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Ethical issues and considerations in counseling

September 19, 2023
Young woman talking about her problems and issues with a counselor.

Mental health counselors give patients a safe space to confide private and sensitive information. These disclosures allow patients to receive proper treatment and improve their mental health.1 However, counselors face serious ethical dilemmas when clients share information that could harm themselves or others. The boundaries between counselors and patients can also become blurred, leading to potential conflicts of interest.2

Mental health professionals can navigate these challenges by adhering to strict counseling ethics. This article explores ethical guidelines for counselors, common ethical issues, and strategies for resolving ethical issues.

What are counseling ethics?

The American Counseling Association (ACA) defines counseling ethics as professional values that serve as “the foundation for ethical behavior and decision making.”2 These values enable counselors to maintain professional relationships with clients and provide compassionate care for patients from all backgrounds.

The ACA’s Code of Ethics lists six essential professional values for counselors:2

  • Autonomy: Empower clients to take control of their own lives
  • Nonmaleficence: Avoid actions that could harm clients and others and take steps to minimize unavoidable harm
  • Beneficence: Positively affect clients and society by helping individuals improve their mental health
  • Justice: Treat all clients with fairness and equality
  • Fidelity: Keep commitments and promises made to clients.
  • Veracity: Be honest when interacting with clients, colleagues, and others in professional settings

Examples of ethical issues in therapy

Mental health professionals frequently confront gray areas in ethical guidelines when interacting with clients and colleagues. Let’s explore two common areas where counselors face ethical dilemmas.

Breaking confidentiality in counseling

According to the ACA, mental health professionals have an ethical duty to maintain client confidentiality. Counselors can be compelled to break confidentiality when the client threatens harm to themselves or others. This is a fairly clear cut example and a counselor would cover this while outlining counseling services. However, counselors may face less clear-cut ethical issues when requests are made by outside agencies for patient records.2

For example, law-enforcement officials may demand access to confidential patient information. Counselors should release records only if the police have a court order. Similarly, a parent might request information about a minor child’s counseling sessions. Counselors should ensure that the parent has custodial rights before revealing any information.3

Dual relationships in counseling

A dual relationship occurs when the counselor has two or more roles in a client’s life. For instance, a counselor might be asked to provide treatment for a family member or a former romantic partner.4

The National Board for Certified Counselors recommends that counselors avoid having multiple relationships with clients to avoid conflicts of interest.4 They can refer these clients to another counselor or terminate their professional relationship if a dual relationship develops.

Ethical guidelines for counselors

Counselors may need to navigate ethical dilemmas that don’t have obvious solutions. Mental health professionals can use a variety of approaches, practices, and techniques to address nuanced ethical issues. Let’s explore examples of these in greater depth.

Informed consent in therapy

A standard when it comes to ethical guidelines, counselors can empower their clients to give informed consent by providing comprehensive information about the counseling process. For example, the counselor should discuss the potential risks and limitations of the treatment with the patient. They should also disclose their credentials, their fees, their confidentiality policies, and other relevant information. The client can decide whether to proceed with the therapy based on this information.2

Informed consent helps mental health counselors avoid ethical issues by clearly defining the counselor-client relationship. It also ensures that clients are willing participants in their therapy and understand their rights.2

Setting boundaries in therapy

Counselors can prevent unethical relationships from developing by setting and maintaining clear boundaries. The ACA prohibits counseling professionals from providing services to previous romantic partners, for example. Also, a counselor can’t enter a romantic relationship with a client until five years after their last session.2

Furthermore, the ACA recommends that counselors exercise caution when extending their relationships with clients outside their practices. These precautions help counselors maintain professional client relationships and avoid violating ethical boundaries.2

Ethical decision-making models

Ethical decision-making models enable counselors to solve intricate ethical challenges. The ACA’s decision-making model includes these steps:5

  • Gather all relevant information about the ethical issue
  • Consult the ACA Code of Ethics for guidance
  • Get feedback from colleagues, supervisors, and professional organizations
  • Brainstorm possible solutions
  • Weigh the consequences of each option
  • Ensure that the chosen option is fair and universal
  • Take action

Following a straightforward decision-making model makes it easier for counselors to think about ethical issues and explain their decisions to others.

Counselor competence

Mental health counselors practice ethical behavior by acting only within their areas of competence. They should provide services only if they have appropriate education and training. Also, counselors should continually educate themselves on new developments in their specialty to ensure they can provide the best care. This practice ensures that counselors don’t harm clients by maintaining ethical standards and providing only appropriate treatment.2

Counselor supervision

Counselors and counselors-in-training receive clinical supervision from more experienced practitioners as a part of the path to counseling licensure. Supervisors provide guidance for ethical issues and help counselors develop treatment plans if they’re unsure about the best course of action.4

Like regular counselors, supervisors must follow strict ethical guidelines. For example, they should intervene if they believe their supervisee may harm a client, and they should avoid having any dual relationships with supervisees.4

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Grounded in the Jesuit tradition, the online MS in CMHC program prioritizes intellectual inquiry and service to others. You’ll learn how to provide cutting-edge treatment by taking rigorous courses like Multicultural Counseling, Research Methods in Counseling, and Professional Ethics and Legal Issues in Clinical Mental Health Counseling. Prepare to become a licensed clinical mental health counselor with a firm grip on ethical principles and how to best support a client's mental health while maintaining professional boundaries.

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