Boundaries and dual relationships
As a professional counselor, one should consider the following criteria as part of an ethical decision making model. First, the counselor should identify all the ethical concerns involved in the issue. Second, one should consider one’s values and skills with regard to the problem. Step three should involve knowing the code of ethics that pertains to the issue.
Afterwards, the therapist should identify some of the probable entrapments that would result from one’s decisions. Thereafter, one should think about some possible responses. Sixth, the counselor should think about the consequences of his or her actions.
Seventh, one should come up with a resolution. Eighth, one should consult with other therapists. The ninth step should involve taking action. Lastly, one should analyze the outcome of one’s decision (Hugman, 2003).
A situation, which would solicit application of this ethical-decision-making model would be a counselor, who must work in a different country like Botswana. The local counselors request some of the recipients of the disaster relief program to participate in a televised recording of the program, but one of the clients claims that she does not want to participate.
When applying the ethical decision making model, one would realize that the main ethical concern is involving a post traumatic victim in a program that she is not comfortable with; this fact exists irrespective of the positive outcome of the televised recording.
As a second step, one must examine one’s values. If a counselor had a client who seemed so distraught, and he/she was going through something that the therapist went through, one should consider sharing the experience with the client. However, the need to remain professional and to limit personal issues in counseling would stop the counselor.
One should ponder about one’s ethical values and beliefs; these might reveal that meeting clients’ needs are a priority for the counselor. Although the atmosphere may make one appear vulnerable, the therapist might still be okay with that if he or she can avoid emotional connections.
As long as something advances the therapeutic session, then counselors should embrace it. However, this should only be done if one thinks the patient does not have dependency issues (Berstoff, 1996).
The fourth criterion entails considering some of the traps involved in a session. As a counselor, when one of the patients asks whether he/she can send the therapist a text message, one should consider the possible traps of this. The patient may continue to text the therapist even during odd hours or he/ she may do it excessively; one would, therefore, be trapped.
A counselor may be prompted to respond to those texts, at first, but this may not be sustainable because of time constraints. These traps would cause the therapist to consider accepting one’s client’s request to SMS seriously. Counselors must ponder over the frequency and level of connection that they initiate with clients as these might be unsustainable.
Another scenario, which would require the ethical decision model is getting an invitation from a client to attend a support group for sexual abuse victims. Criteria six talks about thinking of one’s consequences. Participating in such a group could create power differentials that would undermine the therapeutic process. Additionally, since this is a non office appointment, it could arouse the attention of the clinic’s board (Houser et al., 2006).
Some patients may misread one’s involvement and may make allegations of misconduct. No one would protect the counselor as he or she would be acting in a personal capacity.
On the other hand, the patients may have no other professional to consult. If one chooses not to charge them, the clients may find the only affordable solution to their problem through that counselor. They may be denied any chance of recovery if one refuses to attend their session. These are all consequences that one must consider.
Ethical issues change depending on whether one is a current client or a former one. It would be totally unethical to enter into a social or business relationship with a current client (ACA, 2005). In other words, one should not think about doing business with a current client or becoming a friend to a client. However, in certain circumstances, the same may be permissible after termination of therapy.
Nonetheless, the elapsed time and the client’s circumstances should predetermine this. As long as a therapist does not exploit the former client’s weaknesses and two or more years have elapsed after termination, then a business relationship can be considered. Once again, this should only take place if the concerned patient has fully recovered.
New thinking
The most significant development in one’s thinking occurs when one realizes that ethical issues are not curved in stone. One’s ethical values should not be driven by legal codes or stringent rules. While one must consult with lawyers and other legal practitioners concerning the rules that apply to a certain situation, it is necessary for the counselor to dwell on his or her values while going through therapy sessions.
If these legal codes are the focus of one’s counseling sessions, then the counselor will only protect himself/ herself; he or she will not be helping the client (Corey & Herlihy, 1992). Therefore, this course teaches the importance of developing one’s own principles.
The fluidity of ethical situations comes clearly after one realizes that boundary crossings can sometimes help, not hinder a patient’s recover. For instance, one may take a patient with a fear of the dark to a dark room in an effort to help him confront his fear. Alternatively, one may promise to accompany a patient to a necessary medical examination that scared him.
In isolation, these acts are boundary crossings, but when integrated into a holistic treatment plan, they can lead to successful results. In summary, this course teaches that crossing a boundary does not necessarily have to lead to unethical behavior.
The course also teaches that some people are paranoid about minor boundary matters. Disclosing personal information about oneself, as a therapist, does not mean that the relationship will automatically degenerate into an intimate, social relationship or a sexual one. These extreme situations can only arise if the therapist allows them to happen.
Perhaps one of the most notable things, one can carry away from these classes is that a patient’s needs should come first. A client’s characteristics will ultimately determine what path or course of action to take. Some patients can handle unconventional treatment conditions such as disclosure of the therapist’s experiences or out-of-office contact as part of treatment (Daniels, 2001).
However, others would be considerably thrown off-guard; these include patients with borderline personality disorders. Such individuals may require a highly structured atmosphere. In this course, students can deduce that there is no one-size-fits-all scenario. One’s decisions must be based on one’s assessment of the patient’s conditions, characteristics and capabilities.
Choosing the right treatment alternatives and actions should thus entail a thorough, analytical process. The ethical decision making model would be quite helpful in this regard.
Unless a counselor constantly updates and evaluate his or her attitudes, beliefs, and treatment approaches, then he or she will always be in danger of being on the wrong side of the ethical gauge. This may undermine professionalism, clients’ recovery and ultimately the occupation’s reputation.
References
American Counseling Association (2005). Code of Ethics. Alexandria, VA: Author.
Berstoff, D. (1996). The virtue of principle ethics. The counseling psychologist, 24, 86-9.
Corey, G. & Herlihy, B. (1992). Dual relationships in counseling. Alexandria, VA: Author.
Daniels, J. (2001). Managed care, ethics and counseling. Journal of Counseling Development, 79(1), 119-122.
Houser, R., Ham, M., Wilczenski, F. (2006). Culturally relevant ethical decision making in counseling. Thousand Oaks, CA: Sage publications.
Hugman, R. (2003). Professional ethics on social work: living with the legacy. Australian social work, 56(1), 5-15.