Ethical issues are often complicated and multifaceted and can be challenging for counselors if they attempt to create simple solutions when dealing with difficult issues. Many ethical issues are gray, not black and white, and it is common for biases and personal values, beliefs, and morality to enter the decision-making process. As a result, ethical codes are designed to provide guidelines and general standards for counselors to deal with a variety of ethical issues and situations.
Ethical issues are regulated by laws and ethical codes. However, most people do not understand the inherent difference between the two. Law is a set of rules established by governments, and it defines the minimum standards that people in society tolerate. Ethics, on the other hand, is a set of ideal standards established by a profession as moral principles that members should adopt as a guide for conduct. As a result, ethical codes are generally broad instead of precise and specific. In addition, ethical codes are edited frequently due to the emergence of new issues or the clarification of old ones. For instance, more clients seek counseling using technology than was the case decades ago; thus, there is a need to address potential issues that might occur when integrating technology into counseling. No clear-cut lines separate ethics and laws; hence, counselors often make ethical decisions based on their maturity, philosophy, experience, and knowledge.
Ethical Codes in the Counseling Profession
The first American Counseling Association (ACA) ethics code was established in 1961, and revisions were made during 1974, 1981, 1988, 1995, and 2005. The first version of the Code of Ethics for Marriage Counselors was developed in 1962, and the eighth revision was published in 1991. The ACA code of ethics is the most well known and practiced by counselors.
Moral Principles in Making Ethical Decisions
The primary reason for counselors to follow an ethical code is to protect clients’ welfare, and the following six basic moral principles are priority guidelines designed to help them make most appropriate decisions. Autonomy refers to counselors allowing clients to make their own decisions, with the therapist respecting any choices made. Nonmaleficence means doing no harm, and counselors should strive at all times to avoid hurting clients, even when intentions are worthy. Beneficence means counselors doing what is good for clients. Justice means counselors providing equal treatment to all individuals, regardless of their background, age, gender, religion, ethnicity, etc. Fidelity means counselors making honest promises and honoring their commitments to their clients. Veracity refers to being truthful.
Ethical codes are not blueprints, and therapists will likely be challenged during an ethics application process. It is essential for mental health professionals to understand that potential problems exist and are encountered when counseling ethically. For instance, (a) some issues cannot be handled by simply checking ethical codes, (b) some codes are opaque and difficult to follow, (c) at times, conflict exists within ethical codes as well as among the codes of other organizations, (d) ethical codes are more likely to be reactive than proactive, and (e) conflicts may arise between institutional policies and practices.
ACA Code of Ethics
The ACA code of ethics consists of seven sections: Section A: the counseling relationship; Section B: confidentiality, privileged communication, and privacy; Section C: professional responsibility; Section D: relationships with other professionals; Section E: evaluation, assessment, and interpretation; Section F: super-vision, training, and teaching; Section G: research and publication; and Section H: resolving ethical issues.
Section A
This section addresses ethical issues involved within the counseling relationship. The first issue concerns clients’ welfare. A mental health counselor’s primary responsibility is to ensure his or her clients’ dignity and welfare; counselors may achieve this goal by following the guidelines in this section. Counselors should keep sufficient and timely records, and these should reflect clients’ progress as well as different services provided by the counselor.
The second issue concerns informed consent. Clients have the right to detailed information regarding counseling services and the counselor before making a decision to continue with counseling. Counselors have the responsibility to review informed consent both verbally and in writing with the client concerning his or her responsibilities and rights. Therapists explain the type(s) of counseling services the client will receive as well as the counseling purpose, goals, techniques, procedures, limitations, potential risks, and benefits. Counselors should provide professional information about themselves, such as their qualifications, credentials, experiences, etc. When dealing with clients unable to give consent, counselors need to obtain assent from an appropriate collateral (e.g., parent, guardian).
The third issue deals with the professional relationships that a client may have with other mental health professionals. Under such circumstances, a counselor requests a release from the client to inform those other professionals about the counselor’s work with the client. The counselor also tries to establish positive professional relationships with the other health professionals working with the client. The fourth issue addresses how counselors can avoid harm by not imposing their values on the client. Counselors respect their clients and are aware of their own personal values while avoiding the temptation to inculcate them into their clients.
The fifth issue concerns counselors’ roles and relationship with their clients. Any sexual or romantic relationship is strictly prohibited. When counselors are involved with their former clients sexually or romantically, a document must prove their last professional contact was at least five years earlier. In addition, other documents must show that their new relationship will not psychologically harm the former client. When counselors engage in nonprofessional relationships with clients, the counselor must provide documentation to prove that the clients benefit from such a relationship. When the counselor’s professional role changes, he or she needs to obtain new consent from the client.
The sixth issue discusses counselors’ and clients’ roles and relationships at different levels, such as individual, group, institutional, or societal levels. When roles change, counselors must examine any potential barriers that might restrain clients’ growth. The seventh issue concerns counselors providing counseling services to multiple clients. Under such circumstances, counselors clarify their relationship with each specific client. The eighth issue centers on group work. It is essential for counselors to select group members who have goals that are compatible with those of other group members. In addition, counselors need to protect group members from physical, emotional, and psychological damage.
The ninth issue discusses potential ethical issues when dealing with terminally ill clients. Counselors need to provide high-quality end-of-life care to clients while enabling them to engage in decision making regarding their end-of-life care. Meanwhile, counselors have the responsibility to provide appropriate referral information while ensuring that clients receive adequate assistance. In addition, counselors must recognize their personal, moral, and competence issues when working with terminally ill clients. If terminally ill clients decide to accelerate their own demise, therapists need to follow applicable state law and decide whether to break confidentiality. However, before making such a decision, counselors seek consultation or supervision from appropriate professional parties.
The tenth issue is about fees and bartering. While establishing fees, counselors need to take clients’ financial status into consideration. If the established fee structure is inappropriate for a client, the counselor has the responsibility to assist the client in finding comparable services at an acceptable cost. When clients fail to pay their fees, clients need an opportunity to make payment before counselors use collection agencies. If clients suggest bartering, and it is acceptable among professionals in their community, counselors may accept it. When determining whether or not to accept gifts from clients, counselors consider how it might affect the therapeutic relationship.
The eleventh issue is about termination and referral of counseling services. Counselors never abandon clients under any circumstances, such as illness, vacation, and so on. In fact, counselors need to arrange for clients to continue treatment if the counselor is unavailable to continue providing counseling services. If the client rejects the referral, the counselor needs to terminate the counseling service. In addition, counselors should terminate the therapeutic relationship when the client will not benefit from further services, the client fails to pay fees, or there is potential harm for the client. After termination, counselors need to make appropriate referrals for the client.
The twelfth issue concerns potential ethical issues when integrating technology into counseling. It is the counselor’s responsibility to inform clients regarding any benefits and limitations while implementing technology into counseling services. Counselors need to be aware of their clients’ intellectual and emotional capability as well as the appropriateness of the type of technology they plan to use in the counseling session. When counselors realize long-distance counseling service is not appropriate, they provide face-to-face counseling sessions to their clients. Counselors are responsible to ensure the technology implementation does not violate the law. Counselors also receive informed consent from the client, which must address any potential technological issues concerning the counseling sessions. In addition, when counselors maintain sites on the Web, they regularly update the content and stay current with the activity on their sites. They also need to have other modes of communication with the clients if the technology fails.
Section B
Section B addresses ethical issues regarding confidentiality, privileged communication, and privacy. The first issue concerns counselors respecting the rights of their clients. When working with clients whose ethnic or cultural background is different from theirs, counselors are aware of and sensitive to their clients’ culture, recognizing that it might have impact on confidentiality and privacy issues. Counselors respect clients’ privacy and seek personal information from the client only when the relationship can gain from acquiring it. Counselors may share a client’s information with others only when they have the client’s consent and a legal or ethical justification for this action. In addition, counselors must inform clients regarding the limitations of confidentiality, identifying specific situations when confidentiality must be breached.
The second and third issues center on how counselors disclose clients’ personal information. Counselors disclose only when the client is in danger of hurting him- or herself or in danger of injury from someone else. When counselors are under a court order to release clients’ personal information, it is important for them to obtain informed consent from the client and to disclose as little information as possible. Counselors have the responsibility to ensure that clients’ private information is not revealed to other professional parties, such as employees. If clients are involved in treatment, they should be informed that their personal information might be shared with other professionals as well as the purpose for doing so. Counselors discuss clients’ information only when they are sure that privacy will be maintained.
The fourth issue is about potential ethical issues regarding group and family counseling. Because more than one client is involved in such a counseling relationship, it is essential that counselors clearly explain the importance of confidentiality to each client. The fifth issue is about clients’ capacity to give informed consent. When dealing with incapable clients (minors or adults), counselors need to protect clients’ confidentiality based on specific laws and/or ethical codes. In addition, when working with these clients, counselors obtain permission from an appropriate party regarding the release of confidential information.
The sixth issue concerns how counselors handle clients’ records. It is essential for counselors to keep clients’ records in a secure place where only authorized individuals have access. If counselors need to record or observe counseling sessions, they must obtain clients’ permission beforehand. The seventh issue is about research and training. When counselors conduct research, they must receive institutional approval first. In addition, counselors need to be cautious about disclosing any information that might lead to the identification of certain research participants. The eighth issue concerns consultation within the counseling relationship. When counselors consult with others, they have the obligation to protect clients and not disclose information that might lead to identification of certain clients.
Section C
This section is about counselors’ professional responsibility. The first issue concerns knowledge of standards. It is a counselor’s responsibility to read and comprehend the ethical codes and standards of the profession. The second issue involves professional competence. Counselors should practice counseling based only on their education, training, and professional credentials as well as professional experience. If counselors practice in a specialty area different from the one in which they have been educated or trained, they must take steps to ensure their competence in order to protect potential clients from harm. They should continually monitor and improve their professional skills. When counselors have questions regarding their ethical obligations, they should seek consultation from other counselors. In addition, counselors need to take steps, such as receiving continuing education, to maintain their competence level.
The third issue addresses how counselors advertise for and solicit clients. When advertising, counselors must provide accurate information when identifying their credentials in order to not mislead clients. In addition, when counselors develop professionally related products, they should not use a counseling, supervising, or training relationship to promote their goods. The fourth issue centers on counselors’ professional qualifications. Counselors must truthfully represent their qualifications and accurately describe their professional training, and they may refer only to licenses and certifications that are current and in good standing. Counselors are responsible to state their educational degree as well as the accreditation of their institution at the time their degree was completed. Counselors must distinguish their current from their former association memberships. The fifth issue states that counselors should not discriminate against their clients, supervisees, students, or others based on race, age, culture, religion, and so on.
The sixth and seventh issues discuss counselors’ responsibilities to the public and to other professionals. Counselors should not engage in sexual harassment and should strive for accuracy and objectivity when asked to provide professional reports or judgments to third parties.
Section D
This section primarily discusses counselors’ relationships with other professionals. The first issue centers on counselors’ relationship with their colleagues, employees, and employers. Counselors need to respect others providing counseling approaches different from their own, and they should strengthen their relationships with other colleagues in order to provide the best services for their clients. When counselors are employed in an agency or institution, the implication is that the mental health professionals working there agree with their employers’ general policies and principles. However, when counselors identify inappropriate policies or practices of their employers, they take steps for making constructive changes. When such policies have damaged the effectiveness of counseling, they need to refer clients to another appropriate agency.
The second issue is about consultation. When counselors are requested to provide consultation services, they need to ensure their competency as consultants. They are also obligated to review rights and responsibilities for both themselves and consultees. In addition, they seek understanding with their consul-tees regarding problem definition, goals for consultation, and predicted intervention results. They are also responsible for communicating with consultees regarding related consultation issues, such as the purpose of the consultation service, costs, and potential risks and benefits.
Section E
This section is concerned with how counselors use instruments to evaluate clients and the accuracy of any interpretation of results. There are 13 issues in this section. The first issue is general information regarding assessment. It is a counselor’s responsibility to select reliable and valid instrument(s) to measure a client’s personality, ability, interest, intelligence, or performance. In addition, counselors must know how to interpret the assessment results. Their interpretations should be available to clients when requested.
The second issue addresses counselors’ competence using and interpreting assessment instruments. Counselors may use only assessments that they have received adequate training to and are thus competent to administer. In addition, if counselors serve as supervisors, they need to hold the same standards to ensure their supervisees’ assessment competence. Counselors are responsible for appropriate scoring and the interpretation of instruments used meeting the needs of their clients. Counselors are especially responsible for any decisions made that are based on clients’ assessment results. They must have a thorough understanding of the psychometric properties of any instrument used, such as validation criteria, assessment research, and assessment guidelines for development and use.
The third issue discusses informed consent. Counselors should explain to their clients the purpose and nature of the instrument prior to assessment. Meanwhile, counselors need to be aware of their clients’ culture and level of understanding of the assessment results as well as the potential impact such information might have on the clients. The fourth issue is about releasing assessment data to other qualified professionals. Counselors may only release clients’ data to other qualified professionals after obtaining the consent of the client or the client’s legal representative. The fifth issue discusses how counselors should carefully select instrument(s) and appropriate assessment techniques for a mental disorder diagnosis. In addition, when diagnosing diverse clients, counselors need to take into consideration a client’s culture. Counselors may abstain from reporting a diagnosis that they believe would bring harm to a client.
The sixth issue addresses how counselors should appropriately select an instrument for assessment purposes. Certain criteria, such as validity, reliability, psychometric limitations, and appropriateness of a particular instrument need to be carefully investigated before selecting the instrument. In addition, counselors need to be cautious when selecting instruments for culturally diverse clients and avoid using instruments that appear to have a lack of psychometric properties for the population the client represents. The seventh issue concerns the administration conditions. If, in an effort to accommodate a client’s special needs, a counselor administers an instrument under nonstandardized condition(s), these conditions must be reported in the interpretation. In addition, counselors must understand that the results might be invalid.
The eighth issue regards multicultural issues in assessment. Counselors should be familiar with the effect of a client’s age, gender, race, religion, language, and other cultural components. The ninth issue concerns scoring and interpreting the assessment results. Counselors should recognize reservations that exist regarding validity and reliability of the instrument. The tenth issue addresses the need for counselors to maintain security of tests and assessment. Counselors may not reproduce or modify a published assessment prior to obtaining permission from the publisher. The eleventh issue states the need for counselors not to use outdated assessments. The twelfth issue addresses counselors’ responsibility to select assessment methodologies based on scientific procedures, relevant standards, and professional knowledge. The thirteenth issue discusses forensic evaluation and evaluation for legal proceedings. When counselors provide forensic evaluations, their opinions must be objective and supported by data gathered during the evaluation.
Section F
This section discusses supervision, training, and teaching issues. The first issue regards clients’ welfare with supervision. When counselors serve as supervisors, they are responsible for their supervisee’s understanding and following of ethical codes. In addition, supervisees must explain to their clients who will have access to the clients’ records. The second issue concerns supervisors’ competence level. Before supervisors provide any clinical supervision, they must receive adequate supervision training. The third issue is about supervisory relationships. Supervisors should explain the professional supervisory relationship to their supervisees and avoid any kind of nonprofessional relationship with current supervisees. Supervisors are banned from developing any sexual or romantic relationship with current supervisees.
The fourth issue states supervisors’ responsibilities. Supervisors ensure their supervisees’ awareness of professional and ethical standards and encourage them to follow those standards. In addition, if either the supervisor or the supervisee intends to terminate the supervisory relationship, he or she must give adequate notice to the other before doing so. The fifth issue is about supervision, evaluation, and endorsement. It is essential for supervisors to have periodic formal evaluations with their supervisees and to provide feedback. Supervisors need to be aware of supervisees’ limitations and help them understand options. Supervisors also support supervisees for certification, licensure, or employment.
The sixth issue discusses counselors’ responsibilities as counselor educators. Counselor educators demonstrate that they are skilled teachers and practitioners. They are knowledgeable about legal and ethical issues, and they help their students become aware of their responsibilities. In addition, counselor educators integrate multicultural materials into classes and workshops for the development of professional counselors. When teaching counseling techniques that lack sufficient and solid empirical research data to prove their effectiveness, counselor educators should explain to students about the lack of research support. Moreover, they should explain any potential risks that might arise when applying these techniques to practice.
The seventh issue refers to students’ welfare. Counselor educators should clarify to students what the expectations are for the training program. The program should provide the type of skills and knowledge students need for completing the program. The program needs to provide employment data on their graduates. The eighth issue discusses counseling students’ responsibilities. They should follow the ACA codes, sharing the same obligations to clients as professional counselors. The ninth issue is about evaluation and remediation of students. Counselor educators must provide ongoing feedback to their students throughout the training program. In addition, if students request counseling, counselor educators should make appropriate referrals for them.
The tenth issue addresses roles and relationships between students and counselor educators. Any sexual or romantic relationship between counselor educators and current students is forbidden. Counselor educators must avoid any nonprofessional relationship with students that might potentially harm the student. In addition, counselor educators may not accept any form of service or fee from sites, students, or supervisees. Counselor educators may not provide long-term counseling services to current students.
Section G
This section concerns potential issues when counselors conduct research. The first issue addresses counselors’ responsibilities as researchers. When counselors conduct research, they must report their research following ethical principles and federal and state laws as well as the regulations of the host institution. When counselors recruit humans as research participants, they must avoid harming these participants psychologically, emotionally, or physically. In addition, if counselors do not have access to an institutional review board (IRB), they need to consult with people familiar with IRB regulations.
The second issue addresses the rights of research participants. Before participating in any research, subjects must provide consent. In the consent form, researchers clearly state the purpose of the research, explain procedures in detail, and describe any limitations of confidentiality. In addition, researchers must indicate that participation in the study is voluntary and that participants may withdraw at any point during the process without penalty. If students or supervisees are involved as subjects in research, researchers must inform them that any decision they make concerning participation will not affect their supervisory relationships or the evaluation of their academic performance. In addition, researchers must inform their research project sponsors or institutions about their research results. After a reasonable period of time, researchers must destroy their research data.
The third issue concerns counselors’ relationship with the participants in their research. Counselors are not allowed to develop any nonprofessional relationship, such as a sexual or romantic relationship, with their participants. However, if counselors feel any non-professional interaction between them and their participants might benefit their research outcome, their interaction should be documented. In addition, counselors need to acquire consent from their participants prior to engaging in the interaction. The fourth issue addresses reporting accurate research results. Counselors should not report falsified research results and mislead readers. The fifth issue discusses publication issues. Counselors should not plagiarize others’ work and must always recognize others’ contributions.
Section H
The primary issues in this section are centered on resolving ethical issues. Counselors should be knowledgeable regarding the ACA code of ethics and codes of other licensure organizations. Their professional behavior must follow legal and ethical standards. When counselors face ethical dilemmas, they should consult with colleagues or supervisors. If the conflict exists between ethics and law or other regulations, counselors should take appropriate steps to resolve the conflict. When counselors suspect their colleagues are acting in an unethical manner, they take appropriate action. If a violation has harmed an individual or organization and has not been appropriately resolved, counselors should take further action to address the issues.
References:
- American Counseling Association. (2005). Code of ethics. Alexandria, VA: Author.
- Corey, G., Corey, M. S., & Callanan, P. (1998). Issues and ethics in the helping professions (5th ed.). Pacific Grove, CA: Brooks/Cole.