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Wednesday, January 29, 2020

Crossing Ethical Boundaries Between Counselor and Client Essay Example for Free

Crossing Ethical Boundaries Between Counselor and Client Essay Eli Coleman and Susan Schaeffer, authors of the article _Boundaries of Sex and Intimacy Between Client and Counselor_, write, _Dilemma_. A woman comes to see a male counselor and complains of anxiety and depression associated with her recent divorce. She is also deeply concerned about her attractiveness and ability to attract another partner. The thought of single life frightens her. After five sessions, she confesses to the counselor that she is deeply attracted to him. Although she finds him sexually attractive, she is equally or more attracted to his sensitivity, care, and support of her. Emotional intimacy is something her previous relationships have lacked. And, at times, those relationships have been abusive. The Counselor does not know how to respond. He too is attracted and has already fantasized about a relationship with her. But because she is a client, he does not dare reveal his feelings. He knows that allowing a relationship to develop would be wrong. That, however, does not solve the problem. (Coleman Schaeffer 341). For almost every individual, having to go to counseling can be one of the most nerve wracking things a they may have to go through during his or her life for whatever reason. Becoming attracted to your counselor, or learning they are attracted to you, may just as equally give the same nerve wracking feeling. How can things like this be prevented from happening right from the beginning? Is there not a code of ethics a counselor must follow to ensure that there is only ever professionalism during all sessions, and that clients are only seen during counseling sessions and not pursued at any time outside of sessions? Believe it or not, when it comes to the code of ethics that a counselor must follow with his or her patients during sessions, it is very vague and easy to see where violations can be made,  often times without even being fully aware of the violation. Samuel T. Gladding, author of _Counseling A Comprehensive Profession_, states, Some forms of unethical behavior are obvious and willful, whereas other are more subtle and unintentional. Regardless, the harmful outcome is the same. (Gladding 59), in addition to that, What types of intimacy are appropriate? What types are not? These dilemmas are faced by counselors at one time or another. (Coleman and Schaeffer 341). Most programs spend little to no time addressing the prohibition against sexual contact with clients, yet it is the most commonly violated of the ethical principles. Melba J.T. Vasquez writes in her article, _Counselor-Client Sexual Contact: Implications for Ethics Training_. Kathy Hotelling, author of _Ethical, Legal, and Administrative Options to Address Sexual Relationships Between Counselor and Client_, sheds light on the fact that, Many clients do not know that sexual relationships between counselor and client are unethical and, in some states, illegal. They also do not know that they can file a complaint nor do they know the avenues available for doing so. Unfortunately, many counselors also may not be aware of these facts. (Hotelling 233). The article Hotelling writes is all about educating victims of ethical abuse during counseling, because counselors can not only be an abuser, but a victim as well. After a few counseling sessions, Dave asked his counselor to go have a cup of coffee, and he agreed. Initially, Dave was flattered that his counselor liked him enough to spend time with  him outside of counseling. He enjoyed the counselors company and thought it would be nice to have him as a friend. Meeting in this setting, Daves counselor told him much more about himself and that he was having marital problems. Again, Dave was flattered by this display of trust. It made him feel  important. As time went on, Dave and his counselor began to see more of each other socially (e.g., having dinner together, playing racquetball, inviting each other to parties). At one point Daves counselor call him, looking for support. The counselor had just learned that his wife had asked him for a divorce. At this point, Dave began to question the value of his counseling sessions. (Coleman Schaeffer 343). This is a perfect example of roles being reversed, and the counselor becomes the victim in this situation. Counselors, like many of all of their clients, can have their own problems going on outside of the office. However, even if the counselor sees one of their clients in an outside setting, the roles should never become reversed. This becomes an ethical breach in the sense that vulnerability, and weakness come into play for the counselor and the client can take advantage of this, and begin their own form of manipulation on how the sessions may play out. According to Theodoros Giovazolias Paul Davis, authors of the article _How common is sexual attraction towards clients? The experiences of sexual attraction of counselling psychologists toward their clients and its impact on the therapeutic process_, state in the introduction of their article that, Although there is considerable information about the incidence and consequences of sexually intimate relationships between therapists and clients, there is very little documentation of the extent to which sexual attraction occurs in therapy, especially from the part of the therapist, how such feelings are handled, and what the effects on the therapeutic relationship are. (Giovazolias Davis 281-282). Giovazolias and Davis also uncover that, In a survey by Pope _et al._ (1986), it was found that 87% of 575 psychotherapists revealed that they had been attracted to their clients,  at least on occasion. In a more recent study, Rodolfa _et al._ (1994) found similarly that 88% of psychologists had been sexually attracted to at least one  client. (Giovazolias Davis 282). If this is the case, there is clearly a need for a much stronger ethical training program for up and coming counselors who wish to make a profession out of this career. However, this should not just be limited to new counselors, there should also be a retraining program in place for current counselors so that all ethical boundaries can be refreshed in their mind, and violations can be cut down. The training will not only help cut down the violations, but if made mandatory for a pre-determined number of times per year, this issue could be eliminated altogether. Wood, Klein, Cross, Lammers, and Elliot (1985) found that those psychologists who had had an ethics course were more aware of impaired or burned-out colleagues, more likely to seek help themselves, to help and impaired colleague, and to report an impaired colleague to a regulatory agency. (Vasquez 238), This article proposes that not only should ethical training be a required component of every program in the mental health profession but also that emphasis should be given to the problem of therapists sexual contact with clients. (Vasquez 238). So what would be some of the items stressed to future counselors? 1. dressing in a professional manner, 2. conducting counseling sessions only in the traditional professional setting where others are present, 3. furnishing the office in a businesslike manner, avoiding the too crazy ambience. (Vasquez 240). All of these qualities listed are to help not only the counselor keep a sense of their control and integrity, but also the integrity of the clients they service within the counseling sessions. These professional qualities are provided in order to make a safe and comfortable environment for all parties, and to make sure the sessions stay on track. In the article, _Ethics and the Sexual Countertransference,_ Hugh Gee states, Confidentiality is not there to protect the unethical acting out of the patient as in the case where the patient is a danger to themselves or  others. (Gee 74). Many clients who first start out seeing  a counselor will at one time or another think that the counselor is going to tell everyone about their session once it is over. The client, however, does not have to worry about fears such as these. The ethical code that is in place only allows the counselor to disclose information if it is under court order, or the client has threatened to put someones life is at risk. However, what is the policy for a minor? According to authors Madelyn Isaacs and Carolyn Stone, who wrote _Confidentiality with Minor: metal health counselors attitudes towards breaching or preserving confidentiality,_ say, Confidentiality is further complicated when the client is a minor. Societal stressors such as juvenile crime and subs tance abuse, which threaten the well being of children, have created the need for information sharing among agencies, families, and law enforcement units when the information is necessary to protect children (Taylor Adelman, 1998). Prom, DeMartino, and Prout (1999) explained that professionals working with the same child routinely share information with each other, which is quite different from the way adult confidentiality rights are handled. (Isaacs Stone, 2001). This, however, can feel like an ethical boundary breach to the client in question that the counselor would have to report on. The only thing a counselor can do in this position is speak to the client, and let them know that due to their age, they will not have the same confidentiality as an adult would, however, they should still have complete trust in you as a counselor so that you can find some way to help them. Also let them know that it is not just your policy, but the overall code of ethics that every counselor adheres to, so they will receive the same treatment at any other practice they choose to move to. There are many different ways that a counselor can cross ethical lines, either by a complete accident, or in some cases, intentionally. However, what do you do as a counselor when you see one of your colleagues first pushing, and then completely crossing said  boundaries? The ethical principles that guide professionals and the ethical dilemmas that they face have received much attention in recent years. When a professional becomes aware of unethical conduct practiced by a colleague, however, there is little literature to consult on how to respond and intervene. (Levenson, 1986). This article goes on to list the various ways of bringing to your colleagues attention without it escalading to a hostile altercation, and how you can help them deal with it. The steps are as follows: Learning of Misconduct, this involves gathering solid evidence in order to substantiate your claims. If it is just hearsay, it is likely that it will just be overlooked and no investigation will go into it. You can gather evidence from fellow colleagues to see how they see the counselor you are looking into. Evidence can also be gathered straight from the source. You can talk to them, and see how they respond, and in some rare cases they might confess right away. Next comes the intervention for your colleague. Let them know what is happening, if they have not already confessed to it, and how things will be handled in a professional manner from that moment forward. The intervention process can vary from professional to professional. In some cases, they may just be terminated without question, or they can be treated, and they can go from there. In any case, it is a long process, but one that should be started as quickly as possible while all of the evidence is still fresh, and can be presented right away. The longer you try to compile evidence, the more people will want to know why you let the unethical behavior continue for as long as you did before speaking up. The best policy is to just ask as many people as you know about your colleague before you bring light to their behavior. A series of legal cases have sparked considerable discussion around the question of whether counselors can use their religious beliefs as the basis for refusing to counsel lesbian,  gay, bisexual, and transsexual (LGBT) clients. This discussion has  illuminated tension between counseling professionals and counselor educators who view LGBT relationships as normal and healthy expressions of love and intimacy (see Whitman Bidell, this issue) and some religiously conservative counselors and counselors-in-training who consider same-sex relationships to be immoral. (Herlihy, Hermann Greden, 2014). The act of a counselor using his or her own religious belief so they do not have to work with certain ethnicities, genders, or people who choose a certain sexual orientation that is different from what they consider normal should be basis enough for an ethical violation. Counselors are people who go into this profession with the intention to try and help people make sense of their lives. By denying them this goes against why they chose to be a counselor in the first place. Regardless of how different someone may be from you, by using your religious belief that you cannot counsel someone shows that you are not able to remain objective in the session. This would have many questioning what other issues you were not able to remain objective about, and it could lead to you being investigated as a counselor. A counselor is supposed to remain neutral in all sessions. They are not there to talk about them, but instead the client, whoever he or she may be, and whatever it is they may do. They decided to come to your place of business, and choose you as a counselor, you should be welcoming new clients, not turning them away due to their background. Men and women who choose to go into therapy are seeking answers and guidance, not judgment. The most important thing a counselor can do before he or she begins a session with a new client is to try and find out who they are. It is always best to know what kind of person you are  dealing with before hand, rather than find out half way down the road they have been manipulating you the whole time, because that is what they are there for. It is also best to know the code if ethics inside and out. Ethics and boundaries crossings can be hard to distinguish and often are understood through opinions. There is a difference between crossing the boundaries and violating the boundaries. Crossing a boundary is a gray area where are violating is black and white. Sometimes crossing boundaries can be defensible however; the counselor must take into consideration all possible outcomes. For example, a chemical dependency counselor may have helped a pregnant addict come clean and get her life back on track so that she was able to deliver and keep a healthy baby. Once the babys born the client may ask the counselor to come visit her at the hospital to meet the new bundle of joy. At this time it would up to the counselor to decide whether or not crossing this boundary is justified. The counselor must look at all angles including the legal ramifications that could possibly take place. Either way, deep thought and consideration from the counselors end is necessary. (Live Rehab). This website goes on to list several other examples of what a counselor should be careful of doing in their profession, such as bartering. Bartering is an exchange of goods or services in place of payment. Bartering is not prohibited or unethical in the counseling relationship however there could be situations when it may not run as smoothly as anticipated. If a counselor decides to barter for services oftentimes the proportion of services to counseling can be extremely off. For example, if a counselor is providing services to a mechanic and the mechanic is having troubles paying for services, he or she may offer to provide car maintenance to the counselor. At first this may seem like a decent deal, especially if the counselors car is due for more than the regular maintenance. Lets take for example, the car needs about $1500 worth of work and the counselor charges $250.00 per  session. If the mechanic is attending sessions once per week this would get him about 6 weeks worth of sessions. What about when the 6 weeks are up? An oil change is about $40.00 and thats only needed every few months. At that point the counselor and client could be progressing in their sessions and since their therapeutic relationship is established it would be a shame for the client to be forced to quit counseling for lack of payment. On the other hand however, since it does not go against the ethical standards of the  counseling profession, the counselor and client could look at the situation as a gained benefit and that is that the mechanic received 6 weeks of service that he may not ever had the chance to get. (Live Rehab). While bartering may not be covered as unethical, it still raises a lot of red flags as to why a counselor would be giving the sessions away for free. It is best to just stay ethical, and out of all trouble things like this may lead to. If you would like people to take you seriously, then you have to act like a professional who takes pride in their presence and shows nothing but integrity. RESOURCES Coleman, E., Schaefer, S. (1986). Boundaries of Sex Intimacy Between Client and Counselor. _Journal Of Counseling Development_, _64_(5), 341. Ethics and Boundaries Ethics and Boundaries What is at stake?. (n.d.). _Live Rehab_. Retrieved April 15, 2014, from http://www.liverehab.com/ethics-and-boundaries/ Gee, H. (2007). Ethics and the Sexual Countertransference. _Journal of Analytical Psychology, 52,71-88._ Giovazolias, T., Davis, P. (2001). How common is sexual attraction towards clients? The experiences of sexual attraction of counselling psychologists toward their clients and its impact on the therapeutic process. _Counselling Psychology Quarterly_, _14_(4), 281-286. Gladding, S. T. (2009). _Counseling, a comprehensive profession_. (Sixth ed., p. 59). Upper Saddle River, NJ: Pearson College Div. Herlihy, B. J., Hermann, M.A. Greden, L.R. (2014). Legal and Ethical Implications of Using Religious Beliefs as the Basis for Refusing to Counsel Certain Clients. _Journal of Counseling Development_. 92. 148-153. Hotelling, K. (1988). Ethical, Legal, and Administrative Options to Address Sexual Relationships Between Counselor and Client. _Journal Of Counseling Development_, _67_(4), 233. Isaacs, M.L. Stone, C. (2001). Confidentiality with minors: mental health counselors attitudes toward breaching or preserving confidentiality. _American Mental Health Counselors Association_. 23(4). Levenson, J.L. (1986). When a Colleague Practices Unethically: Guidelines for Intervention. _Journal of Counseling and Development._ 64. 316-317. Vasquez, M. T. (1988). Counselor-Client Sexual Contact: Implications for Ethics Training. _Journal Of Counseling Development_, _67_(4), 238.

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