Week 11 Assignment

Reflective Ethical Autobiography

Past student

Walden University

Reflective Ethical Autobiography

Ethics are generally regarded as the standards that govern the conduct of a person (Herlihy & Corey, 2015). This implies a process of self-reflection and awareness of how to behave as a moral being. Each individual's set of ethics provides the fundamental principles or beliefs by which that person distinguishes between morally acceptable and morally unacceptable behavior (Remley & Herlihy, 2016). We all live our lives under an individual code of ethic but not all these ethical standards will be the same. Each person draws portions, sometimes bits and pieces, of their personal code of ethics from an almost random variety of sources, such as their childhood upbringing, a dramatic or otherwise pivotal life experience, religious beliefs, professional and educational experiences (Remley & Herlihy, 2016). The counseling profession holds a strong mandate for all counselors to understand and maintain a strong sense of ethical awareness in all they do (Herlihy & Corey, 2015). Through my journey of becoming a counselor, I have been required to sit back and evaluate my personal code of ethics and recognize the different aspects of my life which influenced their development.

Personal Reflection

Ethics is an area which address questions about morality. Ethics invariably play an important part in every person’s life, especially when a person is faced with a decision. As stated, the ethical view of an individual is formed by many contributions (Remley & Herlihy, 2016). Through completing an individual evaluation of the formation of my personal code of ethics, I have identified several major life experiences, both positive and difficult, which have molded the values in which I strive to live by. There are three major influence exerted on my ethics: my childhood, my children, and my educational experiences.

Diversity I Experienced During Childhood

During my childhood, I moved over 20 times, which included residing in 8 different states and three different countries. Due to relocating many times throughout my childhood, I was provided the opportunity to experience different cultures and was able to gain the understanding of the importance of diversity in the world. Everywhere we lived, I experienced different cultures and recognized how a person’s culture impacts the way in which they perceive, comprehend, and respond to the world around them. Through these moves I was able to obtain what it referred to as a “global mindset”. A “global mindset” is defined as the ability to work successfully across cultures (Smith, 2012). This has allowed me the skillset on how to be cultural sensitivity; the ability to interpret diverse situations, information and facts while being an empathetic team player; and a passion and curiosity that enables me to enjoy the cultural diversity which exists all around each of us.

As I started to recognize that there were differences in a person’s cultural believes and the ways they lived their lives based on such factors as the geographic of where they lived, their ethnicity, religion, family traditions/heritage, and race; it caused me to want to better understand my own culture. By learning more about my own believes, it allowed me to recognize the importance of my own culture and how much regard I held for my culture. This evaluation also allowed me to consider how I felt about those believes and/or cultures which are different than my own. Though my culture and views may be different than others, the one common factor I could recognize was that others held their culture with as high regard as I did my own and therefore I should always provide as much level of respect for other’s culture, as I would want shown towards mine. Therefore, when interacting with people, it is imperative that we appreciate that each person's intrinsic values are different. Because values are so ingrained, we are not often aware that our responses in life are, in large part, due to the values we hold and are unique to our own culture and perspective. Furthermore, we seldom reflect on the fact that the people with whom we associate hold their own unique set of values that may be different from our own (Remley & Herlihy, 2016).

In my work as a future counselor, I will draw from my experiences as a child learning and encountering the opportunity to grow up around so many individuals who shared different cultures than that of my own. Counselors need to be aware that, like their clients, they bring their own set of values to the counseling sessions. Counselors must remain aware of, and open to, these differences in values in building a strong counseling alliance with clients. To prevent unintentional misunderstanding or judgement which could cause a breakdown in the counseling relationship and process (Remley & Herlihy, 2016).

Mental Health Struggles

My mother has struggled with her mental health, throughout her entire life. Due to the stigmatism which encircles mental health, even after being diagnosed with a mood disorder and depression, she chose to not receive treatment. This was due to her fear of being judged and it negatively impacted her ability to support my sister and I. My mother, by not receiving any treatment to help manage her symptoms, caused a situation in which my sister and I were required to become self-dependent at a very young age. My mother’s fear of being unfairly stigmatized and discriminated against for her mental health struggles, had an everlasting impact on us all because she never received any relief from her struggles and we never were able to experience the stability we needed growing up.

Looking back at all these hardships; it really strengthens my belief that there is a need for mental health advocacy. The emergence of mental health advocacy movements in several countries has helped to change society’s perceptions of persons with mental disorders (World Health Organization, 2001a). I have witnessed firsthand, throughout my personal and professional life, instances where a mental health diagnoses has led to unfair treatment and ridicule; therefore, through these experiences, I have found the courage to stand up and to improve the general population’s knowledge, understanding and acceptance of mental disorders. Living with and loving a person who struggles with mental health, significantly impacted my ethical development in not labeling or defining an individual by their struggles.

My Children

My husband and I were married as teenagers due to I becoming pregnant at the age of sixteen. We have now been married almost twenty years. It was through this partnership, I was able to gain stability and trust in another person. Plus, I had too learned the importance for another person to be able to trust you. As a mother, my focus changed from only looking out for myself, to having to place another’s welfare above my own. This taught me the requirement of considering the importance of alliances when it comes to relationships.

The counseling relationship is central to counselors’ work with clients. The counseling relationship is the association, rapport, and connection between a counselor and client. The establishment of the counseling relationship begins with the joining process, wherein the counselor and client get to know each other and clarify the need and purpose for counseling. The counseling relationship includes such things as unconditional regard for the client, placing the needs of the client first, engaging the client in a positive and collaborative manner (Geldard & Geldard, 2012). Ethically the counselor has a responsibility to cause no harm and place the client’s needs first (ACA Code of Ethics, 2014).

Educational and Professional Experiences

Throughout my time as a student, preparing to become a licensed counselor, I have gained a greater understanding on the importance of continuing education in this field. This field continues to grow and evolve, it is imperative for counselors to remain aware of new procedures, research, and best practices. The ACA Code of Ethics states the importance of counselors not practicing in specialty areas before first receiving the appropriate education, training, and supervision experience; so to not cause unintentional harm to a client by attempting to provide a level of treatment, in which they are not prepared to do so (ACA Standard C.2.b., 2014).

Throughout my time working in child welfare, all of my cases involved children who had experienced some form of trauma. Trauma from the abuse and then trauma from being separated from their parents, if removed for safety issues. When working with these children and seeing the different behaviors and attitudes they present because of this trauma, you want to help. It is very easy to take on the role of a counselor to these children, in an attempt to help them address and resolve all these emotions they are experiencing because of the trauma they have and continue to experience. I learned firsthand how a person could unintentionally cause additional emotional and mental harm to a child in these type of situations if they are trying to work outside the scope of their role and do not have the proper education and experience in trauma informed care (Ko, Ford, Kassam-Adams, et al., 2008). It is imperative that counselors continue to become educated in all the different research and theories which are continuing to be developed and utilized in their area of specialty and never get to the point in which they believe, “they know it all” because this can cause great harm to the client and their therapeutic progress.

Four Counseling Issues

Counseling is a profession which is founded on a strong code of ethics (Remley & Herlihy, 2016). When it comes to ethics, counselors find themselves in gray zones in most ethical dilemmas which arise due to the type of services they provide, the sensitive topics which are being processed, and ultimately holding a higher responsibility to protect the client first, so not to cause harm (McHale, 2009). Issues of counselors’ responsibility to maintain client confidentiality and privacy, duty to warn, manage dual relationships, and understanding multicultural sensitivity with clients, are all subjects with considerable potential for ambiguity and risk. The counseling profession has codes of ethics which counselors have to adhere to as well as state licensing standards and laws which have to be followed as well in the protection of client rights (Herlihy & Corey, 2015).

Confidentiality & Privacy

Confidentiality in counseling services is one of the most basic ethical obligations for counselors and, at the same time, one of the most problematic (Meier & Davis, 2011). A counseling alliance needs to be built on trust. Clients need to feel free to be vulnerable during counseling sessions without being concerned that their personal fears, hopes, disclosures and other private aspects of their lives will not be inappropriately shared with others. The American Counseling Association (ACA) Code of Ethics addresses the ethical requirements a counselor needs to adhere to in respecting a client’s privacy and the counselor’s responsibility in the prevention of causing “no harm” to the clients served (Standard B.1.c., 2014).

Due to the nature of the service being provided and the information being shared, there will be times in which information about the client will have to be shared. Counselors at the start of the counseling relationship have an obligation to inform and discuss with the client, the exception to confidentiality which exist (Herlihy & Corey, 2015). These exceptions include, sharing information to provide best possible services, to protect someone in danger, when counseling minors, or to obey a court order (Herlihy & Corey, 2015). The standard to inform clients of these confidentiality exceptions is defines and regulated by the ACA Code of Ethics, Standard B.1.d. (2014).

Informed consent is perhaps the most basic rights of clients in counseling (Remley & Herlihy, 2016). Counselors allow the client to provide informed consent when the counselors inform the client on the exemptions which exist in confidentiality, by allowing the client to make a decision on whether to move forward in participating in counseling and on what information the client chooses to disclose. By providing this insight, if the client continues to choose to disclose certain information, they have now provided informed consent in having the information released to outside parties if required (Herlihy & Corey, 2015). A Client has the right to know what they are getting into when they come for counseling and what information they may share which could then be released to an outside party (Remley & Herlihy, 2016). The ACA Code of Ethics provides an explanation of the informed consent standard in Standard A.2.a. (2014).

The State of Kansas Statute K.S.A 30-60-47 mandates all mental health centers to develop and oversee policies and procedures to guarantee the confidentiality of clients and their mental health records. Kansas Statute 65-5810 states “the confidential relations and communications between a licensed professional counselor and such counselor's client are placed on the same basis as provided by law for those between an attorney and an attorney's client” (Kansas Legislative Sessions, 2015-2016). Kansas Statute K.S.A 65-430 states the Kansas Behavioral Science Regulatory Board may suspend or revoke the license of a mental health professional or center if they are found negligent in upholding and maintaining the confidentiality and privacy of a patient receiving mental health services (Kansas Behavioral Sciences Regulatory Board Regulations, 2015). Confidentiality is fundamental factor in counseling and it must always remain a priority to the counselor but a counselor must understand, they cannot guarantee a client total confidentiality due to some of the other mandates which exist in this field. For a counselor to offer total confidentiality would be unethical in itself. Therefore, to help address this ethical dilemma, counselors need to prepare ahead of time by being upfront and diligent in informing and educating their clients from the start about the exceptions which do exist with confidentiality. Counselors also need to make sure these conversations are not just occurring at the start of the counseling relationship but throughout the entire time services are being provided. If a situation arises where confidential information does have to be released, the counselor needs to be advising the client of this release immediately (McHale, 2009).

Duty to Warn

The duty to warn refers to a counselor’s obligation to warn identifiable victims. The duty to protect is a counselor’s duty to reveal confidential client information in the event that the counselor has reason to believe that a third party may be harmed (Herlihy & Sheeley, 1988). Duty to warn is both a federal and state mandate which requires and permits counselors from breaching confidentiality in cases where another person is at risk of sever harm. Several examples of this regulation include mandated reporting for situations which include the abuse and/or neglect of a child, the elderly, or other vulnerable adults as well as in situations which the client is suicidal and poses a danger to themselves (Herlihy & Corey, 2015).

The American Counseling Association Code of Ethics in Standard B.2.a, states one of the exceptions to maintaining confidentiality is “if a disclosure is required to protect clients or other identifiable other from serious or unforeseeable harm” (2014). The legal precedent for establishing a duty to warn and a duty to protect was set in the wrongful death case of Tarasoff v. Regents of the University of California. In ruling on the case of Tarasoff v. Regents of the University of California, the court determined that the need for therapists to protect the public was more important that protecting client-therapist confidentiality. Despite the controversy over the circumstances for breaching confidentiality, Tarasoff laws have been adopted across many U.S. states and have guided similar legislation in countries around the world (Herlihy & Corey, 2015).

State of Kansas is silent as to the counselor’s duty to warn. This means the State of Kansas allows, but does not require, psychologists, psychiatrists, marital and family therapists, social workers, and licensed professional counselors to disclose information that would otherwise be confidential between the patient and therapist when they believe a serious risk of imminent personal injury to the patient or third parties exists. The statutes applying to the different mental health professionals are worded slightly differently. They all authorize disclosure, but they do not require it, nor do they place an affirmative duty on the mental health professional to warn either potential victims or law enforcement agencies. The statutes do not specify to whom the information may be disclosed. Mental health professionals may be held civilly liable under the common law, however, if they fail to warn an identifiable victim of an imminent physical threat (NCSL, 2015).

Duty to warn is another regulation which should be presented and addressed by the counselor with the client from the start of the counseling relationship. Counselors must disclose confidential information when legally requirements demand it. At the same time, it may be difficult to determine if the threat is serious. In these types of situations, it would benefit the counselor to seek guidance from other professional colleagues and supervisors in making the decision if the counselor is unsure if the situations falls under the required mandate for reporting (Herlihy & Corey, 2015).

Dual Relationships/Boundaries

In counseling, a dual relationship occurs when a counselor has a second, significantly different relationship with a client in addition to the traditional client-counselor one. Dual relationships in counseling can be unavoidable and occur when a professional counselor takes on two roles that are usually professional in nature (Herlihy & Corey, 2015). Having a dual relationship with a client can lead to a greater chance of a boundary violation if clear and defined perimeters are not put in place from the beginning, between all parties involved. Boundary violations are breaches in client care that causes harm to the client and therapeutic process (Herlihy & Corey, 2015). Counselors need to remain aware of the complexities a dual relationship can cause and continually evaluate if the dual relationship creates a benefit for the client or placing the client of being at risk of receiving harm. If the risks outweigh the benefits, the conflicting relationship should end (Erickson, 2001).

Most ethical decisions considering dual relationships and boundary violations can be addressed with general aspects of ethical code but making the decision involves mindful awareness of personal values that are specific to the client (Pope & Keith-Spiegel, 2008). Standard A.6 of the ACA Code of Ethics provides guidelines for professional counselors to adhere to in those instances when a dual relationship may occur (2014). These codes recommend avoiding nonprofessional interactions or relationships with clients or former clients. The ACA Code of Ethics, however, recognize that some nonsexual dual relationships are unavoidable and have a potentially positive effect on the client/counselor relationship. Standard A.5.c. states if a boundary extension does occur, the counselor has a responsibility to document the rationale for the relationship, its potential benefit, and any foreseeable consequences (2014). A counselor also needs to continually evaluate if these dual roles could cause harm to the client. The client's consent should be obtained prior to entering into the relationship when feasible (Remley & Herlihy, 2016).

The Kansas Behavioral Science Regulatory Board oversees and investigates all claims of ethical violations by licensed counselors. The Kansas Behavioral Regulatory Board Regulation 102-3-12a Unprofessional Conduct, a counselor’s license may be suspended, limited, conditioned, qualified, restricted, revoked, not issued, or not renewed upon a finding of unprofessional conduct (Kansas Behavioral Sciences Regulatory Board Regulations, 2015). Unethical behavior includes an act of having an inappropriate relationship with a client, while acting in the role of the client’s counselor (Kansas Behavioral Sciences Regulatory Board Regulations, 2015).

Appropriate distance between therapist and client are inherent to the therapeutic process, many experts on ethics in the counseling profession advocate for therapists maintaining strict boundaries with clients. Clear boundaries are viewed as essential in therapy, and deviation from those boundaries presents a potential threat to the therapeutic process (Gottlieb, 1993). Another concern with dual relationship is referred to as the slippery slope. The term slippery slope refers to the notion that failure to adhere to rigid standards will gradually lead to relationships that are exploitative and harmful to the client. This process is thought to occur when one boundary is crossed without a clear damaging result, making it easier to cross future boundaries (Gottlieb, 1993). It is important for counselors to define and maintain firm and clear standards when it comes to holding multiple roles in a client’s life.

Multicultural Understanding/Sensitivity

Ethics in multicultural counseling is an ever-changing enterprise. Nested within the considerations for diverse cultural elements may be issues of power, privilege, and oppression to which counselors must attend. Responsible ethical practice, then, demands responsible multicultural and advocacy sensibilities (Cottone & Tarvydas, 1998). As a mental health counselor your cultural values and beliefs should not impact the counseling process with your client. Counselors must, professionally and without discrimination, try to understand their client's individual cultural background and how it guides their behaviors and personal goals in which they hope to achieve throughout the counseling process (Herlihy & Corey, 2015. If a counselor allows their own values to interfere with the counseling process, it becomes an ethical issue (Cottone & Tarvydas, 1998).

Multiculturalism and diversity impacts every area of every individuals’ life and therefore has a huge impact on counseling processes. American Counseling Association (ACA, 2014) features a major emphasis on cultural diversity. In order to be culturally competent counselors, individuals must be open-minded and recognize that valuing and respecting cultural differences requires a commitment to gain education and desire to make sound ethical decisions within diverse cultural contexts. The ACA Code of Ethics Standard B.1.a recommends counselors maintain awareness and sensitivity regarding cultural meanings of confidentiality and privacy (2014).

Kansas Behavioral Sciences Regulatory Board Regulations identifies discriminating against any client, student, or supervisee on the basis of color, race, gender, religion, national origin, or disability, as unethical conduct which could lead to a counselor’s license may be suspended, limited, conditioned, qualified, restricted, revoked, not issued, or not renewed upon a finding of unprofessional conduct (Kansas Behavioral Sciences Regulatory Board Regulations, 2015).

The development of cultural competency is a life-long personal and professional journey. This developmental process will be enhanced if counselors understand the unique and ever changing dynamics of the concepts which underlie culture and commit themselves to understanding their clients as complex, multidimensional, cultural beings. Counselor who are committed to gain a multicultural understanding and sensitivity must be predicated on the realization that clients simultaneously experience the world on a number of cultural dimensions that include not only race/ethnicity but gender, sexual orientation, religion/spirituality, socioeconomic status, and ability status and therefore interventions should be developed to match the needs of each individual client rather than focusing on matching the values of the counselor (Robinson & Howard-Hamilton, 2000).

Ethics and Law for Social Change

Social change refers to the process of providing full and equal participation of all individuals and groups, allowing their needs to be met equally (Vera & Speight, 2003). Rather it just being the counselor’s role to support individuals in change only through individual empowerment, a social justice framework within the counseling field encourages counselors to change the contextual variables that contribute to social inequity and oppression (Vera & Speight, 2003). Numerous scholars have suggested that client advocacy and public policy work can be infused into the skills of counselors (Vera & Speight, 2003). Advocating for social justice requires that counselors become more knowledgeable about oppression and societal inequities and how they are experienced by individuals and groups. Counselors must also personally reflect on issues of oppression and privilege in their own lives. An important part of being a social justice-oriented counselor is to critically examine one’s experience as an oppressor, the oppressed, or both. To think critically about these experiences may influence the ways a counselor conceptualizes and interacts with clients in becoming a proponent of social change (Vera & Speight, 2003).

Ethical and legal issues are complex. Adhering to a legal counseling practice protects counselors, clients, and society, and promotes a sense of trust in a relatively new profession that has founded itself upon ethics and the law (Vera & Speight, 2003). Counselors ethically and legally engage in the work they do; so that they might better meet the needs of their clients while also creating a healthier society. To accomplish this goal, counselors have to be well researched and up-to-date with the codes of ethic. Ethical principles are not absolute. Ethical principles are continuously changing over time according to the needs of the society. As social condition and status of the society changes, the ethical principles must be subjected to those changes. Corey (2001) asserted that counselors must become active agents of constructive social change.

My Development

As I reach the completion of this course, I have a deeper understanding of the ethical mandates which exist in the counseling profession as well as a greater recognition on how a person’s life experiences, greatly impact their ethical framework. This assignment allowed me to complete the journey of really gaining insight on my own personal ethical values. Through this process, I was able to gain a deeper understanding of how my life experiences have assisted in establishing this ethical foundation.

Impact of Work in the Class

I have a stronger sense of appreciation for the work counselors do and their ethical commitment to the client’s they serve. This class caused me to complete a thorough evaluation on if my ethical standards and priorities could fall in line with the ethics which make up the framework of counseling profession. This class has opened my eyes to the importance of ethical and legal issues as a future counselor.

Meaningfulness of the Assignment/Examination

When I started working in child welfare, I felt immediately connected to the field because I was able to become the voice for a child. A voice, I so desperately needed for myself as a child. As a child welfare worker, there are also ethics which guide you daily to do your job and connect well with these ethics. Through this assignment and the study of the ethics which guide the counseling field, I realize the two fields share similar code of ethics in some regards but in others, the two fields are completely opposite. This has caused me to really sit back and evaluate if a career in counseling is the right fit for me.

The area in which, I am having the heaviest struggle with is with mandatory reporting requirements. Working in child welfare, I have experienced those situations in which I have contacted a therapist on a case, requesting information and it was talking to a brick wall due to the counselor’s unwillingness to share information which could potentially make the determination on whether a child would be safe to be reunified into a home or if they needed to remain in foster care longer, while parents continued working services. I can recognize and understand the position of the counselor now after completing those course and gaining a new understanding of what that counselor’s role and responsibility is to their client. As a child welfare worker though, who has always followed an ethical framework that the child’s safety is always priority, I still find myself struggling with accepting that we will put the parent’s right to confidentiality over the potential, future safety of their child. For me the adult client deserves less safety than their child dos, if the adult parent’s actions are what causing the child to be unsafe or at risk.

This assignment and course as a whole has allowed me to recognize that I need to reexamine what direction I want to move forward in my professional career. I do not feel that though my ethical standards are different than those of the counseling field, that either set of standards are wrong; they are just different. The ethical standards which guides child welfare has to be different than those that guide the counselling profession. I can see now when I started down the path to become a counselor, I did so with the intentions of wanting to work with and provide a greater level of support to the families and children which were receiving intervention from a child welfare agency but I lacked a huge amount of understanding about what the position all encompassed and that the work I was doing as a child welfare investigator would be completely different than that of a child welfare counselor.

Conclusion

My ethical framework was developed from all I have experienced through my lifetime, to include, growing up among diversity, mental health struggles, abandonment, and being a teenage mother. The above experiences are what also empowered me to want to become a counselor, to be a support to others in which I felt I missed out on having in some of the most vulnerable times of my life. After reviewing and completing an evaluation of my personal code of ethics compared to the code of ethics which regulate the counseling field, I discovered some incongruence. This has now provided me an opportunity to step back and determine if the disconnect are in areas in which I am willing to work to change my values in or if the counseling field may just not be the best fit for me.

References

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Cottone, R. R., & Tarvydas, V. M. (1998). Ethical and professional issues in counseling. Upper Saddle River, NJ: Prentice Hall.

Erickson, S. H. (2001). Multiple relationships in rural counseling. The Family Journal, 9(3), 302–304.

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Retrieved from the Walden Library databases.

Privacy and Confidentiality in Kansas. (n.d). Health Information & The Law. Retrieved on 5/10/2017 from: http://www.healthinfolaw.org/state-topics/17,63/f_topics

Remley, T. P., Jr., & Herlihy, B. (2016). Ethical, legal, and professional issues in counseling (5th ed.). Upper Saddle River, NJ: Pearson.

Robinson, T. L., & Howard-Hamilton, M. F. (2000). The convergence of race, ethnicity, and gender: Multiple identities in counseling. Upper Saddle River, NJ: Merrill.

Smith, D.H., Facilitating the development of a global mindset through a cultural experience. Journal of Leadership Studies: Expanding Interdisciplinary Discourse, 6(2), 110-115.

World Health Organization (2001a) World health report 2001. Mental health: new understanding, new hope. Geneva: World Health Organization.