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A counselor's relationship with a client depends on trust, and it is up to the counselor to maintain appropriate boundaries. The nature of the relationship between a counselor and a client creates vulnerability to ethical dilemmas. A counselor is not only privy to sensitive information, but holds a position of power over the client. Ethical conflicts may also embody legal and moral complications. The American Counseling Association and the American Psychological Association provide counselors with general guidelines to consider when faced with potential ethical violations.
In his "Counselor Magazine" article entitled "Ethics in Counseling: A Complex Issue," David J. Powell, assistant clinical professor of psychiatry at Yale University School of Medicine, identifies four main reasons why clients sue their counselors. These reasons include inappropriate sexual behavior, improper treatment, violation of confidentiality, and wrong diagnosis. As part of its documentation on "Ethical Principles of Psychologists and Code of Conduct," the APA states counselors "do not engage in sexual harassment." Inappropriate sexual behavior includes verbal, physical and nonverbal unwelcome advances. Violations of confidentiality may stem from what the APA defines as "multiple relationships." Counselors should not have more than one type of relationship with clients. This includes having a personal relationship with a client's friends, significant others or close relatives.
Informed Consent and Privacy
Counselors face the challenge of collecting and documenting only what is necessary. In other words, they should not violate their clients' privacy rights. According to APA guidelines, counselors must get their clients' informed consent. When a counselor conducts research or gives therapy, clients need to provide documentation stating they agree. Exceptions to this standard are permissible if local law does not require informed consent. As a precaution, the APA recommends that counselors obtain only the personal information relevant to therapeutic treatment or research. A counselor should share clients' personal information with other colleagues only if it is necessary.
The American Counseling Association advocates the development of "ethical sensitivity." Without the ability to recognize an ethically compromising situation, counselors are not able to resolve them. Someone who does not possess "ethical sensitivity" may be more prone to making unethical decisions. The development of "ethical sensitivity" involves examining your socioeconomic background. Counselors need to recognize how these backgrounds affect their professional decisions and values. Part of identifying ethical dilemmas means examining what is appropriate. This includes the facts and who stands to gain or lose something in the relationship between counselor and client. For example, it might be compromising for a male counselor to recommend a female incest victim repair her relationship with a male perpetrator.
Part of the ethical decision process involves debating all available solutions. Counselors are able to conclude what options are open by identifying the situation's core issue(s). For instance, are there legal obligations at stake? Does the law require a counselor to break confidentiality? If a person's life or well-being is at risk, the law may obligate a counselor to reveal a client's personal disclosures to law enforcement or social services. According to the American Counseling Association, counselors should rely on professional standards, regulations and the advice of supervisors. Counselors can also apply five ethical principles to the situation. Before reaching a final decision, counselors may need to consider respect for autonomy, non-harm, beneficence, justice and fidelity.