Resolving Ethical Issues Jeannette Baca, Ed.D.,LPC COMMON SENSE OR

Resolving Ethical Issues Jeannette Baca, Ed.D.,LPC COMMON SENSE OR CAREFUL DELIBERATION

Your Presenter Jeannette Baca, Ed.D., LPC [email protected] Counseling, Consulting and Training, Owner Albuquerque, NM Adjunct Faculty Mexico Highlands University Rancho, NM New Rio Retired Educator (30 years) Licensed Mental Health & School Counselor New Mexico

What is your ethical dilemma? “An ethical dilemma is a circumstance that is confusing for the counselor because (a) there are competing or conflicting ethical standards, (b) there is conflict between what is ethical and moral (c) the situation is such that complexities make application of ethical standards unclear, and (d) some other circumstance prevents a clear application of standards.” (Cottone & Tarvydas, 2007, p. 2)

ACA Codes of Ethics [Purpose] 2005 Ethical Code “When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decision-making process.” “Through a chosen ethical decision-making process and evaluation of the context of the situation, counselors are empowered to make decisions that help expand the capacity of people to grow and develop.” (p.3) 2014 Ethical Code “When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decisionmaking process.” “Counselors acknowledge that resolving ethical issues is a process; ethical reasoning includes consideration of professional values, professional ethical principles, and ethical standards.” (p.3)

Resolving Ethical Dilemmas Professional Values Ethical Principles Ethical Code

Core Professional Values of Counseling 1. enhancing human development throughout the life span; 2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts; 3. promoting social justice; 4. safeguarding the integrity of the counselor-client relationship; and 5. practicing in a competent and ethical manner. (p.3)

Ethical Principles The fundamental principles of professional ethical behavior include: Autonomy Beneficence Nonmaleficence Veracity Fidelity Justice

Section I: Resolving Ethical Issues (2014) I.1.b. Ethical Decision Making “When counselors are faced with an ethical dilemma, they use and document, as appropriate, an ethical decisionmaking model that may include, but not limited to , consultation; consideration of relevant ethical standards, principles, and laws; generation of potential courses of action; deliberation of risks and benefits; and selection of an objective decision based on the circumstances and welfare of all involved.” (p.19)

Ethical Decision-Making Process Laws Client Welfare A.1.a. Primary responsibility of counselors is to respect the dignity and promote the welfare of clients” p.4 Ethical Codes Ethical Principles Counselor Consult Risks and benefits Course of Action A review of ethical decision-making models can be found at Cottone & Claus, (2000)

Ongoing Consultation! I.2.c. Consultation: When uncertain about whether a particular situation or course of action may be in violation of the ACA Code of Ethics, counselors consult with other counselors who are knowledgeable about ethics and the ACA Code of Ethics, with colleagues, or appropriate authorities, such as the ACA Ethics and Professional Standards Department. Trusted ACA Colleague Counselor Attorney Expert in the field Professional Literature Someone who has solved issue Practice Board

Define the Problem 1. Acknowledge your emotions and “gut feeling”; happy, sad, afraid/surprised, angry/disgusted. 2. Identify the core issues; clinical, legal, ethical. 3. Determine if a personal or professional value conflict exists. 4. “Intellectualize” the problem, define objectively; what are the facts? 5. Talk to someone! What is their immediate reaction (knee-jerk) Consult

Counselor “Self-Check” World View attitudes & beliefs Ethical Traps Common sense “Gut” reaction “Instinct” Biases & value Influences Emotional Reaction Overconfidence

Personal Values 2005 ACA Code of Ethics 2014 ACA Code of Ethics A.4.b. Personal Values A.4.b. Personal Values Counselors are aware of their own values, attitudes, beliefs, and behaviors and avoid imposing values that are inconsistent with counseling goals. Counselors respect the diversity of clients, trainees, and research participants. (p.5) Counselors are aware of –and avoid imposing---their own values, attitudes beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature. (p.5)

Value Conflicts (Kocet & Herlihy, 2014) Ethical Bracketing (EB) Intentional separating of personal values from profession values; setting aside counselor’s personal values in order to provide appropriate counseling to all clients. 1. Immersion; self reflection & awareness 2. Consultation; codes, professional literature 3. Education; training 4. Supervision & ongoing consultation 5. Personal Counseling (if necessary); identify barriers & personal biases

Counselor Values-Based Conflict Model (CVCM) (Kocet & Herlihy, 2014) The CVCM is a working model designed to assist counselors when faced with a value-based conflict between themselves and a client, supervisee, or student. Counselors are asked to first determine if the conflict is a personal conflict or professional values conflict (p. 184). Step 1 Determine Nature of ValueBased Conflict; personal or professional Step 2 Explore Core Issues and Potential Barriers to Providing Appropriate Standard of Care Step 3 Seek Assistance /Remediation for Providing Appropriate Standard of Care Step 4 Determine and Evaluate Possible Courses of Action

Consider all Relevant Ethical Codes, Laws and Institutional Policy 1. Know and identify applicable ethical standards 2. Access relevant state and federal laws; e.g. licensing laws, abuse, privilege, HIPPA, HITECH 3. Familiarize yourself with institutional policies

Apply Ethical Principles Beneficence Veracity Fidelity Autonomy Nonmaleficense

Generate Potential Courses of Action *consider risks and benefits of each action *possible and unintended consequences *create an argument for (pro) and counter-argument (con) Course of Action Risks Benefits Consequences ACTION A ACTION B ACTION C Termination or referral of clients must be carefully considered

Termination and Referral A.11.a. Competence Within Termination and Referral If counselors lack the competence to be of professional assistance to clients they avoid entering or continuing counseling relationships. Counselors are knowledgeable about culturally and clinically appropriate referral resources and suggest these alternatives. If clients decline the suggested referrals, counselors discontinue the relationship. (p.6) A.11.b. Values Within Termination and Referral Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the clients goals or are discriminatory in nature. (p.6)

Evaluate Course of Action Stadler’s Decision-Making Assessment (1986) Justice Publicity Universality

Select An Objective Decision Define the Problem [Ongoing] Consultation Counselor “Self-Check” Consider Relevant Ethical Codes, Laws, & Institutional Policy Apply Ethical Principles Generate Potential Courses of Action Evaluate Course of Action Select Objective Course of Action

“It is always the right time to do the right thing.” Dr. Martin Luther King

Resources American Counseling Association. (2005). ACA code of ethics. Alexandria, VA: Author. American Counseling Association. (2014). ACA code of ethics. Alexandria, VA: Author. Cottone, R.R., & Claus, R.E. (2000). Ethical decision-making models: A review of the literature. Journal of Counseling and Development, 78, 275. Hayman, M.P. & Covert, J.A. (1986). Ethical dilemmas in College Counseling Centers. Journal of Counseling and Development, 64, 318. Kocet, M.K. & Herlihy, B.J. (2014). Addressing value-based conflicts within the counseling relationship: A decision-making model. Journal of Counseling & Development, 92, 180- 186. Stadler, H.A. (1986). Making hard choices: Clarifying controversial ethical issues. Counseling & Human Development, 19, 1-10.