Ethics, Morals, and Values in Counselling

Counselling is not a value-free activity. “Values are the core of the counselling relationship” (Hansen,
Stevic, and Warner). On the basis of the values held by counsellors and clients, directions are taken and
decisions made. Counselling is also “a moral enterprise requiring irresponsibleness; that is action… based
on careful, reflective thought about which response is professionally right in a particular situation”
(Tennyson and Strom). Counsellors are guided in their thoughts and actions by values, by professional
and personal ethics, and by legal procedures and precedents.
When an aspiring professional group undertakes values into ethical standards that guide how its members
practice is a necessary first step. As the group develops toward professionalism, these ethical standards
are generally codified, providing guidelines for professional behavior. Ethical codes have been
established by the American Association for Counselling and Development (AACD), the American
Psychological Association (APA), the National Association of Social Workers (NASW), British
Association for Counselling (BAC) and British Association for Counselling and Psychotherapy (BACP).
Van Hoose and Kottler posit three reasons why professional codes of ethics exist: -

 Ethical standards are designed to protect a profession from government interference. Professional
codes assert the autonomy of the profession through self-regulation as opposed to being regulated
by legislative bodies.
 Ethical codes establish common norms and thereby protect a profession from self-destructive
internal bickering.
 Ethical standards protect practitioners from the public, especially in regard to malpractice suits. If
professionals behave according to ethical guidelines, the behavior is judged to be following
accepted standards (Talbutt)
Unethical behavior can take many forms. Levenson and Swanson list some of the prevalent unethical
behavior: -

 Violation of confidentiality
 Exceeding one’s level of professional competence
 Negligent practice
 Claiming expertise, one does not possess
 Imposing one’s values on a client
 Creating dependency in a client
 Sexual activity with a client
 Certain conflicts of interest
 Questionable financial arrangements, such as charging excessive fees.
 Improper advertising
There are many counselling situations in which the proper behavior is not obvious (Huber and Baruth). It
is, therefore, critical for counsellors to consult casebooks, colleagues, and professional codes of ethics
when they are in doubt about what to do in a given situation.
The ethical issues most frequently of concern to counsellors are as follows:
1. Ethical issues arising within the individual counsellor
This includes dilemmas concerning the way the counsellor may experience conflict between
his/her needs as a human being and professional role and status as counsellor.
a) Validation of self-image and self-esteem
Ethical dilemmas can arise when practitioners are confronted by a client or situation
which is in opposition to their ‘ideal’ image. The promotion of personal values and
beliefs in the guise of counselling violates the principles of autonomy and fidelity. Any
discriminatory attitudes about race, gender, disability, class, religion, ability, and
opportunity should not be allowed to affect counselling practice. However, this assumes
that the practitioner is fully aware of how s/he demonstrates such value and beliefs
through language and non-verbal behavior. The obligation of all counsellors should,
therefore, be ‘to make every effort to be aware of one’s own attitude that could affect the
intervention strategies.
b) Competence
The British Psychological Society emphasizes that it is the counsellor’s duty to maintain
and develop their professional competence, to recognize and work within its limit and to
identify and ameliorate factors which restrict it’. Each person is, therefore, responsible
for recognizing the limitations of their knowledge and experience, for working to extend
those limitations and for ensuring that others do not misrepresent them. Ethical dilemmas
arise from the definitions of ‘established competence’ and ‘appropriate preparation’.
These in turn pose questions about the amount and kind of training in counselling and
counselling specialisms needed to claim ‘competence’ as a counsellor.

Unexpected issues erupting after the initial counselling assessment have implications for
the counselling relationship, particularly for inexperienced counsellors. A referral to a
counsellor with more specialized experience may accord with the principle of
beneficence but may negatively affect the fidelity of the established relationship and the
therapeutic benefits which have accrued from that relationship. A second difficulty may
arise through wishing to respect the client’s autonomy should they choose to stay with
the less competent practitioner. In this instance, the principle of non-maleficence (‘do no
harm’ or ‘do the least harm’) may provide a valuable guideline.

From time to time, it is important for every counsellor to review their personal and
professional behavior in relation to ethical standards. Questions need to be asked about
possible changes in practice, particularly in regard to demands for greater efficiency and
demonstrable success. It is also important to question how we evaluate our own work and
professional standing relative to other practitioners against such criteria as numbers of
client being seen, length of waiting lists and number of client sessions. Finding clear
answers is less important than asking the questions. In each case checking the autonomy
of the client’s perceived needs against one’s own, and clarifying the fidelity (trust in the
relationship) of the working relationship is the ethical requirement.
c) Fitness to practice
includes the psychological, emotional, and physical status of the counsellor. They are
expected to monitor their own personal functioning and to seek help and/or withdraw
from counselling whether temporarily or permanently, when their personal resources are
sufficiently depleted. Because the work of counsellor necessitates them becoming an
intrinsic tool in the counselling process, any decline in their ability will affect the
effectiveness of counselling. The client is put at risk of harm through the counsellor’s
reduced ability to perceive and respond.
 At times of personal chaos, it can feel very important to try to maintain a semblance of
order and control through work. When riddled with self-doubt and dislike, not
confronting a client who apparently needs and values help can be very seductive. The
ethical dilemma here is between beneficence and non-maleficence – for a time, not
actually doing good for the client whilst aiming to do no harm. Not abusing the
relationship (fidelity) and respecting the client’s right to autonomy to choose other help
are also at stake. In such a position, even temporarily, it is an ethical requirement for the
counsellor to consult with his/her supervisor and find as much personal support outside of
the work relationship as possible.
d) Personal Safety
Counsellors have an ethical responsibility to their clients as well as to themselves to
safeguard their physical state. This includes being clear about the boundaries around
personal availability and about behavior towards oneself that is not acceptable by clients.
It also includes having some training in assessment of the client’s psychological state in
order to avoid taking on a dangerous client or provoking some kind of attack. A client
who makes a violent outburst may be seriously disturbed by what s/he has done. It is,
therefore, important for counsellors to be aware of their ethical and legal responsibilities
to the client. The British Psychological Society recommends all counsellors to take out
professional indemnity insurance, whether self-employed or covered by an employer’s
insurance.
2. Ethical issues arising from the counsellor-client relationship
The relationship between the counsellor and the client is one in which there is an imbalance of
perceived power. The client is in a vulnerable position and research suggests that the success of
the work depends significantly on the quality of the relationship (Wilson and Barkham), i.e., the
extent to which the client can trust the counsellor. Ethical issues relating to the quality of the
relationship concern the clarity of the contract, the management of the practice and the
maintenance of appropriate relationship boundaries, particularly around confidentiality.
a) Client welfare:
All ethical codes affirm that a counsellor’s primary responsibility is to the client. This
means that the needs of the client, not the counsellor, assume primary importance in the
counselling relationship. It also implies that the counselling relationship should be
maintained only as long the client is benefiting from it. It is important that counsellors be
able to concretely evaluate clients’ progress. They must recognize the boundaries of their
own competence as well as clients’ realistic needs and, when appropriate, either refer to
another professional or terminate counselling. In both situations, however, a problem of
ethic arises should the client resist referral or termination. The counsellor must weigh the
potential harm to all concerned and the likely consequence that would ensue should the
relationship continue. Neither the client nor the counsellor lives in a vacuum; they are
affected by other relationships. The counsellor also has a responsibility to his/her own
agency, to any referring agency, to society, and to the profession (Corey).
b) Respect for client’s autonomy:
The counsellor’s self-awareness is one of the main factors in developing anti – oppressive
practice, i.e., practice which addresses ‘interconnections between issues of power within
the counselling relationship and the cultural and socio-political contexts’ (Strawbridge).
Ethical dilemmas arise when clients’ beliefs, values, morals, needs and understanding of
their situation are at odds with those of the counsellor. Difference may be aggravated if
practitioners are not aware of and respectful towards both the clients’ construction of
 their worlds and their dominant racial and cultural beliefs. This is particularly significant
in the case of the Western theoretical emphasis on the self which undervalues the
importance of self in relation to family, community, and culture.

D’Ardenne and Mahtani point out that factors such as the expectations of the relationship
between the client and the counsellor, the directiveness of approach and the nature of the
goals of counselling may all vary with the cultural background of the client and
counsellor. It is, therefore, ethically important for the counsellor to be alert to issues of
power which may be present for the client and to be open to and respectful of the client’s
values. The question, ‘Am I really acting in my client’s best interests? and ‘Would I work
differently if the client was of a different race or culture or gender?’ are crucial.

Ethical issues of autonomy can develop from differing theoretical approaches to the client
(Spinelli). The psychodynamic emphasis on interpretation of the transference relationship
implies the counsellor may know more about what is going on for the client than the
client does. To what extent is the client then really free to challenge or reject the
interpretation?
To what extent is a vulnerable client in a position to reject the concept of rational thought
and choose ‘irrational’ behavior? This may be a particular problem in a time-limited
program where ‘success’ is defined by outcome measures. The humanistic model places
great emphasis on respecting the client’s autonomy. Respect for the client’s autonomy is
not always easy to uphold, particularly when it challenges that of the practitioner.
c) Contracting and informed consent
Respect for the client’s autonomy, together with the principle of fidelity, is reflected in
the nature of the contract with the counsellor. The client must be able to give ‘valid
consent’ that they have adequately understood the nature of the investigation or
intervention and its anticipated consequences.

In order to give informed consent, the client must be given a clear and explicit
explanation of: the counselling process; the management of the sessions in terms of time
and place and confidentiality; boundaries around the relationship with the practitioner;
possible outcomes of the work; the responsibilities of the client in terms of attendance,
termination, and where appropriate, payment, before work begins. Clients should also be
aware that, under the Data Protection Act 1984, they have the right to know if
information about themselves is stored on computer and to see their records. They also
have the right to terminate their work at any time or request referral to another source of
help.

A clear contract gives freedom of choice to the client and promotes the principles of
fidelity and beneficence. While this is clear in theory, the practice may be complicated by
the emotional and psychological state of the client. Children, the elderly and those with
learning difficulties require special consideration. The problem is to balance the client’s
right to free choice against their ability to understand the arguments for and against
treatment. In such cases, it may be useful to include the concepts of limited and
intermittent competence in decision-making (Kitchener). Limited competence usually
refers to those such as children and retarded adults, who are not considered capable of
making rational decisions. Intermittent competence refers to a fluctuating state of
 rationality, as in cases of Alzheimer’s disease. In both cases, the individual’s choice
should be respected when possible and supported by responsible others.

Some counsellors negotiate a working contract with the client, others prefer to set same
contract for all their clients. However explicit the contract is, the counsellor may face
ethical dilemmas deciding what personal information from case notes to share with the
client, what boundaries to draw around availability of support outside the designated
counselling meeting and whether to put pressure on a client to terminate or to continue
working. The desire to have a client stay or go may also be subtly affected by
organizational pressures such as outcome statistics and other indicators of effective
management.

A further source of ethical conflict around contracting occurs when unexpected change
has to be accommodated. A classic situation is when a fee-paying client can no longer
afford the fee. Counsellors have to respect their own autonomy as well as that of the
client and not do harm to themselves. Placing the client’s need for help over the
practitioner’s need for an income may appear to be the charitable act and one of non-
maleficence. However, in ethical terms it can deny the practitioner’s autonomy and that
of the client. It also alters the contract and thereby the principle of fidelity. In trying to
evaluate the best answer, different contexts and theoretical perspectives must be
considered. Above all, care must be taken against the charge of ‘exploitation’ which is
unethical in every code of conduct.
d) Confidentiality
One of the most difficult areas to negotiate ethically is that of confidentiality. Trust and
the fidelity of the counselling relationship, often depends on the client knowing that
her/his secrets are safe with the practitioner: that they are not the subject of gossip or
otherwise made public. What, to whom and in what form information about the client
should be transmitted is a matter of debate.

Promising total confidentiality is unethical because it denies the practitioner’s

requirement for access to supervision, the contractual obligations to team colleagues or to
an employer, intra-agency support systems for the client and some legal requirements. It
does not ensure the principle of non-maleficence. If total confidentiality is an
impossibility, the question is where to draw ethical boundaries that both protect the client
and facilitate practice. The question may be complicated by either or both counsellor and
client having more than one role in respect to the other such as working for some
organization or moving in the same social circles. The key issues here are informed
consent, possible identification of the client, breaking confidentiality in the interests of
others’ safety and time-limits on confidentiality. In setting limits on confidentiality
neither client nor counsellor can know how ethically others may behave and how
situations may change with time.

One of the most difficult ethical question is whether to break a client’s confidentiality
under exceptional circumstances. For e.g., in case of threat of suicide or physical or
sexual abuse of a minor. The principle of non-maleficence toward self (suicide) or other
(abuse) has to be weighed against the client’s autonomy, the others’ autonomy and the
fidelity of the relationship. Individual counsellor may have clear moral answers to the
 dilemma. Codes seem to agree that breaching confidentiality is acceptable if the
practitioner has tried, and failed, to get the client’s consent and if there has been
consultation with an experienced colleague.

In the event of the client’s death, the British Association for Counselling (BAC) code
specifies that: ‘Agreements about confidentiality continue after the client’s death unless
there are over-riding legal or ethical considerations, what is less clear, however, is what
happens in the event of the counsellor’s death or prolonged, involuntary absence, perhaps
due to a serious accident. In such cases, clients may need identification and notification
of what has happened. They will invariably need some continuity of support that does not
breach confidentiality. Such care may be difficult to organize without unauthorized
access to case notes. This is also not a matter that is usually discussed in the initial
contract.
e) Sexual Harassment
A number of surveys of psychologists and psychotherapists in the USA have discovered
that sexual contact between therapists and their clients is not uncommon. It is rather
believed it can be of therapeutic benefit to the client (in some circumstances). Difficulties
arise because they act on them inappropriately.

Edelwich and Brodsky provided a number of guidelines for recognizing seductiveness in

themselves and in their clients, as well as has suggested strategies for dealing ethically
with feelings of attraction: -

 Understanding one’s own feelings

 distinguishing your feelings while dealing with the client
 Avoid over-identification with client’s problems
 Prohibit transferring your problems to the client
 Discussion with others (e.g., colleagues or supervisor)
 Limit setting for self-expression
 stop rejections
 Express non-sexual caring
 Avoid giving ‘double meaning conversations
In most instances sexual misconduct began with boundary violations, such as touching
the client, seeing him/her socially or inappropriate, counsellor self – disclosure to the
client, etc.
f) Dual Relationship
Dual relationships in counselling occur when the counsellor is also engaged in another,
significantly different, relationship with a client. Examples of dual relationships include
-- being a counsellor to someone who is a neighbor, friend or business partner; accepting
payment from client in the form of services (e.g., child-minding); or being the landlord to
a client. Pope identifies five main ways in which dual relationships conflict with
effective counselling. First, the professional nature of the relationship is compromise.
Second, a conflict of interest is introduced. Third, the counsellor is unable/ should not to
enter into other non-therapy relationships equally. Finally, if it became acceptable for
counsellors to engage in dual relationships after counselling had terminated, it would
 become possible for unscrupulous practitioners to use their professional role to set up
relationships engineered to meet their needs.
3. Ethical issues involved in use of touch
The main underlying fear in use of touch appears to be that touch will lead to sexual gratification
on the part of the client, the counsellor or both. Another concern can be that the client may feel
violated, or he/she can even accept being touched against his/her wishes. For example, a person
who has been physically or sexually abused may have a great terror of being touched, but may
have little or no capacity to assert their needs. Also, a matter of great concern for some
counsellors arises from anxiety of being accused of behaving over-intimate by clients. Hunter and
Struve make a number of recommendations to deal with these dilemmas.
Touch is clinically appropriate when: -

 The client desires to touch or be touched

 The intention of touch is clear
 The touch is clearly meant for the client’s benefit
 The client understands concepts of empowerment and has demonstrated an ability to use
these concepts in counselling
 The counsellor understands the impact of using touch
 The boundaries are clearly understood by both.
 Enough time is provided to process the touch interaction
 The client-counsellor relationship has maturely developed
 Touch can be given to all types of clients
 Consultation or supervision is accessible and used
 The counsellor is comfortable with the touch

4. Dealing with Ethical Dilemmas

Kitchener reviews some of the general theories of moral philosophy that can be called upon to
resolve complex ethical dilemmas. The application of a utilitarian approach would be to consider
an ethical decision in the light of the costs and benefits for each participant in the event. Another
core philosophical approach is derived from the work of Kant, who proposed that ethical
decisions should be universalizable. In other words, if it is right to breach confidentiality in this
case, it must be right to do so in all similar cases in the future. For example, in debates over
abortion, some people support the moral priority of the right of the unborn child, while others
assert the woman’s right to choose. Philosophers such as MacIntyre argue that such debates can
never be resolved through recourse to abstract principles. Instead, it is more helpful always to
look at moral issues in their social and historical context. More concepts such as ‘right’ or
‘autonomy’ only have meaning in relation to the cultural tradition in which they operate. From a
‘virtues’ perspective, a set of personal qualities of all practitioners help in taking moral decisions,
viz, empathy, sincerity, integrity, resilience, respect, humility, competence, fairness, wisdom, and
courage. These qualities should be deeply rooted in the person concerned and developed out of
personal commitment rather than the requirement of a personal authority. Finally, it is worth
noting that the tension in the field is mirrored in the debate over differences between men’s and
women’s modes of moral decision-making. Chodorow and other feminist writers have suggested
that men aspire to make moral decisions on the basis of abstract principles, whereas women’s
moral decision-making is grounded in consideration of the impact different decisions would have
on the network of relationships within which the woman lives her life. The impact of different
systems of moral thinking can also be detected in debates over multiculturalism. To some extent,
it can be said that Western moral and legal systems are built around utilitarian or other ideas
about moral rules, understood in abstract theoretical terms, whereas most non-Western cultures
approach morality from a position in which moral virtues are invested in qualities of persons. It
can be seen, then, that making sense of ethical dilemmas in fact underpin or lie behind the
challenges in the practice of counselling.