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Counselors who inflict their values or beliefs on a client are imposing a risk of damaging the therapeutic relationship between counselor and client. Such inquisitions can ultimately harm the client and vanish their self-confidence and their desire to further treatment. When a counselor is presented with an issue he or she finds difficult due to varying beliefs and values, the counselor should consult with a supervisor, educate themselves on the issue, refer to the ACA Code of Ethics, and remain objective until a well-informed decision can be made. Referrals may be considered if the client needs specialized assistance or the counselor is unable to remain objective due to differing values (Corey, Schneider-Corey, Corey, & Callanan, 2015). Furthermore, competence should never be justification for a referral to dismiss clients with whom they don’t want to treat for personal reasons.
Ethical Implications of Expressing Values
“Counselors are aware of – and avoid imposing – their own values, attitudes, beliefs, and behaviors” (American Counseling Association, 2014, A.4.b.). Counselors who attempt to directly influence a client’s values and beliefs is dishonoring their professional standard of responsibility, which is the welfare of the client. Bestowing personal values on a client has the ability to make a client feel taken advantage of and leave the client with additional burdens. The goal of a counseling relationship is to explore and clarify the client’s beliefs and apply their values to solving their problems. Moreover, clients may interpret the imposition as personal rejection.
Actions Taken on Confrontation of Abortion
Counselors work with a wide variety of backgrounds and circumstances. When a counselor is confronted with an issue they feel strongly about, the counselor’s total emotional response may induce inaccurate interpretations of the client’s dynamics due to the projection of the therapist (Corey, Schneider-Corey, Corey, & Callanan, 2015). Counselors can use bracketing to manage their personal values in order to keep the counseling relationship free of bias and judgment. Bracketing refers to the counselor’s capability to take his or her own personal values and set them aside but not change them (Corey, Schneider-Corey, Corey, & Callanan, 2015). Ultimately, this involves the counselor being self-aware and realizing the impact they have over a client’s vulnerability.
An issue that has the potential of stirring an emotional response on behalf of the counselor is abortion. Research has shown that some women experience maladjustments, or failure to cope, when dealing with counselors who work from a pro-choice perspective (Reardon, 2018). When a woman is seeking clarity on whether to have an abortion and the counselor displays their pro-life values, the client may experience shame which ultimately hinders their therapeutic experience by closing engaged communication. Abortion is directly linked to an increased risk of depression, anxiety, suicidal behaviors and substance abuse (Reardon, 2018). Exploiting a client’s decision to get an abortion can exacerbate co-occurring conditions.
Legislation and Government Policies Related to Mental Health Counseling
The federal government works in partnership with states to regulate providers, protect the rights of consumers, provide funding for services, and supporting research in the field of mental health counseling (Mental Health America, 2019). Legislation aids in creating and changing federal laws in states. Laws pertaining to mental health may take longer to process through legislation; however, they have more of an impact once passed (Mental Health America, 2019).
Per Mental Health American (2019), the federal government’s primary goal for mental health services is to protect the rights of individuals with mental health disorders in the workplace, schools, and in treatment. Additionally, the most important mental health legislation is the Mental Health Parity and Addiction Equity Act. The Mental Health and Addiction Equity Act was pronounced in 2008 and requires insurance agencies offering coverage for mental health or substance use disorders, to be comparable to their medical coverage (Substance Abuse and Mental Health Services Administration, 2019). Deductibles, copays, out-of-pocket expenses, treatment limitations, etc., for substance use disorders and mental health treatment must be equivalent to benefits offered for general medical care (Substance Abuse and Mental Health Administration, 2019).
Referring to Another Counselor
When considering a referral to another counselor it is imperative the counselor reevaluates the hindrance in which he or she is considering referral. The first instance where a referral may be necessary is if the counselor lacks fundamental skills to treat the issues presented (Corey, Schneider-Corey, Corey, & Callanan, 2015). Counselors should not treat in areas they are not competent; conversely, competence should never be an excuse for a referral to dismiss clients (Natwick, 2017). Professional counselors should be knowledgeable in different racial and ethnic backgrounds, religions, abilities, and sexual orientation; however, there are cases in which a client will need a more specialized treatment to meet their goals.
Another reason for referral is when a counselor’s values conflict with those of a client and the counselor cannot remain objective. Subsection C.5 in the ACA Code of Ethics states, counselors will not engage in discrimination against prospective or current clients based on their beliefs, backgrounds, sexual orientation, or socioeconomic status (American Counseling Association, 2014). If the counselor exhausts all options to include education, consulting with supervisor, and contacting the ACA helpline; a client may be referred to keep the therapeutic relationship objective. If a client feels discriminated against it is likely the client may not be engaged in treatment, making it ineffective.
When Referring is Not an Option
When referrals are not an option, the counselor must take additional steps to ensure they are consistently developing skills to treat the issue at hand. This can be accomplished by seeking advice from colleagues, furthering education and knowledge by attending workshops or seminars, and reviewing the American Counseling Association (or chosen organization) website for articles, journals, and webinars on the subject presented. “Counselors take reasonable steps to ensure that they have the appropriate resources and competencies when providing consultation services” (American Counseling Association, 2014, D.2.a). Periodically studying the ACA Code of Ethics will guide counselors on the correct way to handle ethical challenges.
Counselors must be mindful in their actions and words to avoid ethical implications and harm to their clients. When a counselor has differing values and beliefs than their clients, counselors must take reasonable steps to consult with other counselors and the ACA Code of Ethics to ensure they are treating the situation ethically (American Counseling Association, 2014, C.2.e.). Continuing education to maintain competency in their skillset and remain informed on policies and procedures has the upmost importance to working with diverse populations. If a counselor cannot remain objective or feels the client needs a higher level of care after he or she has consulted with their supervisor, educated themselves, and referred to the ethics guidelines, then a referral may be necessary. The field of mental health counseling is protected by federal law and legislation to ensure clients are receiving valuable and meaningful care. Nevertheless, counselors are responsible for facilitating client growth and development that nurtures their welfare and trust to engage in an effective counseling relationships (American Counseling Association, 2014).
- American Counseling Association. (2014). ACA Code of Ethics. Retrieved from https://www.counseling.org/resources/aca-code-of-ethics.pdf
- Corey, G., Schneider-Corey, M., Corey, C., & Callanan, P. (2015). Issues and Ethics in the Helping Professions (9th ed.). Stamford, CT: Brooks/Cole/Cengage Learning.
- Mental Health America. (2019). The Federal and State Role in Mental Health. Retrieved from https://www.mentalhealthamerica.net/issues/federal-and-state-role-mental-health
- Natwick, J. (2017). On the ethics of ending: Terminations and referrals. Retrieved from https://www.counseling.org/docs/default-source/ethics/ethics-columns/ethics_may_2017_terminations-and-referrals.pdf?sfvrsn=ea25522c_6
- Reardon, D. C. (2018). The abortion and mental health controversy: A comprehensive review of common ground agreements, disagreements, actions, and recommendations, and research opportunities. SAGE Open Medicine, 6. doi: 10.1177/2050312118807624
- Substance Abuse and Mental Health Services Administration. (2019). Laws and Regulations. Retrieved from https://www.samhsa.gov/about-us/who-we-are/laws-regulations
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