When Personal Beliefs Influence
Counseling Decisions:
Ethical and Supervision
Dilemmas With Clients
Jane Webber, PhD, LPC & J. Barry Mascari, EdD, LPC, LCADC
Counselor Education Department, Kean University
New Jersey Counseling Association
1.To understand the ethical and supervision standards, best practices, and regulations that impact decisions regarding refusal to provide services,
terminating or referring a client based on values and beliefs.
2. To identify the ethical and legal responsibilities of supervisors and
Ethical Decision Making
1. Identify & define the problem
2. Consider moral principles
3. Tune into your feelings
4. Consult with colleagues or experts
5. Involve client in decision making
process
2. Identify desired outcomes
3. Consider possible actions
CVCM Approach
•
Determine the nature of the value-based conflict
•
Explore core issues and potential barriers to providing
appropriate standard of care.
•
Seek assistance/remediation for providing appropriate
standard of care.
•
Determine and evaluate possible courses of action.
•
Ensure that proposed actions promote client welfare.
ACA Code of Ethics Quiz: Yes or No
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Racism is ethical.
•
Homophobia is ethical.
•
Religious bias is ethical.
•
Terminating counseling because a client fails to pay is ethical.
•
Referring a client because of
your
religious beliefs or values is ethical.
•
Terminating counseling because
a client’s
beliefs or values differ from
your’s is ethical.
•
Terminating counseling because a client’s skin color or ethnicity differs
from your’s is ethical.
•
Terminating counseling because a client is exploring
gay/lesbian or other sexuality identity questions is
ethical.
•
Terminating counseling because of your personal
beliefs is ethical.
•
Terminating counseling because of your church’s or
Ethical Bracketing
the intentional separating of a counselor’s personal
values from his or her professional values or the
intentional setting aside of the counselor’s personal
values in order to provide ethical and appropriate
counseling to all clients, especially those whose
worldviews, values, belief systems, and decisions differ
significantly from those of the counselor. (Kocet &
Fundamental Principles of Ethical Behavior
•
Autonomy:
foster the right to control the direction of one’s life;
•
Nonmaleficence:
avoid actions that cause harm;
•
Beneficence:
work for the good of the individual and society; promote
mental health and well-being;
•
Justice:
treat individuals equitably and foster fairness and equality;
•
Fidelity:
honor commitments and keeping promises; fulfill
responsibilities of trust in professional relationships; and
What is unethical?
When biases and/or personally held values and beliefs:
•
collide with ethics
•
promote discrimination
•
marginalize individuals or groups
•
deny equal access to and opportunities for counseling
services
•
lead to unethical practices
•
harm clients
Core Professional Values
•
Enhancing human development throughout the life span;
•
Honoring diversity and embracing a multicultural approach in support
of the worth, dignity, potential, and
•
Uniqueness of people within their social and cultural contexts;
•
Promoting social justice;
The primary responsibility of counselors is to
respect the dignity and promote the welfare of
clients.
The mission of the American Counseling Association is to
enhance the quality of life in society by promoting the
development of professional counselors, advancing the
counseling profession, and using the profession and
Tests
1. Test of Justice:
Treat others in
the same way in the same
situation.
2. Test of Publicity:
Would you
want your action reported in the
press
Cultural Competence
•
Bracketing-setting aside our usual assumptions
& biases
•
Broaching-directly addressing differences in race,
culture, socio-political issues in counseling (not
avoiding the elephant in the living room)
Foster-Miller, & Davis, T. (2016). The practitioner’s guide to ethical decision-making
Ward v. Wilbanks
Julea WardEastern Michigan University
Can a counseling practicum student deny counseling to a gay client on the basis of her religious values?
Can counselors make referrals any time they want?
Ward v. Wilbanks
•
Julea was assigned a client at the Eastern Michigan in-house
clinic operated by the Counseling Program
•
Client stated on intake form wanting help with depression
and same sex relationship issues.
•
Julea sought to refer the client based on her religious beliefs
•
Program offered remediation to help her counsel client with
values different from hers.
Keeton v. Anderson-Wiley
•
counseling student, Augusta State University, GA,
•
against counseling GLBT individuals
•
Supported reparative therapy
STATES ALLOWING REFUSAL TO TREAT
•
Tennessee - House Bill 1840, also known as
Senate Bill 1556, shields counselors from being
required to provide services to clients if
providing those services would clash with the
counselors’ personal values
(
Earlier versions of
the bill phrased it as “sincerely held religious
beliefs”).
STATES PROHIBITING CONVERSION THERAPY
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California
•
Connecticut
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Delaware
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New Hampshire
•
New Jersey
•
New Mexico
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New York
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Nevada
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Maryland
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Illinois
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Hawaii
•
Oregon
•
Rhode Island
•
Vermont
•
Washington
Supervision/Consultation
What would your supervisor say?
What would your peers say?
What would your professors say?
Did you share this client and the problem with your supervisor from
the start?
How did you document your dilemma?
Did you role-play with your supervisor?
Reverse role play?
Values and Ethics in Counseling:
The Case of Tony and Lisa
Tony is a seasoned licensed counselor with his own practice in a rural community. He is the only practicing counselor within a 100-mile radius. Tony is known in the community for his skills and reputation. Lisa was
referred to Tony by a friend because of his experience. Lisa recently went
through a divorce and presented with symptoms of depression that emerged six months after her divorce. Lisa reported that the counseling and
homework that Tony provided has helped clarify what has been contributing to her depression. In session, Lisa uncovered that she has been battling with her sexual character since she was a teenager and wants to explore her
sexuality and the process of coming out. Tony is aware that his faith
orientation and values will not align with Lisa’s new exploration. To remain transparent, Tony informs Lisa that he may not be able to continue
Issues
1. Responsibility to client
2. Discrimination against client (race, culture, gender, sexual
orientation, religion)
3. Hand-off (refer)
•
Your client B. makes this statement in session: I hate
Jews. It’s too bad Hitler wasn’t able to finish what he
started.”
•
You are Jewish.
•
How would you feel?
•
How might his statement affect your relationship and
your counseling.
•
What if anything do you say in response to this
statement?
You planned to go to ACA Conference
in Nashville, Tennessee
•
The ACA Governing Council votes not to hold the
conference in Nashvllle because of the new
legislation.
•
How did you feel about their decision then?
•
How do you feel now?
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If you had been on Governing Council would you
Pregnancy
•
Your 16 year old client A. informs you that she is pregnant by her 17
year old boyfriend. She tells you that she does not love her boy friend
and was thinking about ending the relationship prior to the
pregnancy. She wants to have an abortion and needs your help. You
are pro-life and do not support abortion; however, you work in a
public school that does not have a policy prohibiting counselors from
working with students considering abortion.
You meet with a new client who would like to discuss with
you the decision to undergo gender reassignment.
•
What personal values do you hold about persons being
other than the gender they were identified as having at
birth?
•
How would you bracket (set aside) personal values that are
not in some way consistent with the values of the client?
•
What steps would you take to ensure that any differing
values you hold would not be imposed on the client, or be
imposed on the client or be allowed to adversely affect the
counselor-client relationship?
A.4.a. Avoiding Harm
Counselors act to avoid harming their clients, trainees, and research
participants and to minimize or to remedy unavoidable or
C.5. Nondiscrimination
Counselors do not condone or engage in discrimination against
prospective or current clients, students, employees, supervisees, or
research participants based on age, culture, disability, ethnicity, race,
religion/spirituality, gender, gender identity, sexual orientation, marital/
partnership status, language preference, socioeconomic status,
C.2.e. Consultations on Ethical Obligations
Counselors take reasonable steps to consult with other counselors, the
ACA Ethics and Professional Standards Department, or related
A.4.b. Personal Values
Counselors are aware of—and avoid imposing—their own values,
attitudes, beliefs, and behaviors. Counselors respect the diversity of
A.12. Abandonment and Client Neglect
Counselors do not abandon or neglect clients in counseling. Counselors
assist in making appropriate arrangements for the continuation of
A.11.b. Values Within Termination and Referral
Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients,
especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.
A.11.c. Appropriate Termination
Counselors terminate a counseling relationship when it becomes reasonably apparent that the client no longer needs assistance, is not likely to benefit, or is being harmed by continued counseling. Counselors may terminate
C.2.a Counselors practice only within the boundaries of their competence, based on their education, training, super- vised experience, state and
national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all
counseling specialties, counselors gain knowledge, personal awareness,
sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population.
C.2.b. New Specialty Areas of Practice
Counselors practice in specialty areas new to them only after appropriate education, training, and supervised experience. While developing skills in
