Ethics in the field of marital and family psychology is a very sensitive subject to both the clientele treated and the counselors. The issue of ethics as it pertains to marital and family counseling can create barriers and obstacles preventing clients from being able to fully trust the counselor.
Other ethical concerns vary from whether or not to inform a parent of their child’s admitted illegal drug use to that of having a client who divulges having a life-threatening sexually transmitted disease but does not wish to have their spouse informed. Different accredited psychiatric associations have developed and implemented a defined code of ethics upon which each participating member is responsible in upholding (ACA, 2005; Leong, 2008)). Education and training for licensed counselors serve as a platform to provide answers to ethical dilemmas, however; it is up to the individual counselor as to how he or she chooses to respond.
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Chase and Gina provide marital and family counseling to a variety of individuals. Chase works for a private mental health group and has been practicing for the last eight years. Gina is a licensed counselor working for a public mental health services organization. She has been employed at the same office for the last fourteen years. As professional counselors, both Chase and Gina indicate that the defined code of ethics outlined by the American Counseling Association (ACA) serves as a major tool of ethical reference (personal communication, May 18, 2010; ACA, 2005).
Ethical Dilemmas I. Chase He was providing marital counseling for a very troubled couple (personal communication, May 18, 2010). The couple had entered into marital counseling because of issues of trust, mistrust, and possible infidelity. The wife was asserting that her husband had been unfaithful. One evening after work, Chase stopped by the local grocery store. After pulling in he noticed a couple engaged in a very passionate kiss.
Much to his surprise, he discovered that the female involved in the kiss was in fact the accusing wife whom he was currently counseling. She immediately disengaged from kissing her male companion after she recognized her counselor. At the next counseling session, the married couple indicated that the wife had admitted to her infidelities. The husband asserted that he had already filed for divorce, but he wanted to inform the counselor in person and request that his counseling continue on an individual basis. The wife asserted that she, too, wished to continue with individual therapy.
As a result, Chase declined to provide the requested individual therapy, but did provide them each with referrals. His decision to do so was based on the probability of being called as a potential witness in the pending divorce proceedings (Hecker & Wetchler, 2003). II. Gina A memorable case of ethics for Gina involved a mother and her three teenage children. The family had been referred for services via the local family court following a very difficult divorce and custody battle in which the husband, and father to the children, had just left.
The mother had been diagnosed with Bipolar I over three years ago, but she had great difficulty in getting her manic episodes under control. As a result, her children had to be placed into foster care in order to protect their safety and well-being. After much therapy and many medication changes, the mother was deemed well enough to be a fit parent and was awarded custody. At a family session, the counselor noticed that the mother was acting out of sorts. She was extremely talkative but was not making much sense.
She rambled from one subject to the next and was unable to sit down, all the while walking and pacing around the room. The counselor excused herself from the room citing that she had to check on something, and she went and retrieved one of her supervising colleagues. He re-entered the session and was properly introduced. Gina felt it best if the children were not present at this particular juncture, so she invited the children to wait in an adjoining office where they could watch television.
The oldest child indicated that his mom was doing it again; referencing the manic episode. Gina and her supervisor asked the mother if she was still taking her medications. The mother responded that she had discontinued her medications because they made her feel too tired and too groggy which interfered with her being able to take care of her children. The mother then questioned the counselors as to why there were so many bugs crawling on the walls. Gina then asked the mother if she would be willing to go to the hospital for a day or two in order to get her medications regulated. The mother refused.
Gina chose to have the mother involuntarily committed as her mania and delusions provided that she could be of harm not only to herself but to her minor children as well (Corey, Corey, & Callanan, 2007). While issues involving ethics often seems to center around the function and professional abilities of the counselor, they also come from the client (Pope & Vasquez, 2007). Some clients are very concerned over the issues of confidentiality. This can lead both the counselor and the client to a dead end if the client does not trust the counselor enough to support his or her privacy.
Some clients will test the ethical boundaries of the counselor as a means for determining the level of trust to be bestowed on the counselor. This is especially true in the ethical dilemma faced by Chase. In Gina’s case, she was faced with the issue of protecting the physical and mental well-being of her clients, the entire family. Involuntary commitment is usually a last resort for counselors who are trying to help their clients.
In rare instances, some clients will hinder the counselor with unwelcomed sexual advances. Counselors like Gina and Chase received much training from their respected secondary educational institutions of learning. This training and education was furthered during their graduate studies. Both counselors, however, explain that face-to-face experience is sometimes the best educator. It has been suggested that when an ethical dilemma is difficult to resolve, the best and most absolute measure to take is to consult with a supervising colleague.
Other professional colleagues in the field may have already encountered a similar situation or know of someone that was involved in a similar dilemma (Kottler & Shepard, 2007). Ethical dilemmas will continue to plague and confuse psychiatric professionals. Clients will invariably continue raising ethical questions whether deliberately or unknowingly. Organizations like the American Counseling Association have attempted to define and outline a specific list of possible problems with possible solutions.
Experience combined with education and training offer recourse to counselors whose dilemma may be more difficult to resolve than referring to the currently endorsed code of ethics. In the meantime, counselors will dutifully stand by their clientele and support their mental well-being, which is ultimately the most important ethic of all.
References
- American Counseling Association (ACA). (2005).
- Ethics. Retrieved from http://www. counseling. org/Resources/CodeOfEthics/TP/Home/CT2. aspx Corey, G. , Corey, M. , & Callanan, P. (2007).
- Issues and ethics in the helping profession (7th ed. ). Belmont, CA: Cengage Learning. Hecker, L. , & Wetchler, J. (2003).
- An introduction to marriage and family therapy. Binghamton, NY: Haworth Clinical Practice Press. Kottler, J. , & Shepard, D. (2007).
- Introduction to counseling: voices from the field (6th ed. ). Belmont, CA: Cengage Learning. Leong, F. (2008). Encyclopedia of counseling. Thousand Oaks, CA: SAGE Publications, Inc. Pope, K. , & Vasquez, M. (2007).
- Ethics in psychotherapy and counseling: a practical guide (3rd ed. ). San Francisco, CA: Jossey-Bass.
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