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Abstract

Counseling is a principal area in the medical field. Professional counselors have an ethical duty and code of standards that they must follow during their practice. The current research will explore the legal, ethical and professional issues in counseling faced by medical practitioners in their everyday practice. The impact of such issues in different approaches to mental health treatment diagnosis, assessment, and procedures will be described.

Ethical, Legal and Professional Issues in Counseling

Introduction

Every counseling professional has a responsibility to ensure that he/she upholds the public trust when seeking to deliver high levels of training, education, and supervision in practice, given that this activity takes place behind closed doors with minimal supervision. In counseling, ethical standards have been developed by professional associations to help guide the behavior of the practitioners (Hendricks, Bradley Brogan, & Brogan, 2009). These standards help to educate the professionals about sound conduct, provide a framework for personal responsibility and improvement of professional engagement. Additionally, there is a legal framework to enact regulations that are binding upon the practice of counseling in the country. These regulations encompass areas that have not been addressed through other state legislations, more so, regarding the counseling practice. Professionally, counselors are expected to maintain professional growth through continuing education, represent credentials accurately, and maintain appropriate knowledge and expertise, as regards responsibility. This paper is a reflective ethical autobiography that addresses ethical, legal, and professional issues in counseling.

Personal Reflection

There are several influences to personal, moral, and ethical progress and experiences that have boosted my personal and professional growth. Over time, these influences and experiences have helped me to comprehend and appreciate the role of character building in making a successful counselor. They have also helped me to learn how to connect with different people through communication and interaction, aspects which have proven to be crucial in a successful practice. Additionally, these experiences have taught me the valuable lesson of learning through observation and practice, elements that are crucial in character and behavior building.

My parents and family have played a critical role in building my personality. Since I was young, my parents taught me to differentiate between what is wrong and what is right. Additionally, they taught me to be respectful of others, their opinions, and personal beliefs. Given that my parents were healthcare providers, they taught me what they had learned about treating others with care and compassion.

Komarnicki (2004) asserts that parents and family play a significant role in modeling an individual’s character. Parents are urged to be alert to spontaneous expressions in their children’s environment, as these are the ones that provide additional opportunities for them to acquire knowledge. He further adds that the children have to be motivated to be innovative and inventive in the manner they deal with people and the surroundings, which are useful tips for guidance.

My teachers also influenced my personality. They taught me the importance of following rules in different social settings and avoiding any actions that would otherwise be a breach of regulations. Additionally, my teachers consistently talked about the repercussions of the lack of following the professional code of conduct in the field. This was by giving examples of individuals and institutions which were fined heavily for not following the code of conduct, as set by the governing body.

Wilcoxon and Magnuson (2002) insinuate that even though counselors do receive regular training in consultation at specific points in their careers, extra intervention by counseling trainers plays a role in introducing the learners to the utilization of counseling skills. These skills can only be perfected if the learners are innovative enough, and have the urge to venture into the unknown. However, to do this successfully, the learners are supposed to follow the set rules and regulations, so as not to break the law in their operations.

Religious leaders also played an integral role in shaping my personal, moral and ethical progress. One of the main lessons from the religious leaders was the importance of respecting other people’s desires. They reminded me that in a dynamic society, different people have different feelings, which influence their personal desires. Therefore, to avoid conflict of interests, one has to respect the opinion and feelings of others. The religious leaders guided me in understanding the importance of confidentiality, which is crucial between councilors and patient relationships.

Nickles (2011) highlights the role of spiritual guidance in counseling. He says that the concepts of spirituality and religion always overlap and that they are often used interchangeably. He believes that religion helps one to organize his/her moral values, and recognize his/her role in involvement in the general community. Further, Wilkerson (2006) asserts that addressing spirituality and religion in counseling has therapeutic values in the sense that its integration aids counselors to support their clients professionally and ethically. Therefore, the role that my spiritual leaders played in shaping my personality, ethics, and professionalism was of utmost significance.

Counseling Issues

This part outlines four counseling issues that I have come across in my practice as a professional counselor. All these issues present unique ethical challenges. There are also specific state and regional laws that have been formulated by the counseling body, which presents legal challenges in regards to the counseling practice. The issues include a response to a court of law about my client’s confidentiality, conforming to the use of data-based problems mind solver, and refusing to counsel a gay client based on my moral standings. Through categorical description and reference to specific laws and statutes, I outlined the specific ethical challenges that are addressed and how the law is used to ensure that professionalism is upheld throughout.

• Issue I

The first issue was about responding to a court of law about one of my clients’ confidential counseling issues. According to Welfel (2012), it is common in certain circumstances for law attorneys to use a subpoena to demand information about counseling for a case. A subpoena is a legal document, which is obtained by the client after informed consent, should they wish information to be released.

In the case of a court ruling, it is most preferable that a family therapist should not be present during the actual hearing. However, as a family therapist, I may possess important information which may be helpful with the case. Nevertheless, in this case, if I voluntarily offered my statement about my patient before the court, I would be in contrast to my professional code of conduct as a counselor, and be liable to punishment, fine, or discontinuation from practice.

This ethical dilemma is addressed by the U.S constitution, which states that subpoenas are enforceable by law. Subpoenas can thus be performed on a family therapist to seek information regarding an ongoing case in the court of law. According to the American Counselors Association’s code of conduct, I am expected not to automatically comply with the subpoena without discussing it with my client and/or his attorney, and that I should consult with the right channels before taking any actions.

The challenge presented here is that if both a subpoena and a court order are received, it is my duty as a family therapist to release all the information, with or without the client’s consent. This contradicts my Christian moral beliefs, that all people’s feelings and desires should be respected. However, failure to do so may result in me being arrested for contempt of court.

• Issue II

The second issue is conforming to the use of the Data-Based Problem Solver Model in evaluating my patients, as compared to the use of traditional transference or countertransference counseling techniques. The Data-Based Problem Solver Model was designed with a sample of 55 patients, and it was found that the results were helpful. Later, the MANOVA Repeated measures design was used to analyze and standardize the results of the Data-Based Problem Solver Model However, the MANOVA was not ranked among other traditional counseling techniques.

The ethical challenge presented by this issue is that both techniques have been tested in counseling patients, and they have offered valid results. However, my employer’s guidelines demand that all the counselors use the DBPSA model, even though most of the institution’s employees prefer the other method.

Professionally, there are no laws or statutes that outline which specific method should be used in counseling sessions at the hospitals. The statutes only address the protection of patient confidentiality. According to the ACA code of conduct, confidentiality is a sense of trust and privacy between the counselor and the patient, which is essential for successful treatment (ACA, 2014). It has been identified by many psychological experts as the cornerstone of counseling, which marks the boundary between counseling relationships and other types of relationships where information is shared.

The biggest dilemma regarding this issue is the self-referral practice, which is outlined in the ACA Code of ethics section A.10. (ACA, 2014). Should I feel that given the institution’s strictness of methodology would not help the patient, I would offer to help them on a personal level. This, however, contradicts this particular code of conduct that states that a counselor working in an organization that provides counseling services cannot refer clients to their private practice unless that organization’s policies make explicit provisions for self-referrals.

• Issue III

The third, and, perhaps, one of the most controversial issues I have ever come across, concerned a patient whose sexual orientation I did not approve of. I once refused to counsel a gay client, since my moral and Christian standing supports straight sexual preference. This was a gay patient, who stood for all that my morals were against. I was particularly uncomfortable maintaining a conversation with the patient, as his “immorality” kept ringing in my mind.

The major ethical challenge with this issue is that failure to help a person based on their sexual preference may warrant termination of employment if the patient files a case in the court of law (Remley & Herlihy, 2014). Many counselors have had to deal with legal matters regarding such issues with most of them either losing their jobs or being fined heavily.

According to the amendment of the code of conduct in the counseling profession, all patients, regardless, of their sexual preference, are entitled to fair and professional counseling healing. The ACA code of conduct Section C.5 touches on discrimination. According to this article, “counselors should not condone or engage in discrimination”, based on several issues, amongst them the patient’s sexual orientation (ACA, 2014). This is a punishable act and should be avoided at all times. However, based on this ethical code, I found it challenging to go against my morals and engage the patient accordingly.

• Issue IV

The fourth issue was about receiving a gift from one of my clients while working at a certain hospital. The client had earlier visited the institution, and after a successful first session with me, she insisted that I would be the counselor she would like to meet every other time she visited the hospital. We had three successful sessions, and on the last day that she visited, she insisted that I receive some amount of hard cash as a token of gratitude.

The ethical challenge about this is that a counselor should understand that accepting gifts from clients may be a show of appreciation from the client’s side. Whenever a counselor is accepting a gift from the patient, they should consider the therapeutic relationship with the client, the gift’s monetary value, and the client’s motivation for accepting the gift. According to my parent’s teachings, I should consider other people’s feelings and respect them. I had to accept the gift, even though the hospital’s policies are against such.

The ACA code of conduct section A, A.10.f says that professional counselors should recognize the client’s culture regarding gifting (ACA, 2014). On my part, I did not have deep knowledge about the client’s cultural beliefs, especially regarding gifts, but assumed that she meant good by rewarding me.

Meaning of the Assignment

This assignment has helped me to have a deeper understanding of the importance of ethics in counseling. In the counseling practice, professionals have increasingly found themselves comforted with moral questions and other related ethical dilemmas, which may affect the way they deliver their services. Ethics help to change the context in which counseling is provided to the patients and improving the general quality of these important services. Through the research, I did in this paper, learned more about ethical guidelines from the ACA, IAMFC, and AMHCA, which I believe will play a role in making me a better practitioner.

Secondly, this assignment has helped me in improving my decision-making skills. According to the Professional Association of Counselors, practitioners must be able to set standards with the intention of modeling them. We face several patients, with different cultural and social backgrounds, and, thus, we must have a way of handling each according to their personality and culture. With the information I have learned while handling this assignment, I am in a better position to approach each patient and engage with them on a personal level, and apply guidelines to take the necessary and appropriate actions as needed.

Working on this assignment has helped me to sharpen my professional research skills. The assignment needed a thorough examination of material and related literature, to collect the most useful information to compile a sound academic report. In the field of counseling, research is essential to the continuance of practice, as it seeks to dig up new information to address various issues. This assignment has, therefore, helped me to carry out better research as pertains to the field of counseling.

Finally, this assignment has helped me explore and analyze experiences in the classroom and actual practice. By reflecting upon the experiences I have had before. I am now in a better position to improve my actions as a student, which is a catalyst to my future career. The reflection has helped me to realize a greater level of self-awareness and impacted my perception of the practice in general.

How Adherence to Law and Ethics Impacts Social Change

The most significant impact of social change is that it helps the patients to build their confidence in counselors. By doing so, they become comfortable and open up more to the counselors, without holding anything back. This helps them on the path to a quick recovery. A society with fewer psychological problems promotes mental health, and, thus, fewer incidences such as suicide, and related violence.

Adherence to the ethics code helps the counselors to build better relationships with society, including interest protection and participation in activities that promote the general well-being of the public. Unethical conduct may lead to violation of policies that have been implemented to prevent malpractices, such as discrimination and racism. By doing this, the general interest of the entire society is protected and the counseling practice is more appreciated.

By adhering to professional counseling ethics and laws, individuals in society with certain societal problems such as victimization of homophobia are supported. The code of conduct has clearly outlined how to treat every client, regardless of their orientation or preferences. By doing this, the mental well-being of certain members of society is improved, and they can receive the necessary support they need.

My Development

Impact on Work in the Class

My definition of ethics and law has gradually changed. By researching specific clauses in the statutes, I am now in a better position to relate various classwork to the actual practices, as far as the code of conduct is involved. I also recognize additional ways of correlating case studies with the law and statutes regarding professional counseling.

As I did the project, I interacted with classmates on research and practice. This has helped me to develop a closer relationship with my classmates, who are my potential future workmates. In counseling, professionals can share ideas that help in delivering the best services. Close professional relationships are, therefore, important to create a mutual working environment in the future.

Personal Values Re-Examined

I re-examined my personal values regarding patient confidentiality. In the profession of counseling, I have come to learn that it is a paramount desire for professionals to uphold confidential issues with the clients. Initially, I did not regard this as a priority, but through the coursework, I have gained an insight into the importance of privacy and confidentiality in practice.

I have also re-examined my discipline as a counselor. Discipline is paramount in practice, given that counselors must have focus and play as role models for their patients. Changing perspectives about various social issues and having a clear stand on approach are disciplinary issues that define a successful and effective counselor.

Ethical Values Re-Examined

I have had second thoughts about how I treat individuals whose character I deem unethical. In my Christian upbringing, I was brought up to believe that the only moral sexual orientation is straight. However, I understand that every person is shaped by his/her own upbringing and that no one should be victimized or discriminated against because of their sexual orientation.

I have re-examined my general comprehension of ethical standards in the course of this coursework. I now have a deeper understanding of the concepts of ethical standards, which are the promotion of professionalism and delivery of quality counseling services to clients. This helps me to set personal standards of ethics which would help me to become a successful practitioner.

Conclusion

In this paper, I have presented a personal reflection on ethics and values in the profession of counseling. I have outlined personal experiences which have shaped my personality and developed my character. Additionally, I provided specific experiences which, over time, have proven to be the foundation of my future career. With the four counseling issues presented, ethical challenges and statures that apply to them have been outlined, and issues arising from addressing these ethical issues evaluated. The assignment has been instrumental in developing me as a student and preparing me for the future career. Additionally, the role of ethics and law for social change has been explained, and the role that the assignment has played in developing me as a counseling student is outlined.

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