utilize, and a section of the ACA Code of Ethics that aligns with my personal beliefs. Examining my personal experiences and traits that may conflict with the ACA Code of Ethics, I am better preparing myself to prevent any effects they may have had toward my future clients. It is important to me that I continue to learn and apply the knowledge I gain in graduate school and additional educational settings to improve myself as a person and as a professional counselor.
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Griswold, K.S., & Pessar, L.F. (2000). Management of bipolar disorder. American Family Physician, 62(6), 1343-1353.
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