Counseling Today, Ethics Update

A new focus on cultural sensitivity

David Kaplan June 2, 2006

Editor’s note: American Counseling Association members received the 2005 ACA Code of Ethics bundled with the December 2005 issue of Counseling Today. Completed over a three-year period, this revision of the ethical code is the first in a decade and includes major updates in areas such as confidentiality, dual relationships, the use of technology in counseling, selecting interventions, record keeping, end-of-life issues, and cultural sensitivity. 

All ACA members are required to abide by the ACA Code of Ethics, and 21 state licensing boards use it as the basis for adjudicating complaints of ethical violations. As a service to members, Counseling Today is publishing a monthly column focusing on new aspects of the ACA Code of Ethics (the ethics code is also available online at www.counseling.org/ethics).  

ACA Chief Professional Officer David Kaplan conducted the following interview with Courtland Lee and Tammy Bringaze, two members of the ACA Ethical Code Revision Task Force.

David Kaplan: It is clear that the revised ACA Code of Ethics has a new focus on cultural sensitivity.

Courtland Lee: That was a primary charge of the Ethical Code Revision Task Force — to look at the revision with an eye on making the code more culturally sensitive. To accomplish this, we kept two questions in mind: 1) How do we need to rethink things in terms of changing population demographics and issues of multiculturalism and, 2) What is missing from the code that will make it more culturally sensitive?

Tammy Bringaze: We realized that multiculturalism and diversity impacts every area of our life and our practice. It affects our sensitivity toward the people we serve. As such, instead of just having one section focusing on cultural sensitivity, we infused multiculturalism and diversity throughout the entire code of ethics.    

CL: As an example, until now it has been considered unethical to receive gifts from clients. However, in some cultures giving a gift is really considered to be the highest form of praise, and to refuse a gift is considered culturally insensitive. So we revised the section on receiving gifts (Standard A.10.e.) to reflect this. It now reads, “Counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and showing gratitude. When determining whether or not to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, a client’s motivation for giving the gift and the counselor’s motivation for wanting or declining the gift.”

DK: So based on the last sentence of A.10.e., one of the implications of gift receiving is that even within a cultural context, counselors should not accept a gift that has a substantial monetary value.

CL: Right! While it is important to understand and appreciate the cultural context of a client, the counselor has to use some common sense.

DK: Let’s focus on confidentiality. Standard B.1.a. talks about how important it is for counselors to maintain cultural sensitivity regarding confidentiality, privacy and the disclosure of information.

CL: Much of this is based on the difference between individualistic and collectivist cultures.

TB: For example, I work with Afghan refugees, and the idea of confidentiality has a very different meaning in their culture. It is much more communal. There is really the sense among the Afghans of trying to look out for one another and pull together. The other day I had an Afghan woman come in and sit down in the middle of another woman’s session, and neither blinked an eye. So I thought, “Well, OK. If it works for them, it works for me.” If a counselor were not sensitive to the collectivist norm of the Afghan culture, he or she might feel pretty angry or agitated at the client and ask the “intruder” to leave immediately. If that were done, I’m afraid the counselor would lose the relationship with both clients.

DK: So an implication is that there are some cultures where confidentiality is less important than it is for the dominant American culture.

TB: Yes, I definitely think so.

CL: Another example of the importance of cultural sensitivity regarding confidentiality and the disclosure of information revolves around disciplining a child. When an African American kid tells you, “I got in trouble and I’m afraid to go home because my mom is going to give me a whipping!” it sounds really harsh, as if the kid is going to get the heck beat out of him with a whip. But in the African American community, the term “whipping” generally refers to a form of mild discipline. So understanding how words and meanings are different in different cultures is important.

DK: So staying with this discipline example from a cultural prospective, there would be times when a child reports a “whipping” that would not necessarily trigger mandated reporting laws.

CL: That’s right.

DK: Let’s turn to assessment. Standard E.8., “Multicultural Issues/Diversity in Assessment,” talks about the importance of recognizing the effects of age, color, culture, disability, ethnic group, gender, race, language preference, religion, spirituality, sexual orientation and socioeconomic status on test and inventory administration, interpretation and use.

CL: An important aspect of Standard E.8. is that a counselor must make sure that any inventory or test they utilize has been normed on the population that the counselor is using the instrument with. Back in the 1970s, a group of people, I think from the San Francisco Bay area, instituted a lawsuit against the school system because of the large number of African American schoolchildren who were in special education classes. The outcome was a moratorium on testing until instruments could be normed on the African American population.

DK: The Code of Ethics also now speaks to multiculturalism and diversity in supervision.

TB: We have recognized the ethical complexity of having to speak to the cultures of at least three people in supervision: the supervisor, the supervisee and the client. As we add people, we need to be sensitive to the many cultural layers.

CL: I hope that this will start a new dialogue and research on multicultural and diversity issues in supervision. This is something we talk about, but we really don’t know a lot about it. In particular, when there is a cross-cultural supervisory relationship, it is critical for both the supervisor and supervisee to understand and be sensitive to each other’s cultural view and how that view impacts the counseling process.

DK: Is there a specific example that comes to mind?

CL: I was supervising a graduate student, a white woman who was doing career counseling with a Latino client. My student was getting really frustrated because every time a viable option was explored the client would say, “That sounds like a good career change, but I have to ask my father.” My student had a feminist worldview and felt strongly that the client should not have to check with her father because she was an adult and had free choice. I had to talk to my supervisee about her client’s culture and that the role of the father in protecting his unmarried daughter is an important part of the Latino culture. I therefore encouraged my supervisee to develop a consultative relationship with the father.

DK: Does the revised ethical code infuse multiculturalism and diversity into counselor education and training? 

TB: For the first time, there is a statement in the ethical code that counselor educators must infuse multicultural and diversity material into all courses and workshops (Standard F.11.c.).

DK: CACREP (the Council for Accreditation of Counseling and Related Educational Programs) does not require every course to have multicultural/

diversity material in it. So is it reasonable to say that this goes beyond national training standards?

TB: We are going beyond current expectations and requirements and raising the bar for the profession. I am very proud of that.

DK: What would you say to a counselor educator who states that an ethical mandate to infuse multiculturalism and diversity into course work is a violation of academic freedom?

CL: I would state that a professor’s ethical responsibilities to the counseling profession supersede their role as an academic. I don’t know if that would hold up in court, but that’s how I see it.

DK: As a final topic, the revised ACA Code of Ethics attends to multiculturalism and diversity in research (Standard G.1.g.). What should counselors know about this?

TB: Researchers need to speak to some basic questions: Can the research benefit a diverse group of people? Can the research be applied to a diverse population? Are there any aspects of the research protocol that will be perceived as culturally insensitive by participants?

DK: Has all of the effort to infuse multiculturalism and diversity throughout the revised ACA Code of Ethics moved the profession forward?

CL: Well, I think that remains to be seen. This code has just hit the street. We’ll have to see what unfolds in the next few years. I am very optimistic!

Next month: Permission to refrain from making a diagnosis

Letters to the editor: ct@counseling.org

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