Case: Breach of Confidentiality

Jane, a counselor with several years of experience, is working with a client

named Alex who is struggling with substance abuse issues. Alex has shared
sensitive information about their history of addiction, including details about
illegal activities they were involved in while under the influence.
One day, Jane runs into a mutual friend, Mark, at a social event. Mark is not
aware that Jane is Alex's counselor. During their conversation, Jane discloses
details about Alex's struggles with addiction, mentioning specific illegal
incidents that Alex had shared in confidence during counseling sessions.
Mark is surprised and concerned by the information, especially because he
knows Alex personally. Feeling obligated to help, Mark decides to inform Alex's
family about the situation, causing a breach of confidentiality.
 Case: Dual Relationship
Alex, a licensed therapist, has been providing counseling to a client named
Jordan for several months. Jordan is seeking support for relationship issues and
struggles with low self-esteem. Over time, a strong emotional connection
develops between Alex and Jordan during therapy sessions.
One day, Alex and Jordan unexpectedly run into each other at a local bookstore.
They strike up a conversation, and it becomes clear that they share a mutual
interest in literature. They exchange contact information to discuss book
recommendations further. As they begin to communicate outside of therapy
about shared interests, their conversations gradually become more personal.
Eventually, Alex and Jordan find themselves romantically attracted to each other.
They decide to pursue a romantic relationship outside of the therapeutic context,
blurring the lines between their professional and personal connections.
ETHICAL ISSUES IN
COUNSELLING
PRACTICE
Chapter 3
 ETHICS IN COUNSELLING
Ethics in counselling are concerned with human conduct and doing what is in the best interest
of the client.

Ethical guidelines are important in counselling for a variety of reasons. For example, ethical
guidelines in counselling can maximize client benefits and minimize possible harm to the client.
It is common for clients to become vulnerable during counselling sessions as sensitive topics are
discussed. Although ethics in counselling are not always clear-cut or concise, ethical guidelines
can help the counsellor develop a bond of trust with their client. When the client trusts their
counsellor, they are more likely to speak more openly.

In addition, ethical guidelines are important because they can protect the counsellor from
repercussions. For example, if the counsellor breaks client confidentiality, they may be at risk of
losing their license or facing a malpractice suit. However, the counsellor can minimize these
risks by following ethical guidelines.
Ethical Decision Making
Ethical decision-making in counseling psychology involves the
thoughtful consideration and application of ethical principles and
guidelines to navigate complex situations and dilemmas within
the therapeutic relationship. Counselors are bound by
professional codes of ethics that provide a framework for ethical
behavior and guide their interactions with clients.
 Ethical Decision Making

Here are key components of ethical decision-making in counseling psychology:

1. Ethical Principles
2. Professional Codes of Ethics
3. Informed Consent
4. Confidentiality
5. Cultural Competence
6. Boundary Management
7. Supervision and Consultation
8. Continuous Professional Development
9. Conflict Resolution
10. Accountability
ETHICAL PRINCIPLES OF COUNSELLING
Autonomy: Counsellors should encourage and enable clients to take
control of the direction of their own lives wherever possible. Respecting
the client’s right to make their own decision.
Non-maleficence: Avoiding harm to client and minimizing the risk of
potential harm
Beneficence: Acting in the best interest and promoting client’s wellbeing
Justice: Counsellors should treat all people fairly and equitably
Fidelity: Counsellors should honour all personal and professional
commitments, promises and responsibilities
Veracity: Truthfulness and honesty
Boundary Management:
● Maintaining clear and appropriate professional boundaries to prevent
harm and ensure the integrity of the therapeutic relationship.
● Recognizing and addressing the potential for dual relationships and
conflicts of interest.
Supervision and Consultation:
○ Seeking supervision and consultation when facing challenging
ethical dilemmas.
○ Collaborating with colleagues and experts to gain diverse
perspectives and guidance.
Continuous Professional Development:
○ Engaging in ongoing education and training to stay informed about
current ethical standards and best practices.
○ Reflecting on personal biases, values, and beliefs that may impact
ethical decision-making.
Conflict Resolution:
○ Developing skills in resolving ethical conflicts that may arise in the therapeutic
relationship.
○ Prioritizing the well-being and best interests of the client in the decision-making
process.
Accountability:
○ Taking responsibility for one's actions and decisions.
○ Acknowledging mistakes, addressing any harm caused, and taking corrective
measures.
Cultural Competence:
● Recognizing and respecting the diversity of clients, including their cultural
backgrounds, values, and belief systems.
● Integrating cultural competence into the therapeutic process to provide effective and
relevant services.

Professional Codes of Ethics:

● Counselors adhere to established professional codes of ethics (e.g., American
Counseling Association (ACA), British Association for Counselling and
Psychotherapy (BACP)) that outline specific ethical standards and guidelines for
practice.
Ethical issues affecting clinical practice
Therapist Competence: Therapists need to only provide services for which they are
qualified

Client Welfare: Client needs come before counsellor needs and counsellor must act in
client’s best interest
Informed Consent: Counsellors must inform clients regarding nature of counselling and
answer questions so that clients can make an informed decision
Confidentiality: Clients must be able to feel safe within the therapeutic relationship for
counselling to be most effective

Dual Relationships: More than one relationship with a client (e.g. the counsellor is a
friend and the counsellor) should be avoided when possible

Sexual Relationships: Sexual relationships with clients are strongly prohibited and in
some states constitute a criminal offense
 Competence and malpractice

To provide competent treatment, therapists need to:

• only provide services for which they are qualified
accurately represent their credentials and
qualifications
• keep up on current information of the field, especially
in specialty areas
• seek counselling when they have personal issues

Malpractice

• Occurs when a counsellor fails to provide reasonable

care that is generally provided by other professionals
and it results in injury to the client.
 Informed consent

All of the following should be covered in order for

the client to be able to make an informed choice
• The financial costs of counselling
• The competencies of the counsellor
• Nature and purpose of treatment
• Treatment procedure
• Confidentiality (and its limits)
• Risks and Benefits
• Professional Boundaries
• Involvement of Third parties
• Client’s right to ask questions
• Emergncy Procedures
Nature and Purpose of Therapy:
● Explanation of the type of therapy being offered (e.g., cognitive-behavioral therapy,
psychodynamic therapy).
● Clarification of the therapeutic goals and the expected outcomes.

Treatment Procedures:
● Description of the methods, techniques, or approaches that will be used during therapy
sessions.
● Discussion of the frequency, duration, and anticipated length of the therapy.

Risks and Benefits:

● Explanation of potential risks and benefits associated with the proposed therapy.
● A clear discussion about any potential discomfort or emotional distress that may arise
during therapy.
Confidentiality:
● Explanation of the limits of confidentiality, including situations where the therapist may
be required to disclose information (e.g., harm to self or others).
● Clarification of how client confidentiality is maintained within the therapeutic
relationship.

Fees and Payment Policies:

● Disclosure of the therapist's fees, billing practices, and any potential additional costs.
● Discussion of the therapist's cancellation policy and any fees associated with missed
appointments.
Professional Boundaries:
● Clarification of the therapist's role and responsibilities.
● Discussion of appropriate and inappropriate behavior within the therapeutic
relationship.

Qualifications of the Therapist:

● Presentation of the therapist's professional qualifications, credentials, and relevant
experience.
● Information about the therapist's approach to ongoing professional development and
supervision.
Involvement of Third Parties:
● If applicable, clarification of any involvement of third parties (e.g., family members,
other professionals) in the therapy process.

Emergency Procedures:
● Discussion of the therapist's approach to handling emergencies and the process for
contacting the therapist in urgent situations.

Client's Right to Ask Questions:

● Encouragement for the client to ask questions at any time during the therapy process.
● An invitation for ongoing discussion and feedback about the therapy.
 Dimensions of Confidentiality

Confidentiality
Confidentiality is an ethical concept, and in most states it is the legal duty of therapists
not to disclose information about a client.

Exceptions to Confidentiality
• There is a legal requirement to break confidentiality in cases involving child abuse, abuse
of the elderly, abuse of dependent adults, and danger to self or others
• When the therapist believes a client under the age of 16 is the victim of incest, rape, child
abuse, or some other crime
• When the therapist determines that the client needs hospitalization
• When clients request that their records be released to them or to a third party
 Managing Multiple Relationships in
Counseling Practice

Dual or multiple relationships, either sexual or nonsexual, occur

when counselors assume two (or more) roles simultaneously or
sequentially with a client.
When clinicians blend their professional relationship with another
kind of relationship with a client, ethical concerns must be
considered. Many forms of nonprofessional interactions or
nonsexual multiple relationships pose a challenge to practitioners.
 Managing Multiple Relationships in
Counseling Practice

Some examples of nonsexual dual or multiple relationships are combining the

roles of teacher and therapist or of supervisor and therapist; bartering for goods
or therapeutic services; borrowing money from a client; providing therapy to a
friend, an employee, or a relative; engaging in a social relationship with a client;
accepting an expensive gift from a client; or going into a business venture with a
client. Some multiple relationships are clearly exploitative and do serious harm
both to the client and to the professional. For example, becoming emotionally or
sexually involved with a current client is clearly unethical, unprofessional, and
illegal. Sexual involvement with a former client is unwise, can be exploitative,
and is generally considered unethical.
 Establishing Personal and Professional
Boundaries
Establishing and maintaining consistent yet flexible boundaries is necessary if you are
to effectively counsel clients
A boundary crossing is a departure from a commonly accepted practice that could
potentially benefit a client. For example, attending the wedding of a client may be
extending a boundary, but it could be beneficial for the client.
boundary violation is a serious breach that harms the client and is therefore
unethical. A boundary violation is a boundary crossing that takes the practitioner out
of the professional role, generally involves exploitation, and results in harm to a
client.
Some boundary crossings pose no ethical problems and may enhance the counseling
relationship. Other boundary crossings may lead to a pattern of blurred professional
roles and become problematic
 Tasks to Do For Self Development Folder!

1. Make an Informed Consent for a Counselling Session of Adult Client, include

all the components discussed in the class.
2. Give one Example of Boundary Crossing and One example of Boundary
Violation.
 Assignment for Mid Term
Choose one of the provided case scenarios (in the start of the chapter)or select a real-world
case from professional literature, news, or personal experiences (ensuring confidentiality
and anonymity).
1. Case Analysis:
a. Provide a detailed overview of the case, including the key ethical dilemmas presented.
b. Identify the relevant ethical principles, guidelines, and professional codes applicable to the
case.
2. Ethical Analysis:
a. Discuss the potential consequences of the actions taken in the case and their impact on
the client, therapist, and the therapeutic relationship.
b. Explore the ethical considerations, such as autonomy, beneficence, non-maleficence,
justice, and fidelity.
3. Alternative Courses of Action:
a. Propose at least two alternative courses of action that the therapist could have taken to
address the ethical dilemmas in the case.
b. Evaluate the advantages and disadvantages of each alternative.
4. Decision-Making Process:
a. Describe the steps the therapist should have taken in the decision-making process,
considering consultation, supervision, and collaboration with other professionals.
5. Prevention and Future Planning:
a. Discuss strategies for preventing similar ethical dilemmas in the future.
b. Explore how ongoing professional development and self-awareness can contribute to
ethical practice.
6. Conclusion:
c. Summarize your analysis and propose a recommended course of action based on ethical
principles and guidelines.
d. Reflect on the importance of ethical decision-making in counseling psychology and its
impact on client well-being and the integrity of the profession.

Format and Submission:

● Submit a well-organized written report following academic writing standards.
● Include proper citations and references to support your analysis.
● The report should be approximately 1500-2000 words.