Ultimately, our single most important instrument is the person we are, and our most powerful technique is our ability to model aliveness and realness. It is an ethical mandate that we take care of ourselves, for how can we take care of others if we are not taking care of ourselves? We need to work at dealing with those factors that threaten to drain life from us and render us helpless. I encourage you to consider how you can apply the theories you will be studying to enhance your life from both a personal and a professional standpoint. If you are aware of the factors that sap your vitality as a person, you are in a better position to prevent the condition known as professional burnout.
Learn to look within yourself to determine what choices you are making (and not making) to keep yourself vital. This can go a long way toward prevent- ing what some people consider to be an inevitable condition associated with the helping professions. You have considerable control over whether you become burned out or not. You cannot always control stressful events, but you do have a great deal of control over how you interpret and react to these events. It is important to realize that you cannot continue to give and give while getting little in return. There is a price to pay for always being available and for as- suming responsibility over the lives and destinies of others. Become attuned to the subtle signs of burnout rather than waiting for a full-blown condition of emotional and physical exhaustion to set in. You would be wise to develop your own strategy for keeping yourself alive personally and professionally.
Self-monitoring is a crucial fi rst step in self-care. If you make an honest inventory of how well you are taking care of yourself in specifi c domains, this can give you a framework for deciding what you may want to change. By mak- ing periodic assessments of the direction of your own life, you can determine whether you are living the way you want. If not, decide what you are willing to actually do to make changes occur. By being in tune with yourself, by hav- ing the experience of centeredness and solidness, and by feeling a sense of personal power, you have the foundation for integrating your life experiences with your professional experiences. Such an awareness can provide the basis
for retaining your physical and psychological vitality and for being an effective professional.
If you are interested in doing supplementary reading on therapist self-care, I highly recommend Leaving It at the Offi ce: A Guide to Psychotherapist Self-Care (Norcross & Guy, 2007) and Caring for Ourselves: A Therapist’s Guide to Personal and Professional Well-Being (Baker, 2003).
Summary
One of the basic issues in the counseling profession concerns the signifi cance of the counselor as a person in the therapeutic relationship. In your profession- al work, you are asking people to take an honest look at their lives and to make choices concerning how they want to change, so it is critical that you do this in your own life. Ask yourself questions such as “What do I personally have to offer others who are struggling to fi nd their way?” and “Am I doing in my own life what I may be urging others to do?”
You can acquire an extensive theoretical and practical knowledge and can make that knowledge available to your clients. But to every therapeutic ses- sion you also bring yourself as a person. If you are to promote change in your clients, you need to be open to change in your own life. This willingness to at- tempt to live in accordance with what you teach and thus to be a positive model for your clients is what makes you a “therapeutic person.”
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k Introduction
k Putting Clients’ Needs Before Your Own
k Ethical Decision Making
The Role of Ethics Codes as a Catalyst for Improving Practice
Some Steps in Making Ethical Decisions
k The Right of Informed Consent
k Dimensions of Confi dentiality
k Ethical Issues in a Multicultural Perspective
Are Current Theories Adequate in Working With Culturally Diverse Populations?
Is Counseling Culture-Bound?
Focusing on Both Individual and Environmental Factors
k Ethical Issues in the Assessment Process
The Role of Assessment and Diagnosis in Counseling
k The Value of Evidence-Based Practice
k Dual and Multiple Relationships in Counseling Practice
Perspectives on Dual and Multiple Relationships
k Summary
k Where to Go From Here
Ethical Issues
in Counseling Practice
k
Introduction
This chapter introduces some of the ethical principles and issues that will be a basic part of your professional practice. Its purpose is to stimulate you to think about ethical practice so that you can form a sound basis for making ethical decisions. To help you make these decisions, you can consult with colleagues, keep yourself informed about laws affecting your practice, keep up to date in your specialty fi eld, stay abreast of developments in ethical practice, refl ect on the impact your values have on your practice, and be willing to engage in hon- est self-examination. Topics addressed include balancing clients’ needs against your own needs, ways of making sound ethical decisions, educating clients about their rights, parameters of confi dentiality, ethical concerns in counseling diverse client populations, ethical issues involving diagnosis, evidence-based practice, and dealing with dual and multiple relationships.
At times students think of ethics in a negative way, merely as a list of rules and prohibitions that result in sanctions and malpractice actions if practitioners do not follow them. Mandatory ethics is the view of ethical practice that deals with the minimum level of professional practice, whereas aspirational ethics is a higher level of ethical practice that addresses doing what is in the best interests of clients. Eth- ics is more than a list of things to avoid for fear of being punished. Ethics is a way of thinking about becoming the best practitioner possible. Positive ethics is an ap- proach taken by practitioners who want to do their best for clients rather than sim- ply meet minimum standards to stay out of trouble (Knapp & VandeCreek, 2006).
Knowing and following your profession’s code of ethics is part of being an ethical practitioner, but these codes do not make decisions for you. As you be- come involved in counseling, you will fi nd that interpreting the ethical guide- lines of your professional organization and applying them to particular situ- ations demand the utmost ethical sensitivity. Even responsible practitioners differ over how to apply established ethical principles to specifi c situations. In your professional work you will be challenged to deal with questions that do not always have obvious answers. You will have to assume responsibility for deciding how to act in ways that will further the best interests of your clients.
You will need to reexamine the ethical questions raised in this chapter through- out your professional life. You can benefi t from both formal and informal opportu- nities to discuss ethical dilemmas during your training program. Even if you resolve some ethical matters while completing a graduate program, there is no guarantee that they have been settled once and for all. These topics are bound to take on new dimensions as you gain more experience. Oftentimes students burden themselves unnecessarily with the expectation that they should resolve all potential ethical problem areas before they begin to practice. Ethical decision making is an evolu- tionary process that requires you to be continually open and self-refl ective.
Putting Clients’ Needs Before Your Own
As counselors we cannot always keep our personal needs completely sepa- rate from our relationships with clients. Ethically, it is essential that we be- come aware of our own needs, areas of unfi nished business, potential personal
problems, and our sources of countertransference. We need to realize how such factors could interfere with effectively and ethically serving our clients.
Our professional relationships with our clients exist for their benefi t. A use- ful question to frequently ask yourself is this: “Whose needs are being met in this relationship, my client’s or my own?” It takes considerable professional ma- turity to make an honest appraisal of how your behavior affects your clients. It is not unethical for us to meet our personal needs through our professional work, but it is essential that these needs be kept in perspective. An ethical problem ex- ists when we meet our needs, in either obvious or subtle ways, at the expense of our clients’ needs. It is crucial that we avoid exploiting or harming clients.
What do we need to be aware of? We all have certain blind spots and dis- tortions of reality. As helping professionals, we have responsibilities to work actively toward expanding our own self-awareness and to learn to recognize areas of prejudice and vulnerability. If we are aware of our personal problems and are willing to work through them, there is less chance that we will project them onto clients. If certain problem areas surface and old confl icts become reactivated, we have an ethical obligation to seek personal therapy to avoid harming our clients.
We must also examine other, less obviously harmful personal needs that can get in the way of creating growth-producing relationships, such as the need for control and power; the need to be nurturing and helpful; the need to change others in the direction of our own values; the need for feeling adequate, par- ticularly when it becomes overly important that the client confi rm our compe- tence; and the need to be respected and appreciated. Although these needs are not necessarily unhealthy, it is essential that our needs be met outside of our work as therapists if we are to be involved with helping others fi nd satisfaction in their lives. It is crucial that we do not meet our needs at the expense of our clients. For an expanded discussion of this topic, see Corey and Corey (2007, chap. 1).
Ethical Decision Making
As a practitioner you will ultimately have to apply the ethics codes of your pro- fession to the many practical problems you face. You will not be able to rely on ready-made answers given by professional organizations, which typically provide only broad guidelines for responsible practice.
Part of the process of making ethical decisions involves learning about the resources from which you can draw when you are dealing with an ethical ques- tion. Although you are ultimately responsible for making ethical decisions, you do not have to do so alone. You should also be aware of the consequences of practicing in ways that are not sanctioned by organizations of which you are a member or the state in which you are licensed to practice.