Counselor Ethical Boundaries and Practices

Most professions including social work such as counselling have ethical guidelines. Professional counselors and supervisors are expected to behave ethically when dealing with their clients. For counselors to provide quality services, they ought to stick to their boundaries between them and their clients and ensure good relationships with their colleagues. This paper will explore four sections: boundary issues and dual relationships, professional collaboration, relationships with supervisors and colleagues, and lastly, my development of thinking on ethics.

Section 1: Boundary Issues and Dual Relationships

Boundary-crossing and the formation of dual relationships are inevitable between counselors and their patients. Some dual relationships are boundary-crossing but boundary-crossing does not always mean a dual relationship (Reamer, 2001). For this reason, determining why a certain counselor is crossing boundaries with a certain client is crucial since it be may be of benefit to the patient.

One of the criteria I would use to determine ethical dual relationships and boundary-crossing is determining whether they are necessary or not. Experts in therapy have it that successful therapy is difficult without the introduction of other external factors like crossing boundaries (Vermeire, Hearnshaw, Van Royen, & Denekens, 2001). Therefore, in some instances, counselors are forced to have a friendly relationship with their client for therapy to work. In such a case, the relationship is ethical. For instance, when a patient needs someone to accompany them to the hospital, the therapist can help them thereby serving as both a therapist and a friend. Also, crossing the boundary beyond therapy session in such a case is ethical.

The second way of determining whether they are appropriate and ethical is looking at their effects on both the patient and counselor. Some dual relationships and boundary-crossing are exploitive to the patients, which is unethical. If the impact is likely to be negative especially on the patient’s side, then they are unethical (Smith & Fitzpatrick, 1995). For instance, sexual relationships which lead to a client becoming pregnant. Ethical dual relationships result in both the therapist and client benefiting.

The first example of an ambiguous dual relationship is a physical attraction between the counselor and the client. Firstly, the attraction is not necessary for both of them. Secondly, it is likely to have negative impacts on both. For example, the counselor may lose their jobs or the client may be discontinued from attending the therapy. Thus, the attraction is unethical. On top of that, the APA code of ethics forbids and terms physical attraction between the counselor and client as unethical (Sonne, 1994).

The second example is a social or personal dual relationship. When the relationship becomes too personal. For example, if after the session the therapist goes to the client’s house at night for other reasons. It may not be necessary to do that because what they are discussing at home could be discussed during the session. Also, it may bring about undesirable effects like the therapist knowing personal information about the client which is not called for. Thus, this type of relationship is unethical.

The third example is improper gift-giving and receiving. Bringing clients expensive gifts or clients bringing counselors gifts shows the two have another relationship beyond therapy. (Tournier, 2012), explains that when someone is giving out gifts, the person expects the gift of love in return. It could also mean romantic love. Therefore, if this happens between the counselor and the client, then the impacts may not be pleasing. It is thus unethical unless the gift is from the school itself rather than an individual.

The fourth example is a business or financial dual relationship.  A counselor transacting an illegal business with a client is not appropriate because it may ruin the expected respect between them. Again, it may result in the counselor being fired if the board of the school learns about it. For example, when the counselor is secretly selling drugs to the client, it may ruin the reputation of the school and the counselor may be fired. For these reasons, transacting illegal business activities is unethical.

Section 2: Professional Collaboration in Counseling: Working with a Multidisciplinary Team

I would employ three skills to effectively collaborate with my colleagues

The first one is to show respect to other mental professionals. Showing respect even to their work, opinions, and ideas would help me work collaboratively in bringing out the best to a client. For instance, when my fellow professional tells me that a certain drug is not fit for a particular client, I will respect that and need to know more from the professional. Through this, the client will receive quality care.

The second way is to partner with other professionals. This revolves around brainstorming with my partners during meetings which bring about team-work. Experts say that teamwork results in improved efficiency and productivity (Clements, Dault, & Priest, 2007). Therefore, this will improve the quality of services offered to clients.

The third way is by being responsible and committed to my duties. Collaboration also means everyone doing their part as expected. Quality mental care responsibilities are shared among different professionals. For example, when dealing with a drug addict, there will be a counselor for quality health, another one for the effects of drugs, and so on. Therefore, fulfilling my duties will result in quality services to clients.

I would expect to work with three people as part of a multidisciplinary team namely, a social worker, a clinical psychologist, and a psychiatrist. The role of the social worker would be to provide information and assistance to clients. Such information includes providing directions to a place when a client needs one. A clinical psychologist would help in the assessment and evaluation of results for clients. A psychiatrist’s role would be to diagnose and treat clients as well as prescribe necessary drugs. Then as a counselor, my role would be to educate clients who are adversely affected by their conditions, give them guidelines as well as encourage them to focus on the positive side of their lives.

Section 3: Relationships with Supervisors and Colleagues

According to the ACA code of ethics, clinical supervisors’ role is to ensure a mutual understanding of counselors and students, and also between them and supervisees (ACA Code of Ethics, 2014). Some of their primary responsibilities include;

1. Monitoring services offered by therapists and client’s welfare
2. Ensuring counselors communicate their credentials to foster quality services to clients.
3. Protecting the client’s rights and confidentiality in the counseling relationship.
4. Evaluating and providing feedback to counselors for their work.

One of the ethical issues involved in the counselor-supervisor relationship is sexual relationships. For example, a male supervisor may be physically attracted to a female counselor leading to sexual harassment. Another issue is supervisors engaging in supervisory relationships with friends or family members. It is unethical because the supervisor cannot remain objective towards the counselor (Page & Wosket, 2013). 

The relationships are similar to counselor-client relationships in that in both cases, they are prohibited. On the other hand, they differ in how consequences are administered. In a counselor-supervisor relationship, both may lose their jobs while in a counselor-client relationship, the counselor may lose their job while the client may maintain their admission.

One of the unethical behaviors that a counselor might see in their colleagues is crossing the boundaries to flirt with a client. (Hill, 2019) describes a therapist touching clients or making sexual comments without permission is unethical. For example, a certain counselor might spot a male colleague touching a female client’s body parts while the client tries to resist the touch. This may suggest that the counselor is doing that out of permission.

The observing counselor might address the issue using the six-step decision-making model (Porzsolt, 2003). The first step is identifying the ethical issue. In this case, the ethical issue is the counselor touching a client without permission. The second step is collecting information. For example, the observer may ask the client when it started, how, and any other relevant information. The third step is stating options. The observer brainstorms possible solutions to the problem. For example, advising the colleague, talking to the supervisor among others. The fourth step is applying the ethical principles to the options. Evaluate whether the options are ethical and appropriate. For instance, whether they are confidential to the client. The fifth step is making a decision based on the merits and demerits of each option. The final step is implementing the decision. For instance, if the observer has decided to confront the counselor, they should respectfully confront them.

Section 4: Development of Your Thinking about Ethics

My knowledge of ethics has tremendously developed in three areas during this course. One of them is about boundary-crossing. Crossing the boundaries of having a sexual relationship with my client is unethical. For example, even if I am not married, and my client is also not married, flirting with the client will cause more problems in my workplace. It is also forbidden in the ACA code of ethics.

The other area is on collaborating effectively with my colleagues and other multidisciplinary through respect, team-work, and being committed to my duties. For example, if my colleague speaks, I should respect their ideas and views. Also, through teamwork, clients will receive high-quality services.

The third area I have developed is keeping the clients’ information confidential and respecting them. Earlier, I believed that because I am the counselor, the client is just a student and their respect should be of a high level than I respect them. During the course, I discovered that respect is two way to both the counselor and the client. Also, keeping their information confidential builds trust between us. Therefore, as an ethical counselor, these two qualities are crucial.

Conclusively, for counselors to provide quality services to their clients, they must ensure that they stick to their lanes and observe ethical behavior while on duty. Furthermore, they should maintain a mutual relationship with their colleagues such as supervisors and social workers. They should avoid crossing boundaries like engaging in sexual relationships with clients, develop a collaborative behavior with their colleagues among others. The ultimate goal of counseling is to change clients’ behavior and promote an ethical society. Thus, counselors too should be ethical.

References

ACA Code of Ethis. (2014). Retrieved from https://www.counseling.org/resources/aca-code-of-ethics.pdf

Clements, D., Dault, M., & Priest, A. (2007). Effective teamwork in healthcare: Research and reality. HealthcarePapers, 7(sp), 26-34. DOI:10.12927/hcpap.2013.18669

Page, S., & Wosket, V. (2013). Supervising the counselor: A cyclical model. Routledge.

Porzsolt, F. (2003). Evidence-based decision making–the six-step approach. Evidence-Based Medicine, 8(6), 165-166. DOI:10.1136/ebm.8.6.165

Reamer, F. G. (2001). Tangled relationships: Boundary issues and dual relationships in human services. Columbia University Press.

Smith, D., & Fitzpatrick, M. (1995). Patient-therapist boundary issues: An integrative review of theory and research. Professional Psychology: Research and Practice, 26(5), 499-506. DOI:10.1037/0735-7028.26.5.499

Sonne, J. L. (1994). Multiple relationships: Does the new ethics code answer the right questions? Professional Psychology: Research and Practice, 25(4), 336-343. DOI:10.1037/0735-7028.25.4.336

Tournier, P. (2012). The meaning of gifts. Wipf and Stock Publishers.

Vermeire, E., Hearnshaw, H., Van Royen, P., & Denekens, J. (2001). Patient adherence to treatment: Three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics, 26(5), 331-342. DOI:10.1046/j.1365-2710.2001.00363.x