An Ethical Dilemma in the Counselling Profession Essay
2835 WordsMar 3rd, 201312 Pages
Exploring an Ethical Dilemma
“Confidentiality is the foundation of safe therapy.”
(Corey&Corey, p.208 from Grosso, 2002)
As a counsellor I have an obligation to follow professional standards and apply appropriate behaviour defined by mental health associations. The purpose of this is to prevent harm to clients as well as to define my own professional values.
Working in the helping profession I will come across situations where I need to make a decision on whether to breach confidentiality in order to protect my client or others or “simply” practise within the framework of social equity and justice.
I will use the “Practisioner’s Guide to Ethical Decision Making” model of Holly Forerster-Miller and Thomas…show more content…
Are there any other paths I could follow in this situation?
The trust between Heather and me as a Counsellor is a vital part of our therapeutic relationship. I am aware that my client must feel that whatever she discloses in therapy will be treated confidentially. As a counsellor I am not to disclose information unless required by law or authorized by my client. The informed consent document Heather has signed prior to our first session does not state particularly that the Counsellor has to break confidentiality in instances of child abuse.
Applying the ACA Code of Ethics
I am now reviewing the ACA Code of Ethics to find out whether I can use these guidelines to find a solution to the problem. Reading the Code of Ethics (ACA, 2005) I find the following aspects that are part of this dilemma:
A.1.a. Primary Responsibility
My client is vulnerable and in need have trust in our therapeutic relationship. Heather is generally not an outspoken person therefore I do not take her openness in my sessions for granted. Heather has expressed how much our sessions have helped her so far and that they have become an important part of her life.
A.4.a. Avoiding Harm
I will have to find out whether the harm on breaching confidentiality is bigger than the harm we might do when keeping the violence of the father confidential.
Group counseling is set up when a small group of members come together to gain counseling through forming of goals, sharing problems, providing support to the fellow members and trying to change their unsocial and defeating disorders. The head of the group is usually a qualified counselor who gives guidance to the members in their resolve to combat their disorders. Ethical and legal issues arise from the group therapies and are as discussed below.
Ethical Issues of Group Therapy
Ethical Issue #1: Informed Consent
One of the ethical issues that should be observed is informed consent. The members should join out of their own volition, and with adequate knowledge on the goals of the group, their ground rules, applicable fees, confidentiality, rights and responsibilities of group members (Tuckman & Jensen, 2001). It is important for the new members to understand the consequences of breaking ground rules of the group. Due to the nature of the people involved in counseling, it is also important to stress on the importance of treating other group members with respect and avoiding quarrels. It is also important for the group counselor to state the need for confidentiality of by group members.
Ethical Issue #2: Autonomy
It is also important for the counselor to allow autonomy of the group members. The group members should be treated with respect and given freedom to choose how much they want to participate in the discussion. No one should be forced to say or tell their story to others when they don’t want to do so. This applies even when the members are not there voluntarily. The autonomy of each member is important, because it fosters group cohesion during the process of counseling (Bales & Strodtbeck, 2000).
Ethically, the counselor should protect clients from sustaining physical, emotional or psychological trauma from the group sessions (Tuckman B. W., 2001). The counselor should give the support and encouragement to the members, because dealing with their problems could live then psychologically traumatized. The counselor should also install measures to ensure that no member attacks another physically when they relate their stories. Where necessary, the counselor should give private audiences to the members for the support purposes.
Ethical Issue #3: Equolity or Equity?
In group counseling, the counselor should treat all members equally, and should be unbiased in his support. He should provide services equally to all members, while respecting their human rights and dignity (Schnurr, Friedman, Foy, Shea, Hsieh, & Lavori, 2003). The counselor should have the ability to appreciate differences in people, while shunning discrimination against an individual or a group of people within the group, due to their social or personal characteristics.
The counselor should also be self respecting by encouraging active engagement in development of social characters and enhancing lives (Schnurr, Friedman, Foy, Shea, Hsieh, & Lavori, 2003). The active involvement of the counselor in therapeutic counseling should be limited to professional engagement. The counselor should seek therapy from other counselors when need to enhance his professionalism in providing counseling services.
The counselors should understand the intervention strategy and choose to employ in helping the members deal with their disorders (Burlingame, McClendon, & Alonso, 2011). They should also use the right techniques for each individual, despite the sessions being for the group counseling. The counselor, therefore, should understand all the members on an individual level and reach out to them using the defined and appropriate remedial techniques.
The issue of confidentiality is important in group therapies. They should not only be addressed during screening of group members, but should be repeated each time the group meets. The counselor should be strict about the issue of confidentiality of the members outside the group sessions.
Ethical Issue #4: Best Interest
The counselor should be committed towards promoting the well-being of the group members. The counselor should perform an analysis of each group member prior to joining the group, so as to asses their personal needs. The counselor should only welcome an individual into the group, if he/she has the capacity and ability to deal with the clients problems. The counselor should be committed to making sure that clients do not live, as they come and gain different skills each session to deal with their problems. The counselor should seek to achieve the interests of the client in becoming a better being in the society. The counselor should be adequately trained to deal with the problems of the individuals who form the group. The counselor should be able to give practical guidance to the members of the group.
A group leader should also make sure that he/she does not force his/her values on the group. It is an ethical concern when the group counselor uses the group to cater for his personal needs and to advance his/her to win the agenda at the expense of the group members (Abouguendia, Joyce, Piper, & Ogrodniczuk, 2004). It is disrespectful to the members’ integrity, when a group leader imposes his values on them. It is, however, important at times to expose his values as the leader, because they may help build an individual in the group. This is also important because the members need to feel that the counselor understands them and empathizes with their situation. This helps them identify and relate with their issues and resolve to face their problems.
Ethical Issue #5: Challenging the Authority
The counselor should be able to deal with difficult members who challenge his authority or the norms of the group. Dealing with him should not be punishing, but rather guiding towards the acceptance of the group. The counselor should also be in control of how other members may react towards such an individual. As a group leader, the counselor should be able to provide the damage control caused by an unruly member to other members, so as to retain cohesiveness of the group. The counselor should guide all members to turn their negative energy into positive energy for the benefit of all parties involved.
Ethically, a counselor should avoid forming the dual relationships with clients which may hinder a member from participating fully in group counseling (Baldwin, Murray, & Shadish, 2005). Such relationships include romantic relationships or friendships that compromise professionalism. This is according to the ninth guideline in of the ethical guidelines for the group workers. Dual relationship may appear when a counselor offers group and individual counseling to an individual simultaneously. In such a situation, the counselor may breach the confidentiality code, because he/she may not remember during which session the individual gave certain information. Counselors should avoid simultaneous therapies in group and individual counseling, and opt for it instead of sequential therapies.
Ethical Issue #6: Group Problems
Finally, the counselor should not use the group therapy as a session to sort out his personal issues and conflicts. His problems should remain discreet form the group members and his personal life should not be shown during the group therapy. The group leader should remain professional in dealing with all members, and personal life of the counselor should never be used as an example or a topic of discussion for the members. A group leader should keep away from offering services to people he has personal relationships with, because such therapy may be influenced by personal relationships. Where the group involved is a family, the counselor should be bale to identify and define who his clients are within the group, because others may be there by virtue of their relationship to the client. The counselor’s first responsibility lies with the client, but other parties should be respected and given time to express themselves as well.
The counselor should also follow up on therapy for each individual to examine how each one employs the teachings from the session in the outside world. This should not be biased and should not be without the knowledge of the individual. The counselor should not act in a manner suggesting harassment of the individual involved in the group therapy. The group therapy ethical issues are similar to the individual counseling ethical issues, because counseling demands that the client should be held as autonomous, respectful, and should be treated with justice and confidentiality. The only difference is that group therapy ethical issues involve other clients and not the counselor only. The work of the group counselor is fundamentally support and control of the crowd (group), as compared to individual counseling where the counselor deals with a single personality and disorder at a time.
Why One Would Prefer Group Therapy to Individual Counseling
Group counselling is preferred by some therapists over individual counselling, because of the following facts and issues. Some therapists prefer working on a group, as opposed to an individual, because it offers them a chance to enhance more than one life (Schnurr, Friedman, Foy, Shea, Hsieh, & Lavori, 2003). When dealing with a large society in need of counselling, group therapy is most practical because it offers services to a large number of people simultaneously, thus, saving time.
The fact that the group therapy saves time is acknowledged even by those receiving therapy. To them, it is easier to get an appointment when one is in a group, as opposed to the personal/individual counselling. The counsellor also has a sense of responsibility towards a larger number of people, as opposed to being answerable to an individual. Therapists, therefore, make certain they are available before setting the time for the next session, so as not to disappoint many people at a time.
Therapists prefer working on a group therapy, because it enhances the support available for each individual in achieving their goals. The members are able to learn from other mistakes and experience through sharing (Burlingame, McClendon, & Alonso, 2011). Group therapy also enhances the ability of an individual to interact with the society and conform to the norms of that society. This is unlike individual counselling, where the client has no one to share experiences with at a peer level.
Counsellors who deal with teenagers find it more appealing to work with a group as opposed to individual. This is because most teenagers will talk more readily to other teenagers than to an adult (Burlingame, McClendon, & Alonso, 2011). The reality of finding other people stuck in problems for a client hastens his/her resolve to rein disorders under control. Therapists find it important for an individual to receive the support and understanding from other clients, so that they can feel as belonging to the part of something larger than their grievances. The ability to share problems with a large number of people gives clients the energy needed to resolve their problems and achieve their goals (Baldwin, Murray, & Shadish, 2005). This is important for members, because they tend to work on their problems, so as to keep pace with the others in the group.
Group Therapy vs individual Therapy
Group therapy is recommended by most therapists depending on the situation of the client and the problem to be addressed. Therapists prefer working with a group, where social misbehaviour or misconception is the underlying problem. This is because the group gives a member a platform to launch a code of conduct acceptable to others, other than self (Foa, 2008). Group therapy in this regard offers the social support and not just a sense of belonging.
Sometimes, the problems of the client may be as a result of in-acculturation. In this regard, the therapist would prefer working on a group with the individual, so as to provide him/her with a society he/she can identify with. As the whole group improves, so does the individual who eventually is able to adapt to the culture of the society he comes from. An individual is able to receive and accept the different viewpoints, ideas and experiences from other group members in a group therapy.
Group therapies not only deal with the issue at hand, but also arm the clients with experience and skills to counteract to other problems experienced by group members (Wheeler & Kivlighan, 1995). This is good for the client, because it deals with the whole being and a variety of life problems that the client did not foresee in the first place. The clients get an opportunity to see and experience how people deal with their problems and how they are guided by the counsellor.
It is also important for one to go through the group therapy, because it helps to remove feeling, so isolation or tendencies of anxiety and depression in an individual (Para, 2009). Facing others with the same problem allows the client to know that his/her case is not rare, and that it can be resolved. The client is also able to have a sense of belonging in the group and may even make permanent friends from the group who they can talk to freely outside the group session.
Therapists prefer using group therapies to individual therapies, because each member can see their mirror image in each other, and therefore, strive to change their behavior. The reality of a client’s situation may not be clear to them, until they see other with similar problems. This allows the members to have a chance to explore their personality from another person’s perspective. Group therapies also help an individual to build personal self-esteem and confidence through sharing and helping others from experience to resolve their problems. The groups work towards enhancing the self-worth of each individual in helping one another.
On the other hand, therapists prefer working with individual therapy when the question of confidentiality is fundamental to the client. Individual counselling is also preferred when the counsellor wants to gain more information about a client to facilitate counselling. Counsellors find individual counselling useful in helping an individual in identifying personal problems and in defining the meaning of life without influence.
Individual counselling is handy when the counsellor needs to have a lot of time devoted to the client without sharing with the group members (Abouguendia, Joyce, Piper, & Ogrodniczuk, 2004). Such sessions are useful in creating trust and a personal relationship between the client and counsellor to better facilitate future working environment. Individual counselling are preferred by the counsellor, because they allow the client a favorable environment to deal with personal issues without interference. During an individual counselling session, the client is able to logically deduce the causes of his/her problems without helping, thus, boosting the confidence to deal with them in the outside world.
Individual therapy is important and encouraged by therapist in the family counselling, so as to enhance personal behavior of each person before dealing with the family issues. This is important, especially in marriage therapy, because problems in relationships, such as marriage are primarily communication problems and stress. Personal issues causing a client stress and depression must be dealt with before the marital problems are addressed.
Therapists prefer the group therapy in relationship problems, because they get to hear both sides of the story, when all partners are present (Abouguendia, Joyce, Piper, & Ogrodniczuk, 2004). This is helpful because each party is able to comprehend how their actions affect the other parties. They also get to hear what the other party thinks of him/her. Group therapy is important in the relationship issues, because an honesty analysis of each party by self and by others is offered which prompts of an individual to analyse the self-personality. The group therapy in this case is fundamental because it helps the involved parties to come up with ways to improve their relationship. The resolution is an agreement between the two parties and not imposed by one on another. It also offers an opportunity to offer support to one another, especially where family members are involved.
Therapists prefer dealing with a group session where relationships are involved, because it is not possible to explain the complexities of relationships in individual counselling (Abouguendia, Joyce, Piper, & Ogrodniczuk, 2004). Therapists need the concerned parties to be available, so as to ascertain his argument from different perspectives. For instance, it is very hard to explain how relationships go through the stages in marriage. Explaining this to a woman without the presence of the man is almost impossible. This is because a misconception is formed, which can only be dispelled by the presence of the man and his contribution.
A good counsellor should have the capacity to empathise with clients. The leader should have empathic understanding for the benefit of the clients. This enables the leader to have an understanding of the issues that face a client from his point of view. This enables the counsellor to capture the thoughts and feelings of the client and give them the level of support they require.
A counsellor should receive his clients with warmth and understanding due to his agreeable nature and appropriate actions as defined by the code of ethics. A counsellor should not fake understanding, but should be genuine while dealing with the client. They should also not threaten their clients through the body language, such as posture. The counsellor should maintain the eye contact, but should also respect the clients’ personal space. The ton of voice of the counsellor should also be encouraging and comforting to the client when addressing his /her issues.
The counsellor should show the client that he /she are acceptable and respected by showing the positive regard of the client. A counsellor should not condemn the client whether on a personal level or on a social level. When dealing with teenage clients, an adult should refrain from acting like the parents to the teenagers so as to avoid condemning them. The counsellor should show the client that his /her well-being is fundamental to other factors that surround a counselling session.
Counsellors must be committed towards maintaining the human dignity for the client (Trotter, Chandler, Goodwin-Bond, & Casey, 2008). They should maintain professionalism, while being open to the client to create an atmosphere of genuine intentions and comfortable acceptance. The counsellor should show the client that he is committed to the alleviating personal distress, while remaining non-judgemental. A counsellor should also be able to appreciate all cultures in ensuring that the client is comfortable to share. This helps in building trust, because the clients understand that the counsellor appreciates him/her.
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A good counsellor should have excellent organisational and planning skills to deal with different needs of the clients. The counsellor should also have good interpersonal skills to be bale to accommodate different personalities and to work towards achieving different personalities for the clients. Counsellor should also possess good motivational skills, because the profession of counselling is hinged on the ability of the counsellor to talk and convince a client. They should also exhibit excellent problem-solving skills necessary for guiding the client in the right direction, while dealing with his/her problems.
Finally, a good counsellor should be able to control the tools of service available to him/her during counselling. For instance, the counsellor should control the use of the self-disclosure to the level allowed by the code of ethics (Hornsey, Dwyer, & Oei, 2007). These tools should only be used to mode to the client how to open up and to help in building of trust.
Challenges that I would face as a counsellor include self disclosure. The inability to control the extent of information given or the inability to control the curiosity of the client to know his/her counsellor could be defeating. As a counsellor, one would also face the challenge of not imposing values and beliefs on a client. In an effort to make them better people in the society, the temptations to force the client to conform to the counsellor’s ideologies can be overwhelming. Other may include the lack of patience and control over the passing judgement on clients. This is especially so, when a client is a chronic law breaker who shows no remorse over his/he actions.
In conclusion, the group therapies should be adopted more frequently and widely where circumstances allow. This is because they offer a faster remedy to the clients and reach many clients at a time, thus, saving time and cost of counselling. With the right control over the group, group counselling is beneficial to an individual than ai individual counselling session. Group therapies help the counsellor to tap into the knowledge and skills of each individual for the benefit of the whole group.
Group therapies do not target a specific question for each client, but rather focus on sharing experiences, thus, improving the lives of the participants holistically. Group counselling is able to address many social problems at a go, as opposed to individual counselling. For instance, it can tackle alienation, depression and impulsive behavior just by the member being present at a group meeting.
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