Examples Of Ethical Dilemmas In Counseling
Abstract
This paper explores the ethical dilemma of a licensed professional counselor who is practicing out of a church setting. Most of the counselors’ clients are clients who are overall stable and well-functioning. Due to the status of the clients he sees he does not feel that it is necessary to keep records of the clients he sees therefore he does not keep any records at all. He feels that in a different situation where his clients were not stable he would then need to consider record keeping. The following explains why it is important for all professional counselors to keep records despite the setting or condition of the clients. It will also use the ACA’s Decision Making Model to analyze the situation and help make the best possible …show more content…
choices and choose the best course of action for the counselor to take in order to ensure that he is practicing in an ethical manner.
Ethical Dilemma 3
It is the responsibility of all professional counselors, ethically, legally, professionally and clinically, to keep accurate records pertaining to their clients. Counselors must keep records of clients with information pertaining to the assessment and treatment of the client. This may include information such as; the patients name and contact information, reason for initial contact, initial assessment information, history of treatments and medications, plan for treatment, dates of services and notes of discussions from each date, and any other information that may be pertinent (New York State Education Department, 2009). Ethical dilemma 3 states that Dan is a professional counselor who feels that record keeping is not necessary because he works in with clients in a church setting and the issues presented by his clients are not severe, overall his clients appear to be well. Dan suggests that record keeping would be needed if he were working with clients in an agency setting, who had severe issues. Despite Dan’s reasoning, it is clear that he could be faced with professional, clinical, ethical and legal issues due to his lack of record keeping. From a clinical perspective keeping clinical notes serves two important purposes. One purpose being that they allow the counselor to provide the best possible services and also to provide evidence of the level of care based on the standards of the profession (Corey, Schneider Corey, & Callanan, 2011). Although Dan’s clients may not display severe issues there is a reason that they are seeking Dan’s services. The reason or reasons should be documented to ensure that Dan is providing the best possible services despite the severity of the client’s issues. Despite the severity or reason for counseling, Dan is a professional counselor and must practice within the standards of the profession. Failure to keep adequate records could also result is severe legal issues for Dan. The fact that Dan’s clients appear to be well functioning would not prevent him from being accused of malpractice or any other legal issues. As a counselor Dan should be sure to follow the code of ethics which requires record keeping regardless of the situation. According to Corey, Schneider Corey, & Callanan (2011) keeping adequate clinical records is a legal and ethical requirement regardless of the degree of functioning of a client (Corey, Schneider Corey, & Callanan, 2011).
Identifying the Problem
As mentioned previously the main problem in this dilemma is Dan’s failure to keep records of his clients and his failure to acknowledge the importance of doing so regardless of his work setting or client functionality.
Dan feels that it is not necessary to keep records because his clients are well functioning and their issues are not severe, this could create many problems for Dan and possibly his clients. As a counselor Dan should contribute to the welfare of a client. There may be situations in which client records would be a benefit to the client for various reasons pertaining to the client’s welfare. If Dan is unable to provide records he would not be contributing to the welfare of the client and could possibly do …show more content…
harm.
Applying the ACA Code of Ethics
By making the choice to not keep client records Dan is breaking the ACA Code of Ethics. According to the code of ethics counselors should keep records needed to assist with providing professional services and should do so following laws and regulations as well as agency or institution policies. These records should also reflect the client’s treatment and progress (American Counseling Association, 2013). Dan feels that if he worked for an agency and worked with really sick client’s record keeping would then be required. However, the ACA code of ethics does not state that record keeping is optional based on practice setting or condition of clients or any other circumstances. Record keeping is ethically required as a professional counselor.
Dilemma Nature and Dimensions
Nonmaleficence, beneficence, justice, and fidelity can all be applied to this ethical dilemma. The concept of not causing harm to others or nonmaleficence can be applied because while it may not be likely it is possible that the lack of record keeping could harm the client. For example, there could be situations in which an individual is required to prove that they have received or are receiving counseling services. Without written record there is no proof of the services provided. This could leave the client faced with other problems thus causing them harm. Beneficence can be applied for similar reasons. It is the counselors responsibility so be proactive, to protect from harm, and to do good for the client. Failure to keep records does not uphold the counselor’s responsibilities. Justice suggests that all individuals should be treated the same. Dan thinks that he does not have to keep records because his clients are functionally well but suggests that if his clients were not functionally well he would keep records. With this reasoning Dan would not be treated functionally well clients the same as he would clients who were not functionally well. Fidelity can be related as well because regardless of client functionality clients need to be able to trust Dan. By not keeping records of clients it is possible that Dan could forget pertinent information or confuse information between clients (Forester-Miller & Davis, 1996). If Dan were to bring up the wrong information to a client is would possibly hinder the trust the client has for him and threaten the therapeutic relationship.
Potential Course of Action
The courses of action for Dan are limited. To do what is ethically and legally right Dan either needs to stop counseling clients or begin keeping records of the clients he counsels. Dan should evaluate the reasons he feels it is not necessary to keep records of clients who appear to be functionally well. It would be a benefit to Dan to educate himself on the topic of record keeping and to review the ACA Code of Ethics. Doing so may allow Dan to understand the importance of keeping records and influence him to begin doing so.
Consequences and Course of Action
If Dan continues to choose not to keep records of his clients the chances of one day being faced with ethical and legal issues are high. If Dan chooses to no longer counsel his clients he may also face ethical and legal issues if he fails to have adequate reason to refer his clients elsewhere or if he fails to terminate services in an ethical and legal manner. If Dan decides to continue counseling clients and begin keeping records he will need the consent of the client. Clients may question why Dan has suddenly decided to begin keeping such records and it is possible that trust could be hindered since Dan had not previously kept records. Despite this risk, the best course of action for Dan would be to educate himself, review the code of ethics and to continue counseling his clients while ensuring to keep record of each client. This is the best course of action because it allows Dan to do what is right while continuing his responsibilities to the clients and providing them with professional services. It is also best because it will most likely allow Dan to avoid future legal and ethical issues, allow him to avoid the risk of treating individuals unequally, harming them, and allow him to avoid the risks of referring or terminating the counseling.
Selected Course of Action
The selected course of action for Dan is to begin keeping records of each of his patients even working with them in a church setting. Record keeping will avoid many legal and ethical issues for Dan however; there are some that may still arise. For example to prevent some issues Dan will have to ensure that his records contain accurate information and that they are reflective of the services that he provides. He should also ensure that records ensure client privacy and that they include only information that is pertinent to the services he is providing.
Implementing the Course of Action
The first step Dan needs to take is to gain education on record keeping and review the code of ethics.
This will allow him to understand the importance and the benefits of record keeping. It will also allow him to learn how to properly keep records of his services and his clients. By educating himself and reviewing the ethics code he will also become aware of ways to avoid other legal and ethical issues. Dan will then need to inform is clients that he will now be keeping records of their sessions and explain why he will be doing so. He will then need their consent to begin keeping such records. Once Dan begins keeping records he will also need to ensure that he is storing them properly and that he is protecting the privacy rights of his clients.
References
American Counseling Association. (2013). ACA Code of Ethics. Retrieved from http://www.counseling.org/Resources/aca-code-of-ethics.pdf
Corey, G., Schneider Corey, M., & Callanan, P. (2011). Issues and Ethics in the Helping Professions (8th ed.). Belmont, CA: Cengage Learning.
Forester-Miller, H., & Davis, T. (1996). A Practioner 's Guide to Ethical Decision Making. Retrieved from http://counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2
New York State Education Department. (2009, June). Practice Guidelines. Retrieved from
http://www.op.nysed.gov/prof/mhp/mhppg4.htm
This paper explores the ethical dilemma of a licensed professional counselor who is practicing out of a church setting. Most of the counselors’ clients are clients who are overall stable and well-functioning. Due to the status of the clients he sees he does not feel that it is necessary to keep records of the clients he sees therefore he does not keep any records at all. He feels that in a different situation where his clients were not stable he would then need to consider record keeping. The following explains why it is important for all professional counselors to keep records despite the setting or condition of the clients. It will also use the ACA’s Decision Making Model to analyze the situation and help make the best possible …show more content…
choices and choose the best course of action for the counselor to take in order to ensure that he is practicing in an ethical manner.
Ethical Dilemma 3
It is the responsibility of all professional counselors, ethically, legally, professionally and clinically, to keep accurate records pertaining to their clients. Counselors must keep records of clients with information pertaining to the assessment and treatment of the client. This may include information such as; the patients name and contact information, reason for initial contact, initial assessment information, history of treatments and medications, plan for treatment, dates of services and notes of discussions from each date, and any other information that may be pertinent (New York State Education Department, 2009). Ethical dilemma 3 states that Dan is a professional counselor who feels that record keeping is not necessary because he works in with clients in a church setting and the issues presented by his clients are not severe, overall his clients appear to be well. Dan suggests that record keeping would be needed if he were working with clients in an agency setting, who had severe issues. Despite Dan’s reasoning, it is clear that he could be faced with professional, clinical, ethical and legal issues due to his lack of record keeping. From a clinical perspective keeping clinical notes serves two important purposes. One purpose being that they allow the counselor to provide the best possible services and also to provide evidence of the level of care based on the standards of the profession (Corey, Schneider Corey, & Callanan, 2011). Although Dan’s clients may not display severe issues there is a reason that they are seeking Dan’s services. The reason or reasons should be documented to ensure that Dan is providing the best possible services despite the severity of the client’s issues. Despite the severity or reason for counseling, Dan is a professional counselor and must practice within the standards of the profession. Failure to keep adequate records could also result is severe legal issues for Dan. The fact that Dan’s clients appear to be well functioning would not prevent him from being accused of malpractice or any other legal issues. As a counselor Dan should be sure to follow the code of ethics which requires record keeping regardless of the situation. According to Corey, Schneider Corey, & Callanan (2011) keeping adequate clinical records is a legal and ethical requirement regardless of the degree of functioning of a client (Corey, Schneider Corey, & Callanan, 2011).
Identifying the Problem
As mentioned previously the main problem in this dilemma is Dan’s failure to keep records of his clients and his failure to acknowledge the importance of doing so regardless of his work setting or client functionality.
Dan feels that it is not necessary to keep records because his clients are well functioning and their issues are not severe, this could create many problems for Dan and possibly his clients. As a counselor Dan should contribute to the welfare of a client. There may be situations in which client records would be a benefit to the client for various reasons pertaining to the client’s welfare. If Dan is unable to provide records he would not be contributing to the welfare of the client and could possibly do …show more content…
harm.
Applying the ACA Code of Ethics
By making the choice to not keep client records Dan is breaking the ACA Code of Ethics. According to the code of ethics counselors should keep records needed to assist with providing professional services and should do so following laws and regulations as well as agency or institution policies. These records should also reflect the client’s treatment and progress (American Counseling Association, 2013). Dan feels that if he worked for an agency and worked with really sick client’s record keeping would then be required. However, the ACA code of ethics does not state that record keeping is optional based on practice setting or condition of clients or any other circumstances. Record keeping is ethically required as a professional counselor.
Dilemma Nature and Dimensions
Nonmaleficence, beneficence, justice, and fidelity can all be applied to this ethical dilemma. The concept of not causing harm to others or nonmaleficence can be applied because while it may not be likely it is possible that the lack of record keeping could harm the client. For example, there could be situations in which an individual is required to prove that they have received or are receiving counseling services. Without written record there is no proof of the services provided. This could leave the client faced with other problems thus causing them harm. Beneficence can be applied for similar reasons. It is the counselors responsibility so be proactive, to protect from harm, and to do good for the client. Failure to keep records does not uphold the counselor’s responsibilities. Justice suggests that all individuals should be treated the same. Dan thinks that he does not have to keep records because his clients are functionally well but suggests that if his clients were not functionally well he would keep records. With this reasoning Dan would not be treated functionally well clients the same as he would clients who were not functionally well. Fidelity can be related as well because regardless of client functionality clients need to be able to trust Dan. By not keeping records of clients it is possible that Dan could forget pertinent information or confuse information between clients (Forester-Miller & Davis, 1996). If Dan were to bring up the wrong information to a client is would possibly hinder the trust the client has for him and threaten the therapeutic relationship.
Potential Course of Action
The courses of action for Dan are limited. To do what is ethically and legally right Dan either needs to stop counseling clients or begin keeping records of the clients he counsels. Dan should evaluate the reasons he feels it is not necessary to keep records of clients who appear to be functionally well. It would be a benefit to Dan to educate himself on the topic of record keeping and to review the ACA Code of Ethics. Doing so may allow Dan to understand the importance of keeping records and influence him to begin doing so.
Consequences and Course of Action
If Dan continues to choose not to keep records of his clients the chances of one day being faced with ethical and legal issues are high. If Dan chooses to no longer counsel his clients he may also face ethical and legal issues if he fails to have adequate reason to refer his clients elsewhere or if he fails to terminate services in an ethical and legal manner. If Dan decides to continue counseling clients and begin keeping records he will need the consent of the client. Clients may question why Dan has suddenly decided to begin keeping such records and it is possible that trust could be hindered since Dan had not previously kept records. Despite this risk, the best course of action for Dan would be to educate himself, review the code of ethics and to continue counseling his clients while ensuring to keep record of each client. This is the best course of action because it allows Dan to do what is right while continuing his responsibilities to the clients and providing them with professional services. It is also best because it will most likely allow Dan to avoid future legal and ethical issues, allow him to avoid the risk of treating individuals unequally, harming them, and allow him to avoid the risks of referring or terminating the counseling.
Selected Course of Action
The selected course of action for Dan is to begin keeping records of each of his patients even working with them in a church setting. Record keeping will avoid many legal and ethical issues for Dan however; there are some that may still arise. For example to prevent some issues Dan will have to ensure that his records contain accurate information and that they are reflective of the services that he provides. He should also ensure that records ensure client privacy and that they include only information that is pertinent to the services he is providing.
Implementing the Course of Action
The first step Dan needs to take is to gain education on record keeping and review the code of ethics.
This will allow him to understand the importance and the benefits of record keeping. It will also allow him to learn how to properly keep records of his services and his clients. By educating himself and reviewing the ethics code he will also become aware of ways to avoid other legal and ethical issues. Dan will then need to inform is clients that he will now be keeping records of their sessions and explain why he will be doing so. He will then need their consent to begin keeping such records. Once Dan begins keeping records he will also need to ensure that he is storing them properly and that he is protecting the privacy rights of his clients.
References
American Counseling Association. (2013). ACA Code of Ethics. Retrieved from http://www.counseling.org/Resources/aca-code-of-ethics.pdf
Corey, G., Schneider Corey, M., & Callanan, P. (2011). Issues and Ethics in the Helping Professions (8th ed.). Belmont, CA: Cengage Learning.
Forester-Miller, H., & Davis, T. (1996). A Practioner 's Guide to Ethical Decision Making. Retrieved from http://counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2
New York State Education Department. (2009, June). Practice Guidelines. Retrieved from
http://www.op.nysed.gov/prof/mhp/mhppg4.htm