bacp ethical framework essay

123 – Ethical Frameworks in Counselling

123 – Why Is There a Need for Ethical Frameworks in Counselling

Dual relationships in counselling training – when a client disagrees with us.

In episode 123 of the Counselling Tutor Podcast, Ken Kelly and Rory Lees-Oakes discuss the need for ethical frameworks in counselling. Our new regular segment, ‘Check-In with CPCAB’, then looks at dual relationships in counselling training. Finally, the presenters discuss what to do when a client disagrees with you.

Why Do We Need Ethical Frameworks in Counselling? (starts at 1.15 mins)

The concept of ethical frameworks derives from the theory of utilitarianism, which promotes actions that maximise wellbeing for the majority of a population.

Philosopher Jeremy Bentham founded this concept, based on the idea of the best action being the one that brings about  ‘ the greatest happiness of the greatest number ’.

Professional bodies in most areas of work have ethical frameworks that they expect their members to abide by; these are sometimes also called ‘codes of practice’.

This is all an inherent part of being a professional – a word based on the concept of ‘ professing ’ (i.e. making a public declaration of allegiance to a set of beliefs).

In counselling, for example, there are a number of professional bodies, each with its own ethical framework. One example is the BACP’s Ethical Framework for the Counselling Professions .

Ethical frameworks in counselling give us a set of standards to work to , helping to ensure consistency in provision across the profession – and thus also a benchmark for accountability (so supporting the investigation of any complaints from clients).

They are living documents that are updated periodically in light of new research evidence, learning from complaints, and societal changes.

For example, the BACP’s Ethical Framework was updated in 2018. In Counselling Tutor Podcast episode 83 , Rory interviewed Professor Tim Bond, consultant to the BACP and author of  Standards and Ethics for Counselling in Action  (4th edition) (Sage, 2015).

The ethical framework to which we are working is important in clinical supervision; those counsellors who are BACP members are required to revisit this explicitly at least once a year.

It’s also good to draw clients’ attention to its existence, for example referring to it in contracting and even offering them a copy.

Rory has also written a handout on ethical frameworks in counselling and how to work with these. You can download this free of charge here; it is also available through the Handouts Vault and Counselling Study Resource (CSR).

Check-In with CPCAB: Dual Relationships in Counselling Training (starts at 13.30 mins)

Rory speaks to Heather Price (Senior Counselling Professional) at CPCAB (Counselling & Psychotherapy Central Awarding Body) about dual relationships in counselling training.

Heather explains that this situation occurs when two people who already know each other well outside the classroom (e.g. through being relatives or colleagues) attend the same course.

When Rory worked as a course tutor, he always tried hard to prevent dual relationships in counselling training from occurring.

If it does happen, it can create challenges and difficulties for the two people themselves, their peers and the tutor (whose responsibility it is to hold the boundaries for the whole group). This can have implications for professional ethics and confidentiality.

The ideal situation in counselling training is that there is a ‘ level playing-field ’ for all, with no two people having intimate knowledge of each other’s experiences prior to the course starting.

It can therefore be better if two relatives or colleagues who both want to study counselling either go to different centres or else stagger their studies over time so they are not in the same group together.

For more information, please see CPCAB’s website . CPCAB is the UK’s only awarding body run by counsellors for counsellors.

When a Client Disagrees with Us (starts at 25.00 mins)

This situation could occur for various reasons, such as:

• the client being in denial, i.e. being unable (yet) to accept a situation
• the counsellor having misheard the client
• the counsellor having unconsciously been pulled into their own frame of reference.

Ken and Rory share various tips on what to do when a client disagrees with you:

• Don’t argue back.
• Instead, try to explore their disagreement.
• Be willing to own up to being wrong yourself if that is so.
• Watch the client’s body language carefully, being alert to any mismatches between this and their words.
• Thank the client for having the courage and honesty to point out that they feel you’ve got it wrong.

In short, be curious but gentle, and allow the client their autonomy.

Free Handout Download

Ethical Bodies

Links and Resources

Counselling Tutor Facebook group

Counselling Tutor Facebook page

Counselling Tutor website

Counselling Study Resource

Counselling Tutor Handouts Vault

Basic Counselling Skills: A Student Guide

Counselling Theory in Practice: A Student Guide

Spotted out-of-date info or broken links? Kindly let us know the page where you found them. Email: [email protected]

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In this essay I will be looking at Ethics and the importance of using a code of Ethics.

Introduction

In this essay I will be looking at Ethics and the importance of using a code of Ethics. I will look at our personal values and also professional values that we as counsellors should use when counselling. I will then go on to explain the ethical principles of counselling. I will then look at a counselling Dilemma which as counsellors we could face at any time. I will then apply the values and principles to this Dilemma.

At the end of this essay I hope to have a clearer understanding of Ethics in counselling.

Why is a code of Ethics so important?

The code of Ethics is not a law it is not something that we MUST adhere to, it is a set of guidelines a framework to help and advise us, ultimately it remains the responsibility of the individual.

Most professions, agencies and organisations follow a code of Ethics, such as Nurses, Solicitors, Doctors, Social workers and we as counsellors.

A code of Ethics is there to protect us as Counsellors and our Clients.

I will explain some of the benefits of adhering to a code of ethics.

The code provides a framework for counsellors to consult when an ethical dilemma occurs, it will provide guidance. This guidance serves also to improve the quality of service given to the client. The framework also helps the counsellor and client to identify malpractice. The code also enhances the image of counselling practise in general. The code has left itself open and can be added to for future improvement. The initiators of the code are self regulating and self governing.

Each counsellor has their own personal moral qualities which are of the utmost importance to the client. I will discuss these qualities but it must be stated that not all counsellors possess all of these qualities. The following are some of the personal qualities to which counsellors are encouraged to aim for by the B.A.C.P

Empathy  - To have a deep understanding of the client’s issues and the ability to stay within the client’s frame of reference. Mearns and Thorne describe Empathy as “ Empathy is a continuing process whereby the counsellor lays aside her own way of experiencing and perceiving reality, preferring to sense and respond to the experiences and perceptions of the client”   (Mearns and Thorne 2001:41)

Confidentiality  - The counsellor needs to discuss and clarify confidentiality with the client in the beginning when the contract is set. ”Communication between counsellor and client shall be confidential and treated as privileged information unless the client gives consent to any particular information being disclosed. Exceptions to this principle occur when in the professional judgement of the counsellor, there is clear and imminent danger to the client and others”  Turton, J.(2002) Online Counsellor.   viewed 1 st  December 2002

Integrity  - The counsellor needs to be honest with himself and the client and show a commitment to being moral to others. He also needs to be congruent - genuine

Respect  -  The counsellor needs to accept the client and there issues being none judgemental and give the client unconditional positive regard.

Trust  - The client must have trust in the counsellor   thus enabling the therapeutic process to take place. The counsellor must also trust himself.

This is a preview of the whole essay

Competence   -  The counsellor must have the relevant skills and knowledge and be able to apply these in a beneficial way to the client. The counsellor should also monitor and endeavour to improve there own competence.

The B.A.C.P recommends than we work within the following Ethical principles.

None - Maleficence  - “What will cause least harm” (Bond.1998:33).   The counsellor should be insured. He should take all reasonable steps to protect the client from harm, whether it be physical injury or psychological harm. If a counsellor feels that another counsellor is acting unethically it is his moral responsibility to challenge this malpractice. Counsellors should be competent at all times.

Beneficence - “ What will achieve the greatest good”  (Bond.1998:33). Counselling is a helping profession which expects Counsellors to act in ways that promote the welfare and growth of their clients. The counselor should act in the best interests of the client.

Justice - “ What will be fairest”  (Bond.1998:34) Counsellors shall respect the dignity and worth of every client. Also the client’s human rights regardless of any colour, race, religion etc. and must ensure that the client gets the best possible support for their needs.

Autonomy - The counsellor should help the client realise their own potential giving them the ability to move forward and help themselves without imposing his own views.

Fidelity - Trust is one of the main foundations on which a good counsellor/client relationship is built. A client that doesn’t trust his counsellor is unlikely to make any personal disclosures or even move forward in their therapy. Once the client has trust in the counsellor, it is important that this trust is reciprocated.

Self respect - The counsellor will encounter lots of very emotional issues throughout their work. This principle is in place to protect the counsellor from any emotional/ physical harm. There is also an ethical responsibility to use supervision for personal and professional support and development.

I will now look at a dilemma in counselling that anyone of us as counsellors could face at any time. The dilemma is.

Sexual Attraction with Clients

You are a counsellor in private practice. A new client has come for an initial assessment interview for which they do not pay. You find him/her very attractive and you interpret some of his/her behaviour as flirting with you. Neither of you is in a relationship.

With this dilemma the following points need to be considered.

Professional code of ethics. What does the B.A.C.P say?

Your own personal morals and ethics.

Is the client flirting or is just your perception?

Do you make the client aware of this issue?

First and foremost we need to act in the best interest of our client (Benificence) we must very quickly decide on the best course of action and stay within the B.A.C.P framework.

We need to look at what will cause the least harm to the client. We as counsellors should always behave in a competent way and the clients needs should come first. It is a counsellor’s responsibility to protect the client from harm and in this case possible psychological harm.  

In the event of a complaint there is a possibility of expulsion from counselling associations. Therefore adequate insurance must be held by the counsellor (None – Maleficence).

We need to look at what will be the fairest course of action for the clients well being. We as counsellors must respect the dignity and worth of every client. We must also ensure that the client gets the best possible support for their needs. In the case of this dilemma could we be fair to this client. Would it be appropriate to counsel this client (Justice)?

We as counsellors need to help the client realise their own potential and empower them to move forward without imposing our own thoughts and views (Autonomy).

With this dilemma we will encounter emotional issues and as counsellors we have an ethical responsibility to take this issue to supervision for support and advice.

We also need to consider our own morals and ethics. “It is not unethical to feel attraction to a client. The ethical response is to acknowledge the feeling to yourself and to consult your supervisor”  (Bond.1998:113) You as a counsellor need to consider whether or not you could counsel this person effectively owing to your own attraction to them (Unconditional Positive Regard) Could you put your own attraction to one side and continue counselling this person? This is a personal decision, we are all different. You would also need to look at your own sexuality and your views on this, for example, how would you feel if you were attracted to a client of the same sex, would you then need to question your own sexuality? How would you feel if the client was of the opposite sex, if they were married or single? If you continued with the counselling are you showing true integrity and could we build up a good trusting relationship. Are we able stay within the client’s frame of reference (Empathy) and does our own attraction have some bearing on this? The B.A.C.P framework states that “Practitioners must not abuse their clients trust in order to gain sexual, emotional, financial or any other kind of personal  advantage. Sexual relations with clients are prohibited ” B.A.C.P. (2002:7.18).

We also need to consider, is the client flirting or is it just your perception. Your perception of flirting may not be the same as your clients. Are you aware of any mental problems your client may have. Do you make the client aware of this issue for clarification? (Congruence) This is a matter of your own judgement.

Again these are all questions that only the individual could answer you as an individual will have to look at your own limitations as only the individual knows what their limitations are.

Our Options.

• We report back to our supervisor, Because of your sexual attraction you cannot be totally objective in deciding the correct course of action.
• Discuss the issue with the client, once this issue is brought into the clients awareness it could help the client move forward in their therapy.
• Continue with the counselling but only with the full support and backing of your supervisor. If you as a counsellor are able continue then this would be an excellent learning curve and personal development.
• If our attraction towards the client was too influential then we would have to refer the client to another counsellor.

I feel that we simply have two choices with this dilemma. We either go ahead with the counselling or we don’t. If we felt that it was inappropriate for us to counsel the client then we could refer them to another counsellor then there isn’t a dilemma. However, if we decide to counsel the client we must feel confident and competent enough to be able to put our attraction to one side to enable us to stay with the client. A counsellor should make it clear what their role is when setting the contract with the client, this will include a number of issues, fees, confidentiality, time, harm to self or others clause etc. When setting the contract in the beginning with their client.

Both the client and counsellor have a responsibility but the counsellor has a greater responsibility. It is the counsellor’s responsibility to monitor and maintain safe boundaries within a counselling situation. If this is not adhered to your reputation as a counsellor will diminish it could also damage the profession as a whole. The important point to remember is that you must make use of your supervisor. Your supervisor is there to support your emotional and professional needs also to reinforce your own moral values and decisions.

My personal view of this dilemma is that I would have to refer the client. I could not continue the counselling beneficially.  I see many problems arising. I don’t feel as if I could be totally there for the client because of my attraction. This I feel would be detrimental to both the client and myself. I feel by taking this course of action I am being person centred. I am being (Genuine) and honest. I am showing the client (Empathy) by understanding that this would not be in their best interests.

In this essay I feel I have achieved what I set out to achieve I have looked at Ethics and the importance of using a code of ethics both for the protection of the professional and the public. I have explained both personal and professional Ethical values and the importance of applying these in a counselling situation. I feel I have explained the ethical principles of counselling. I have looked at a dilemma and have applied the values and principles to this dilemma. I have also given my own personal views.

Bibliography

MEARNS, D & THORNE, B (2001) Person Centred Counselling in Action  Sage Publications, London.

BOND, T (1998) Standards and Ethics for Counselling in Action  Sage Publications, London.

Turton, J. (2002) Online Counsellor.     viewed 1 st  December 2002.

(B.A.C.P. (2002) Ethical Framework for good practice in Counselling and  Psychotherapy.

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• Page Count 5
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• Subject Religious Studies & Philosophy

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BACP Ethical Framework

With reference to the BACP Ethical Framework evaluate the ethical, professional and audit issues which may arise in a given counselling setting. In order to evaluate the ethical professional and audit issues which may arise in a given counselling setting, I must first choose an ethical framework model. I will then use the model I choose to outline all the stages of the ethical process I have used to come to my decision on the ethical dilemma. The model I choose for my ethical decision making is by Lynne Gabriel & Roger Casemore.

Stop, think, identify the situation or problem

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The ethical dilemma is whether or not to tell the client that her mother is suffering from a terminal illness with a prognosis of 6 months to live. I need to break the dilemma down further, to understand exactly what or who is at risk. If I tell her, I will be breaking the confidentiality of a dying woman to her doctor. How will I feel about betraying a dying woman’s confidentiality even if she has not directly confided in me? This would make me uncomfortable.

The doctor did not swear me to confidence? Do I take it for granted that the conversation was confidential, even though it was in passing? Is this something I need to discuss with him? Yes I think I should discuss this with him. Are there also any legal implications involved as a counsellor working within the GP practise which I need to consider? I will need to review my contract.

If I do not tell her and she moves away and her mother later dies, will that push my client over the edge, she has already mentioned she has considered overdosing. Are her suicidal thoughts due to the Prozac (medication) she is using? “You may have thoughts about suicide when you first start taking an antidepressant. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Prozac”. (Gomez,C 2010).

If I tell my client she will feel the need to stay, instead of moving to Scotland with her husband, possibly cause the breakdown of her marriage. If I don’t tell my client it will cause resentment against her husband for forcing her to move and possibly cause the breakdown of her marriage. If I don’t tell my client, she may feel betrayed by me. If I were the dying woman, I would want my confidentiality respected. On the other hand if it were my mother I would want to know to be able to make her final days more comfortable.

Construct a clear description

Taking into consideration the client’s, age, gender, race, ethnicity, culture, religion, sexual orientation, disability, language, and socioeconomic status and consider these factors when working with the client to form my decision.

The client is a 34 year old female, she is married (the assumption she is heterosexual). Her cultural background and ethnicity is Italian, she lived with her parents until she was married and now lives on the same street as them. Her religious status is not mentioned, (an assumption she is Catholic). She does not have any known disabilities. Language is not a barrier as she has lived in England since she was a child. Her socioeconomic status is she does not work.

Issues of difference, her age, gender, sexual orientation, disability and language are similar to mine. Having lived in an Italian family for over 3 years, I have a deep understanding of her race, culture and religion. Also coming from an ethic minority, where family and respect of religion plays an important role in the cultural upbringing. The real issues of difference between us would be of race, leaving home at eighteen and work.

Italian children are taught to respect, love and look after their parents. When parents age or are ill it is the responsibility of the child to make sacrifices and look after them. This is similar in my culture. I would take this to supervision, as it would be good for me to explore and evaluate my own values and beliefs. I would also look at the management of my self and my own limitations as a counsellor. Supervision would help to keep myself and my client safe.

Whose problem is it?

The doctors’ as he has broken confidence in telling me. He has broken the doctor/ patient confidentiality. This is a recurring theme in my process. The practise, as the doctor has broken patient/doctor confidence. There are legal implications. Mine as a counsellor ensuring my clients well being. Also the legal aspect if under my contract all information mentioned in a practise setting should be taken as confidential. At present my client is unaware. I would need to speak with the doctor, the practise manager and my supervisor to clarify and appraise my role in this dilemma.

Review in terms of the Ethical Framework

The action which is prohibited/required in relation to this dilemma is to do with my contractual agreement. If it is broken then it will affect me legally and professionally and so I will be prohibited from telling the client. The rest would come under my moral principles.

Consider the moral principles and values

• Being trustworthy: If I betray the doctors’/ mother’s and practises’ confidentiality. Then I will not be honouring the trust placed in me.
• Autonomy: If I tell my client, I will be taking her autonomy away from her.
• Beneficence: If I tell my client I will not be promoting her well-being.
• Non-Maleficence: I will need to consider carefully any malpractice issues and also the clients’ vulnerability.
• Justice: I need to be fair and respect human rights, of my client but also her mother.
• Self-respect: I would not be able to respect myself if I told my client.

The support available will be by the supervisor, practise manager, mentor, other colleagues and the BACP ethical helpline. This is support available on a professional level. The doctor may also be a source of support. Emotional support without breaking confidence can come from their partner, family members and friends.

Initially take it to supervision, assess the legal requirements of contractual obligations. Assess my ethics, feelings, beliefs and courses of action. Take her mother on as a client; Disregarded. Impact on the daughter if she knew she may be guarded towards discussing the whole situation with me. Her daughter may not know. Impact on me, I would be bound by confidentiality to my client and would no longer be in a dilemma as she is now also my client. However, the mother would then be my client and what impact would this have on my motives and outcome of the work I do with her. This would be unethical of me.

Tell my client; Disregarded. I would need to ensure I was not breaking any legal responsibilities I have undertaken. If so the impact on me could be loss of professional membership. I could be sued. The impact on my own ethics, feelings and beliefs would have been discussed with the supervisor.

Impact on my client; she may confront her mother and tell her father breaking her relationship with her mother as she may not want her husband to worry about her. This might cause problems for her marriage and possibly lead to its complete breakdown. This could make her strong enough to stand up to her husband and assert herself. The thought of losing her mother might give her the strength to think about what is really important to her. It might make her feel this is the end, if her mother dies she will not be able to cope and she may to commit suicide.

Do not tell my client; my course of action. Instead in the next few sessions ask her to discuss her feelings about leaving and what family means to her. What importance she puts on her parents and spouse. Ask her how she would feel if she never saw her parents again and then if she never saw her husband again. Maybe use Gestalt empty chair theory and get her to speak to herself/her husband/whoever she chooses to allow her to see the situation from different views.

Impact on my client- is getting her to think about who is really important to her. Impact on me, knowing what I know will I feel guilt if my client decides to go to Scotland and then her mother dies. Would I have done everything in my capacity as a counsellor to ensure my clients mental well being before ending our work if she moves? If she moves she will no longer be under my care or my responsibility. However, this is a fact that I know will cause my client immense mental pain and have I left her vulnerable. I would want to feel that I have helped her make an informed decision about her future regardless of her decision. Having allowed her to look at all her options and discuss what is important to her and allow her to make an informed decision would make me feel that I had prepared her as much as possible in my role as a counsellor.

My role is not to tell her what to do but to allow her to open dialogue with herself and for her to gain self awareness of her true feelings, thoughts, emotions and desires. I would feel justified in my decision and at ease with my ethics and moral and principles.

The client I allowed her to make an informed decision as to her future without any feelings of guilt or having the options taken away from her, by her having to do the right thing, which is expected of her culturally. My practise and the law would be happy with the decision as no confidences have been broken. Some of my professional peers and the media may have different views, I respect their views. I needed to find a resolution I was satisfied with ethically and morally.

On coming to my decision I used the model, whilst constantly asking myself such questions as listed below. I had more questions than answers, but it was these questions that helped me.

When the doctor breached confidentiality, was he making me a part of his dilemma? Why would he breach confidentiality knowing her daughter was my patient? He may feel that the family should be aware of her situation. As they may be able to support her and because he is bound to confidentiality, he is unable to tell the family himself. Is this his personal dilemma? Is the doctor looking to me for support? I think I should discuss the doctors’ motives with him

The impact it may have on my client, their welfare is now at risk, resulting in the aforementioned scenarios (see section one). The welfare of her mother, although she is not my client, but nonetheless a woman in her final days wanting to die without her family knowing. If I told my client would it cause the mother undue distress?

Also the therapeutic relationship I have with my client is now under pressure. How difficult will it be for the relationship if I decide not to tell her? Will this be in mind throughout the sessions? How will it disrupt the relationship and process? Will she feel betrayed when she finds out? Will she blame me for not telling her breaking the therapeutic relationship? On the other hand if I tell what boundaries am I breaking? Whose confidences am I breaking? I feel I would be breaking the confidences of the doctors’, the mothers’ and the practises’.

Will transference occur? Will she want to push the boundaries? Will she feel that we have a special relationship because I told her? Will my position become more powerful in the therapeutic relationship? What does confidentiality mean to me? Confidentiality is very important to me. “Confidentiality – the highest levels of confidentiality possible according to the law and the setting. Responsibility means being responsible to clients, the profession and society.” (Jones et al, 2000, pg 9).

As a responsible counsellor should I not carry the same ethics to the well being of others and respect their confidentiality? What are my feelings and ethics with regards to this? How would I feel if a doctor had broken my confidence? If I am honest to my own beliefs then as a responsible human being I would carry the same ethics to other people not just my client.

To measure the ethnicity of clients in a GP practise using the counselling service, a simple record form with name, age, gender and ethnicity would be produced. This would be handed to the client in the waiting room prior to the session. The client would then be told to hand this to the counsellor on entering the session. This is enable confidentiality of the information.

The counsellor will then collate the information and keep it under lock and key which they alone can access, ensuring confidentiality. The information will be available to the counsellor and practise manager on request. The counsellor will then write a report on their findings outlining not only ethnicity but also gender and age of the clients to find out what age group and gender and ethnicity area accessing the service.

Bibliography

• BACP. (2010). Ethical Framework for Good Practice in Counselling and Psychotherapy. Lutterworth: BACP
• Gabriel, L., & Casemore, R. (2010). Guidance for ethical decision making a suggested model for practitioners. Lutterworth: BACP
• Jones, C., Shillito-Clarke, C., Syme, G.,Hill, D., Casemore R.and Murdin, L. (2000) Questions of Ethics in Counselling and Therapy.
• Gomez,C. The Italian Way of Taking Care of the Parents(2010) Available at: http://www.ehow.com/how_6862132_italian-way-taking-care-parents.html:(Accessed: 23 August, 2010).
• Mothersole, G (2004) CORE: what is it good for? Counselling & Psychotherapy Journal August 2004 18 – 21

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