This is required reading for students taking SC 570 or GC 400.
The norms of ethics to any particular field helps maintain a standard of quality that is expected from certain professionals within a certain field. It guides them in situations of doubt, directs them in proper procedure, and protects them and the client from unintended harm. Dating back to the Hippocratic Oath, the idea to do no harm to those one helps is the cornerstone and foundation of all professional ethics.
Ethics in Counseling
It was not until modern era that ethics began to take a more codified form for professionals. Thomas Percival due to poor performance in his own medical facility created the standard and blue print for modern medical ethics. Other professional careers, including, mental health, counseling and anything within human services soon followed with their own standards. The American Counseling Association (ACA), the American Association for Marriage and Family Therapists (AAMFT), the National Association for Social Workers (NASW), the National Organization of Human Services (NOHS) and the American Association of Christian Counselors (AACC) all have developed mission statements and standards and guidelines for professionals to adhere to. These standards are usually divided into areas of care to the patient, the profession, other colleagues, students, payment policies and publications. It is important if entering into the counseling field to read through these and understand the ethics one must adhere to.
Bear in mind, some counselors are pastoral and others are clinical. Different states assign different titles to licensure. In counseling, the most common is Licensed Professional Counselor or LPC. Other variations can include Licensed Mental Health Counselor (LMHC) or Licensed Clinical Professional Counselor (LCPC). Most states require a graduate degree in counseling and a passing of the state board exam to become fully licensed. Paraprofessionals are unlicensed counselors can work under licensed counselors or within a care facility but there are not able to independently operate. As for pastoral counselors such as ministers or lay apostolates, these individuals are permitted to operate due to separation of church and state but are restricted beyond the realm of guidance. Treatment and pathology are alone reserved for licensed professionals in social work, counseling, and psychiatry. Whether a counselor, social worker or a psychologist, only a healthcare professional such a psychiatrist, medical doctor, or Nurse Practitioner can prescribe medications. This is why many mental health facilities have the proper prescribers available on staff.
If a pastoral counselor with only a certification from AIHCP in Grief Counseling or Christian Counseling, one must ethically adhere to proper identification. The term “counselor” can be very misleading because it is so generic and widely used. Individuals use the term in everyday breath but there is a huge difference between clinical professional counselors and pastoral counselors. Pastoral counselors operating as grief counselors or Christian counselors can help guide but never treat pathology. They also cannot mislead clients into thinking they are licensed. This needs to be understood and articulated upon the first day. What one can do and not do needs to be clearly articulated to and understood by the client. As for licensed professionals who receive certifications from AIHCP, this is clearly not an issue.
In Denise Daniel, short but concise book “Counseling Principles and Christian Beliefs: An Integrated Approach”, she lays out some important concepts not just for Christian Counselors but also any type of licensed or non-licensed counselors. She first points out the importance of identity and what counselors are or not and what are their limitations as licensed or not licensed or the expertise they possess. Second, she points out what is the role of the particular counselor. She emphasizes that most counselors, according to ACA, look to create a professional relationship that empowers and strengthens diverse families and groups to better achieve mental health, wellness, education and career goals. The aim is more centered around wellness and prevention (Daniel, 2020, p. 3). The final third point is integration and how one’s own biases, beliefs and codes of behavior come into play as a counselor. Fortunately, ethical codes point out numerous guide posts for professionals in where and how to integrate themselves with patient care.
According to Daniel, the ACA lays out some core principles. Among the key themes she addressing in her book are patient autonomy, non-maleficence, beneficence, justice, fidelity and veracity (2020, p. 5). Before we review some of the key ethical guidelines, it is important to look at some of these themes and how they apply to licensed counselors but also pastoral counselors, and in some cases, Christian Counselors. Bear in mind, whether grief counselor, licensed or non-licensed, these themes apply to all in the counseling fields.
Important Themes in the Counseling Relationship
Autonomy refers to allowing the patient to be free to make choices in their overall health and life. A counselor needs to respect the choices of a client whether approval or disapproval occurs. For Christian Counselors, this may seem contrary to the goal. There are certain moral precepts that must be obeyed but in a relationship, one must exercise patience. Scripture points out that God gave Adam and Eve free will. He respected autonomy and choices. Again in the parable of the Prodigal Son, the father, permits the autonomy of his son to make poor choices but still never gives up hope that he would one day return.
Non-maleficence refers to doing no harm. Counselors, whether they want it or not, hold all the power in the relationship and they must be very careful in not allowing that power to become corrupted. This can happen very easily because the client is in distress and looking for guidance. A counselor can influence and exploit a client very easily hence numerous standards exist to balance this relationship. The goal of counseling is to heal not harm.
Beneficence refers to promoting only good for the client. It involves helping the client with the best possible and verified studies and knowledge on the subject. It involves looking out for the best of the client and guiding them to their ultimate best end.
Justice refers to fairness to all clients and ensuring equality to the numerous diverse groups one serves. It also involves understanding social justice and promoting justice for those who are persecuted.
Fidelity refers to faithfulness to the client. It involves never betraying them, keeping things confidential and not abandoning them. It means working through the most difficult things and not giving up on them.
Finally, veracity refers to honesty. Trust and honesty is the foundational rock of all relationships. Without honesty, one cannot communicate facts, one cannot share realities, and one cannot heal and grow. Honesty also involves the counselor’s assessments, promises, and outlooks. Even when difficult situations arise, honesty with respect is expected in a counseling relationship.
Important Ethical Codes
There are a variety of critical ethical codes that are all found within the various associations that mirror and reflect the themes above but also dictate more detailed situations.
For instance, in the ACA code of conduct A.4.b., it is clearly emphasized that an individual should never impose one’s own beliefs on another and to respect the diversity of the client. The idea of discrimination against other faiths, cultures, sexualities or values can come into play easily. This is why the AAMFT’s code 1.1 deals directly with this type of discrimination. One is not to discriminate against others based on these types of differences. The AACC has a slightly different tilt on the issue since the type of counseling itself is Biblical and certain life styles or actions are contrary to the type of counseling being sought. This however does not present a green light for the Christian Counselor to impose own personal beliefs. AACC’s code 1-340-a reminds the Christian Counselor that one is still to respect the autonomy and decision making process of the client. Again, 1-530 dictates that the Christian Counselor respect other faith beliefs and only disclose upon request and only if it benefits the client. Daniels proposes a term referred to as “bracketing” where professional opinions are laid aside and avoiding the triggering of one’s own personal views (Daniels, D., 2020. p.4). Please also see ACA’s A.2.c. Developmental and Cultural Sensitivity standard.
Common to this ideal of bias and discrimination fuels the idea of abandonment. Counselors may feel the temptation to dismiss a client who will not listen, fulfill promises, or follow a certain value system. This unethical practice is condemned in all guidelines. The ACA guideline A.12. stipulates that counselors never quit seeing their clients without proper continuation of treatment through themselves or through others. The AAMFT guideline 1.11 shares the same view that no client is to be abandoned and not seen without reasonable arrangements for continued treatment. The AACC in its rule 1-640-a shares with all other human service entities that a client is not to abruptly abandoned and that treatments are to continue until other options are available.
Another important theme is referral. Many times, certain counselors may become overwhelmed with a particular issue beyond their standard of care. This can especially happen with paraprofessionals or unlicensed counselors who are merely pastoral. Many fall under this venue. This does not mean they do not offer a qualify service but due to knowledge or professional and legal limitations, a referral is sometimes necessary. The ACA guideline A.11.a stipulates that a client that is beyond their skill level or competency should be referred to another professional. In the AAMFT guideline 1.10 also states that professionals may refer clients to others professionals when they are unable to help. Again, in the AACC guideline, Christian Counselors 1-240-d, it is stipulated that Christian Counselors should not refer merely based on faith based issues but when situations grow beyond their skill level, they can refer to more capable authorities.
Relationships can also become toxic. Due to the imbalance of power between in the counselor-client relationship, abuses of power can occur. Within the guidelines in all associations are clear cut warning regarding exploitation. Sexual relationships are condemned in the most strict sense. It is not uncommon for a vulnerable person sometimes to develop feelings for a counselor and it is important for the counselor to correct and document these advances. Counselors are also ethically restricted from working with past romances, family, or close friends. The bias can be strong in these cases in helping the individual. Counselors also need to keep a distance in cases of friendship. The relationship is not one of friendship in the social meaning. Hence, counselors should avoid most social interactions with clients, such as parties, graduations, or dinners. In some cases, if it pertains to a particular issue or healing, a counselor can appear on a professional basis only. Please refer to ACA -A.5. Prohibited Non-counseling Roles and Relationships which cover a broad array of relationships that can occur that considered illicit in counseling. In addition a counselor is to refrain from sexual relations in the NASW handbook as well as physical contact (1:10) when such contact would cause psychological harm. So where a hug or a touch of hand is needed is to be very carefully judged by the counselor. In addition, language and proper presentation in how one speaks is listed in the NASW handbook under standard 1:12.
Unfortunately, sometimes, a client may become attracted to a counselor since the counselor represents a source of power and strength when the client is most vulnerable. It is important for the counselor to be empathetic but also distant when attraction occurs, especially mutual. In some cases, referrals may be needed. To also help prevent such situations, physical gestures such as a touch of the hand or hug should be avoided. In addition, one should carefully screen the acceptance of gifts, unless otherwise approved due to cultural issues and sensitivities.
Other conflicts of interests can occur within agency and client. If dealing with one’s organization, one may also feel tugged and pushed by agency or funder agendas, over client care. Time, funds, and allocation of resources may effect one’s success. This can cause a grey area in client care and the client’s well being. It can also potentially lead to not following policy of employer. As one can see, many ethical dilemmas can spring from such actions.
Another set of regulations we will look at involves confidentiality. A counselor sets out on day one what he or she is willing or can do to the best of their abilities. Within this, there exists a confidentiality that is critical to veracity and fidelity. The boundaries of that need to be clearly laid out. All standards assert that counselors are to keep records and conversations private. Records are to maintained safely, whether paper or electronic, and conversations are to be kept strictly between themselves, unless otherwise dictated. Exceptions, upon approval of client, can include access to records for particular family, or access to records via other team members treating the individual. Again, this agreed upon in advance. Please refer to ACA -B.1. Respecting Client Rights which covers issues of confidentiality as well as exceptions under B.2
In cases, where an individual may cause harm to oneself or others, or upon certain legal orders, a counselor may disclose certain information for the overall safety and good of the client or others. This is far less lax than the seal of confession. One way to better protect and shield oneself from potential mandatory disclosure is listing limits of confidentiality with the informed consent form. In addition, to reminding them throughout the counseling process of the limitations especially when a client seems eager to share a secret. Clients many times feel everything is confidential and fail to understand these limitations.
It is also essential that counselors properly store and preserve documentation. Electronic as well as hand written files needs to be clearly locked and protected and not visible to other wandering eyes. This helps preserve confidentiality.
Another grey area that may occur is transparency in representation. If hired by the state or an authority to review divorce cases, criminal cases, or employee evaluations, counselors need to be very transparent with all parties involved. Documentation for any case needs to be comprehensive, unbiased and utilize accepted and modern strategies. It is also essential to never treat someone beyond one’s ability, or promise things beyond healing. One should also not advertise oneself as a licensed counselor if not a licensed counselor.
Conclusion
Standards and ethical codes are critical to protect counselor and client. They also lay the groundwork for better care and healing for the client. In additional resources and references, there is a list that includes the ACA and others. Links are provided. I highly recommend one reviews these regulations and completely understands the ethical expectations of counseling, whether at a pastoral or clinical level. Whether secular or religious, there are standards that are needed within this special type of relationship.
Please also review AIHCP’s Christian Counseling Certification as well as AIHCP’s Grief Counseling Certification. The programs are online and independent study and open to all qualified professionals seeking certifications in Christian or Grief Counseling.
Additional References
“Counseling Principles and Christian Beliefs: An Integrated Approach”. Daniels, D. (2020). Kendal Hunt Publishing Company
American Counseling Association (ACA). (2014). 2014 ACA Code of Ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdfLinks to an external site.
American Association of Christian Counselors (AACC). (2023). Code of Ethics. https://www.aacc.net/wp-content/uploads/2023/02/AACC-Y-2023-Code-of-Ethics-FINAL-Draft.pd
American Association for Marriage and Family Therapy (AAMFT). (2023). Code of Ethics. https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx
NASW, National Association of Social Workers. (n.d.). https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English/Social-Workers-Ethical-Responsibilities-to-Clients