Tag Archives: code of ethics

License to deny services

By Laurie Meyers June 27, 2016

In April, the Tennessee Legislature passed a bill, which the state’s governor then signed into law, allowing counselors to refuse to see any client if counseling that client involves “goals, outcomes or behaviors that conflict with the sincerely held principles of the counselor or therapist.”

The law, which is in direct opposition to the ACA Code of Ethics, was pushed through despite the concerted efforts of the American Counseling Association, the Tennessee Counseling Association (TCA) and other opponents. Even more alarming is that the legislation could represent only the beginning of efforts to pass similar laws in other states.

In response to the controversial law, the ACA Governing Council made the decision to move the Branding-Images_sky2017 ACA Conference & Expo out of Nashville and relocate it to San Francisco.

“We agreed it was important to move the conference because the Tennessee governor signed a bill into law that attacked our code of ethics and allowed counselors to refuse services to clients in the Tennessee communities based on their religious and personal beliefs,” explains Thelma Duffey, whose term as ACA president ends July 1. “We believed it was important that ACA take a public and powerful stance in opposition to this bill, and relocating provided us with this opportunity. We also believed it was important that we communicate our support to our members who voiced deep concerns about continuing to hold the conference in Tennessee in light of the new law. And, ultimately, we made the move based on our long-held belief of nondiscrimination and our commitment to advocacy for all people.”

The intent of Tennessee’s law is to allow counselors to discriminate against potential clients who identify as lesbian, gay, bisexual or transgender (LGBT), says ACA CEO Richard Yep. “This [is] a full-frontal attack on specific populations that some very conservative right-wing groups in the United States want to exclude from mental health services that they desperately need,” he says. “The new law will permit a counselor to reject an individual simply because of that provider’s beliefs and values. ACA and its code of ethics are very clear that counselors do not bring those beliefs and values into a counseling relationship.”

In addition to being unethical, the law is harmful to those looking for help, Yep emphasizes. “For someone seeking the services of a mental health provider to be told that because of who they are, a service provider will not work with them sends an incredibly negative message of exclusion, bigotry and discrimination,” he says.

Counseling in the crosshairs

When the Supreme Court ruled in June 2015 that states must recognize the validity of same-sex marriage, it marked a significant step forward in the fight for equal rights for LGBT individuals. At the same time, it also served as a clarion call to those determined to continue discriminatory policies and attitudes.

Currently, there are nearly 200 pieces of proposed anti-LGBT legislation in the United States. Like the Tennessee law, many of these proposed pieces of legislation — and other laws that have already been passed — were born partly in reaction to the Supreme Court’s decision, notes Perry Francis, who served as chair of the Ethics Revision Task Force for the 2014 ACA Code of Ethics. ACA believes that conservative politicians and lobbying groups focused on Tennessee and the counseling profession in large part because of a prior legal case, Ward v. Wilbanks.

In 2009, a counseling student named Julea Ward was dismissed from the counseling program at Eastern Michigan University (EMU) for refusing to counsel a gay client. Ward then filed suit against EMU in U.S. District Court, asserting that the university’s counseling program violated her rights to free speech and freedom of religion. In 2010, a U.S. District Court judge granted summary judgment in favor of EMU.

Ward was represented by the Alliance Defending Freedom (ADF), a nonprofit law firm that Art Terrazas, ACA’s director of government affairs, describes as the conservative equivalent of the American Civil Liberties Union. ADF is connected to the Family Research Council, a conservative lobbying organization. These organizations influence the Family Action Council of Tennessee, whose president, David Fowler, is a former Tennessee state senator who was a driving force behind Senate Bill (SB) 1556 and House Bill (HB) 1840. A group of conservative state legislators sponsored the bills, which eventually became the law signed by the governor.

The counseling profession also made an inviting target because the ACA Code of Ethics explicitly focuses on protecting clients by not imposing a counselor’s viewpoint, explains Lynn Linde, ACA’s senior director for the Center for Counseling Practice, Policy and Research. Linde, an ACA past president who also served on the Ethics Revision Task Force, notes that this focus on the client is unique to ACA. Although other organizations’ ethics codes implicitly prohibit mental health professionals from imposing their personal beliefs on clients, she says, the ACA Code of Ethics is explicit in this prohibition.

The legislation was introduced in the Tennessee Senate in January and passed with very little discussion, according to TCA President Kat Coy. It then moved on to the Tennessee House of Representatives. At that point, TCA rallied its members to contact their legislators to express their opinions on the bill, Coy says.

As the legislation was being debated in the Tennessee House, TCA and ACA worked together to provide expert testimony on the harmful nature of the bill and to educate individual legislators about the counseling profession, its code of ethics and the danger the legislation posed to those seeking mental health services in Tennessee. Although the law states that any counselor who turns away a client because of personal beliefs must give the client a referral, Linde notes that Tennessee has a critical shortage of mental health professionals. That raises questions about whom a counselor can refer to if he or she is the only mental health professional within 150 miles and, more important, where prospective clients are supposed to go to get the help they need, she says.

Linde and others testified about the harm this could do to potential clients. In the process, they also tried to clear up some mistaken beliefs that Tennessee legislators held. For example, Lisa Henderson, who chairs TCA’s public policy committee, says one of the first arguments she encountered was that because Tennessee is a sovereign state, it would not be dictated to by the federal government. Henderson had to explain that ACA is a professional organization that is not connected in any way to the federal government.

Linde and others testified that ACA’s opposition to the legislation was not about controlling individual counselors but rather concern for the harm that could be done to prospective clients. In addition, the law would be in direct opposition to the ACA Code of Ethics, which all member counselors are obliged to follow. Many states — including Tennessee — base their licensure standards of practice all or in part on the ACA ethics code.

An ethical dilemma

A common claim by those who support the law is that by asking counselors not to impose their beliefs on clients, the ACA Code of Ethics is actually demanding that counselors give up certain personal beliefs. That is an incorrect assumption, Linde says.

“Nobody is asking us to give up who we are the moment we walk into a counseling session,” she emphasizes. Counselors do not have to change their beliefs, but they must not impose those beliefs on clients, she continues.

“We, as professional counselors, seek to engage our clients in a genuine, thoughtful, caring relationship,” says Francis, a professor of counseling and coordinator of the counseling clinic in the College of Education Clinical Suite at EMU. “In order for me to connect to a client, I need to know who I am and what my personal values are so that I can be genuine in the room. At the same time, the profession is saying to counselors that you also enter the room with the values of the counseling profession, which are clearly delineated in the code of ethics.”

Francis says a counselor’s responsibility is spelled out in the ACA Code of Ethics in Standard A.4.b. (Personal Values): “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.”

Many of those who supported Tennessee’s “sincerely held principles” legislation asserted that ACA changed its code of ethics regarding counselors’ personal values during the 2014 revision in response to Ward v. Wilbanks. Francis and Linde say that assertion is false.

“We clarified what has [long] been there,” Linde says. From the 1988 version onward, the ethics code has stated that counselors can refer clients only when a client is no longer progressing, when the counselor’s services are no longer required because the client has met his or her goals or when counseling no longer serves the client, Linde explains.

Anticipating that some might try to argue that a counselor who holds views diametrically opposed to what the client believes is not “competent” to counsel that client, the 2014 revision of the ethics code clarified the issue of referral, Linde and Francis explain. Standards A.11.a. and A.11.b. were added to further delineate what constitutes competency.

v 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.”

v 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 client’s goals or are discriminatory in nature.”

In addition, Standard A.4.b. was expanded to include the necessity of obtaining training and multicultural competency, Francis says.

Linde says ACA’s official position is that although counselors in Tennessee are now legally able to refer clients on the basis of personal beliefs, that action still goes against the profession’s code of ethics. Accordingly, ACA will still sanction any member who engages in such behavior, Linde emphasizes. This also applies to counselors-in-training at university or college programs.

Linde testified in detail for legislators on the issue of competence. “Counselors can’t refer due to client characteristics,” she says. “It’s on [the counselor] if you come from another country and I don’t know anything about you or your culture. I have to educate myself on your culture.”

However, if a client comes to a counselor with a problem or issue that the counselor is not qualified to treat based on his or her individual scope of practice, then referral is appropriate. For example, Linde says, a client might present to a counselor for treatment of depression. In the course of therapy, the counselor might realize that the heavy drinking the client is engaging in is due to a chronic substance abuse problem, not just self-medication. Unless the counselor is specially credentialed to provide substance abuse counseling, the counselor would be operating outside of his or her scope of practice to offer those services. In this case, the counselor should instead refer the client to another counselor who is qualified to provide in-depth substance abuse services.

Values clash

Henderson, a private practitioner in the Nashville area, says that when she met with individual legislators about the “sincerely held principles” bills, it appeared that some of them already had their minds made up. When presented with the ethics testimony, she says, many of these legislators argued that it was impossible for counselors to separate themselves from their beliefs. They also rejected a primary counseling value of putting clients first, Henderson says.

“I kept reminding them that these are complex issues,” says Henderson. She points out that even though it takes years to become a professional counselor, the legislators were making decisions about the counseling profession based on a few hours’ worth of knowledge gleaned in hearings and meetings.

EventhoughDuring efforts to defeat the legislation, Henderson acknowledges that she also encountered some counselors in Tennessee who supported it. The most common reason given was the counselors’ religious beliefs, she says. For example, one counselor told Henderson that he could not separate his religious beliefs from his counseling values. So, if a client came to him for treatment of alcoholism and wanted to use harm reduction, the counselor — who believes it is wrong to drink or take drugs — would only agree to treat using complete abstinence. Another counselor said she would not be able to counsel someone committing adultery unless that person pledged to end the adulterous relationship.

Francis says another common explanation or justification for values-based referrals is that a counselor who has a conflict with a client’s lifestyle or choices might not provide the best service or even cause harm. “This is a perfectly valid concern and is upheld in the ethics,” he says. “We don’t want to cause harm. We don’t want to put the client in any sort of jeopardy.”

However, Francis explains, the flaw in that reasoning is in assuming that the problem resides with the client. Instead, it is the counselor who needs to make adjustments and seek supervision, consult with trusted colleagues or get additional training to better serve the client.

Ultimately, it is those seeking mental health services who will be harmed by the passage of the legislation. “In rural Tennessee, or anywhere in the state that is listed as a mental health shortage area, there simply are not enough providers,” says Catherine B. Roland, who begins serving as ACA president July 1. “So, if a counselor is allowed to pick and choose who they will see simply due to a strongly held belief or value, those most in need of services will have nowhere to turn.”

The law is also written very broadly, which leaves it open to individual interpretation, Terrazas notes. “Initially the bill covered religious beliefs, but the wording was changed to ‘sincerely held principles,’ which could be broadened to include almost anything that a counselor disagrees with,” he says.

Duffey agrees. “People seeking mental health services can potentially be affected in any number of adverse ways as a result of this law,” she says. “For one, they are now aware that a law exists that protects counselors from working with them if the counselors’ beliefs conflict with who they are. That is profound. In a time where so much progress is being made with respect to equality and human rights, this bill may bring a painful resurgence of old feelings of rejection and discrimination and feelings of social exclusion.”

Current and future implications

Although those who defend the law often cite religious concerns for doing so, TCA leaders say many of their members who are Christian counselors have vowed not to use the law to discriminate.

In fact, other counselors have cited their religious beliefs as a reason not to discriminate. “[The Tennessee law] is an affront to the heart of Christianity,” says Ryan Thomas Neace, an ACA member and counselor practitioner in St. Louis. “The Scriptures reveal that those whom the religious folks said weren’t towing the line — not observing religious rituals or laws, not living up to sexual and moral purity codes by having sex too much or with the wrong people or drinking too much, etc. — those people were often far more hungry for genuine, transformative encounter than the religious folks themselves. This is why Jesus kept their company so much.”

Neace, who has been practicing for almost 14 years, cites his experience as an example of how harmful the law is to clients and to the counseling profession’s ideals. “By the time many of my LGBTQ+ clients show up at my office, they’ve already been hounded by unsupportive, and often abusive, friends, family, religious communities and sadly, professionals,” he says. “This law makes the sacred space that we offer as counselors less sacred and less spacious.”

There are already many barriers that discourage potential clients from reaching a counselor’s office, Neace says, and research suggests that LGBT individuals face even more obstacles. In Neace’s opinion, the obstacles the Tennessee legislation has erected for LGBT clients “are perhaps more akin to land mines.”

Unfortunately, Neace says, some counselors don’t seem to comprehend the precedent — and the slippery slope — that this law sets. “In a more long-term sense, it literally opens the door for clients to be denied therapy if they in some way represent an affront to anything counselors sincerely or principally believe,” he says. “This actually could, in my case, extend to me as a Christian. Someone could refuse to see me because of my religious beliefs. It’s hard to understand that religious folks who back this bill don’t see that it ushers in opportunities for the very persecution they hope to avoid.”

Keith Myers, a licensed professional counselor and ACA member, wrote an opinion piece for USA Today in May in which he highlighted some of the potential consequences of the law that its advocates might not have anticipated. “Imagine that Joe, a veteran who served our country faithfully, comes to counseling at a rural Tennessee practice,” Myers wrote. “He talks about his strong opinions concerning the Islamic State terrorist group and ways the military should be intervening. His male counselor happens to be a pacifist. This counselor has strong feelings against any kind of war or any type of military intervention against ISIL. Before the new law, he would have felt obligated to help Joe. Now, he refers Joe to another counselor 25 miles away from where Joe resides. Joe becomes angry and ultimately avoids getting help. The harm has been done.”

Henderson has already seen an effect. “After the news broke that the bill had been signed into law, one of my own clients asked if I would continue to see her now that I don’t have to,” Henderson recounts. “And this is a person who I already have an existing relationship with.”

One of Henderson’s counseling colleagues shared another story related to the passage of the law. During a client intake, the client asked questions about how the counseling process worked but also asked how long it would be before the counselor might decide not to work with the client any longer. The client wanted to know what he would do if that happened.

Counselors who practice in other states might question why they should be overly concerned about what is happening in Tennessee. “Quite simply, if it can happen in Tennessee, it can happen in any state in the union, making it an issue for all counselors,” Roland says. “One only needs to realize that the anti-LGBTQ legislation in so many states continues to grow. Those who believe in an anti-LGBTQ agenda are passionate and are using the legislatures and courts in this country to make their voices heard. ACA stands in support of the counseling profession and the consumers who seek our services — all consumers.”

The law could also contribute to misperceptions that go beyond what is happening in Tennessee. “This bill is problematic for counselors who hold religious beliefs and also support our code of ethics,” Duffey says. “The discussions around this issue can create misunderstandings and generalizations, with suggestions that faith-based counselors are, in principle, discriminatory. This is, of course, unfair and inaccurate, and runs the risk of creating division where it doesn’t exist.”

Terrazas says there is a danger that similar legislation could be proposed in other states and notes that ACA Government Affairs is maintaining a very watchful eye.

Seeking solutions

With the “sincerely held principles” legislation being signed into law in Tennessee, what happens next? ACA and TCA are taking a number of steps.

“We are certainly starting to pick up the pieces of what has transpired over the past several months and focusing on the future,” Coy says. “We are aware that there are varying opinions in Tennessee, and we will need to navigate through all of that in the coming months. Our ultimate goal shall remain meeting the needs of our membership and focusing on the needs of our clients.”

At July’s state leadership institute, TCA plans to focus on educating its members about what happened and encouraging them to in turn educate the public on the issues, Coy says. TCA’s annual conference in November will be devoted in part to additional education and training and to deciding what the association’s next steps should be.

When she was interviewed near the end of May, Coy said the rest of TCA’s plan of action was under development. “We will be sending out a survey to membership asking them what they want,” she said. “Our initial ideas will be training in the form of webinars, single-event training opportunities, podcasts, training bulletins and continued membership development.”

On the national level, Terrazas says that ACA Government Affairs is encouraging counselors in all states to get to know their legislators. The purpose is not only for counselors to be aware of what bills are being proposed in their states but also to educate legislators about counseling and what counselors do, he says.

The ACA leadership also wants counselors in Tennessee to know that even though the 2017 ACA Conference is being relocated from Nashville, the association is not abandoning the state’s practitioners. “ACA stands ready to assist with grassroots advocacy and to provide materials to Tennessee counselors who seek resources that will help the public policy officials understand the deleterious effects of this new law on the citizens of Tennessee,”
Yep says.

“We will continue to work with our colleagues in Tennessee in hopes that this law can be overturned,” Roland says. But she also offers a caution: “We cannot for a moment forget about the other 49 states where efforts like these can arise quickly and without notice.”

Despite the potential damage caused by the “sincerely held principles” law in Tennessee, Duffey believes the counseling profession will eventually emerge stronger than ever. “I absolutely believe we will ultimately be stronger as a result of our decision [to relocate the ACA Conference] and the unity we are experiencing through this advocacy,” she says. “I have been heartened by the outpouring of support for the Governing Council’s decision and by the appreciation of those members who courageously shared their stories and concerns. In fact, people who often vigorously debate other issues have come together on this one — in support, with clarity and with a sense of pride.”

 

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Does the ACA Code of Ethics trump discriminatory institutional policies? Read the July issue of the Journal of Counseling & Development, featuring three articles in the special Trends section that discuss the ethical issues raised by the practice of accrediting counseling programs at colleges and universities that use statements in their Codes of Conduct that are nonaffirming of LGBT individuals.

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

 

2014 ACA Code of Ethics approved by governing council

March 26, 2014

The 2014 ACA Code of Ethics was approved by the ACA Governing Council this week at its meeting at the ACA conference in Honolulu, Hawaii.

The 2014 ACA Code of Ethics replaces the 2005 edition.  The new edition is the first code that speaks to the ethics of using social media with clients.  It also presents new or expanded Branding-Box-Ethicsguidelines for preventing the imposition of counselor personal values, distance counseling, confidentiality, dual relationships, multiculturalism and diversity, the use of technology, record keeping, diagnosis, end-of life care and the selection of interventions.

The 2014 ACA Code of Ethics is posted on the ethics section of the ACA website at counseling.org/ethics

ACA conference attendees can be the first to hear about the new code by attending the six-hour Learning Institute, “Hot Off the Press – The New 2014 ACA Code of Ethics: An In-Depth Review of Critical Changes” on Thursday, March 27, or the 90 minute education session, “A Town Hall Meeting on the New 2014 Code of Ethics: What You Need to Know” on Saturday, March 29.

A podcast focusing on the updates in the 2014 ethics code with Perry Francis, chairman of ACA’s Ethics Revision Task Force, is available at counseling.org/knowledge-center/podcasts

More resources focusing on the 2014 ACA Code of Ethics will be soon be posted on the ACA website, including a six-part webinar series, a ten-part interview series with the Ethics Revision Task Force, updated ACA books such as the bestselling ethics casebook and branch presentations.

 

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See the June issue of Counseling Today for an in-depth cover story on counseling ethics.

In July, Counseling Today will begin a column series highlighting significant changes in the new Code of Ethics.

 

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Counselors, share your thoughts on the Code of Ethics revision

Heather Rudow April 10, 2013

acaCorpLogoAmerican Counseling Association members are invited to review and submit their comments on the first draft of the 2014 ACA Code of Ethics (COE), the latest revision in nearly a decade.

The draft was officially announced at the ACA 2013 Conference & Expo in Cincinnati at a town hall meeting with the Ethics Revision Task Force. The discussion between attendees and the task force members highlighted the importance of the revision: not only is this the first revision since 2005, it will for the first time set a direction for the use of social media and other technology by counselors.

“The ACA Code of Ethics is a living document,” says Perry Francis, chair of the Ethics Revision Task Force Committee. “It is a reflection of the growth and development of the profession of counseling and, as such, must be updated to reflect the current and future issues and standards of today and the near future.”

The Code of Ethics has evolved significantly since it was first conceived.

 “The first COE [in] 1961 was five pages long and contained no glossary,” Francis explains. “The 2005 COE is 20 pages long and has an 18-word glossary. The next COE will have a larger glossary and directly address cutting-edge issues [such as] social media and values in counseling that are stretching our profession. It is a reflection of the progress we have made and the complexity we face as counselors.” 

Those complexities include the rapid increase in the use of technology and social media by counselors.

 “The 2005 Code of Ethics had a subsection that addressed the emerging issue of online counseling,” Francis says. “But social media … was not even in use as a medium for providing services [at that time]. Today, counselors have websites, Facebook pages and can provide services via virtual reality. Our current code does not adequately address these mediums. The revision will contain a separate section that directly addresses the many issues that counselors need to consider when using these mediums for providing services.”

Francis says the revision is as close to a reflection of the values, wisdom and knowledge of the profession as the committee could make. However, “the voice of the profession is incomplete without input from others, including licensing boards, professional associations and the practicing counselors from all of our specializations. In that way, it becomes the ethics of the profession and not a code created in isolation.”

Members can review the draft and submit comments through May 30. The draft can be accessed here. The final version of the 2014 ACA Code of Ethics is schedule to be unveiled at next year’s ACA Conference & Expo in Honolulu.

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Editors note: the revised ACA Code of Ethics was approved and released in March 2014. See: ct.counseling.org/2014/03/2014-aca-code-of-ethics-approved-by-governing-council/

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ACA kicks off major revision of profession’s Code of Ethics

Jonathan Rollins June 1, 2011

When the American Counseling Association last completed and released a revised version of its Code of Ethics in October 2005, issues of multiculturalism and diversity received special focus because they were increasingly coming to the forefront of counseling practice but had not been addressed in much depth in previous versions of the ethics code.

The 2005 revision also highlighted the ethical use of technology applications, including guidelines for a then-burgeoning movement by counselors to launch and maintain professional websites. Fast forward roughly six years, and a technological revolution that wasn’t on many people’s radar screens in 2005 — social media — has opened up a new frontier of ethics questions and implications for counselors.

Not coincidentally, ACA announced this spring that it would again be undertaking a major revision of the ACA Code of Ethics, which began with an April call for participants to serve on the Ethics Revision Task Force. The process of revising the ethics code is expected to take three years, with a goal of presenting a final draft for approval by the ACA Governing Council in March 2014. The rapid rise of social media in and of itself did not determine the need for a revised code of ethics — in practice, ACA reviews and revises the code every seven to 10 years — but the widespread use of Facebook, Twitter and other social media applications did have some influence in getting the latest revision process started sooner rather than later.

“There definitely are some newer areas of concern within our profession that need to be addressed by the ACA Code of Ethics,” says ACA President Marcheta Evans. “Social media stands out as one of those areas. With Twitter and Facebook, there are some ethical boundary issues just floating out there with counselors.”

Even so, the revision process will focus on far more than social media. The Ethics Revision Task Force will be reviewing and updating all sections of the existing ACA Code of Ethics as appropriate, while also trying to anticipate emerging issues that could present counselors with ethical dilemmas down the road.

“The ACA Code of Ethics helps to define who we are, how we operate and how we function as counselors,” Evans says. “Revising our ethics code periodically is part of our professionalization. We want it to be as extensive and as inclusive as it can be while also looking at issues that may pop up in the future. It’s a positive for the public to see us examining ourselves as a profession as we move forward.”

In appointing ACA members to serve on the Ethics Revision Task Force, Evans says she will be “looking for diversity of thought. That diversity covers everything from ethnicity to gender to background and experience. I’m really open to having a lot of color and flavor on this task force so we can perhaps uncover some things that we may have missed or that hadn’t become apparent yet when we did previous revisions.”

The desire is to assemble a task force composed of counselor practitioners from varied settings and specialties who have experience applying the ACA Code of Ethics in their work as well as counselor educators who have engaged in scholarly activities pertaining to the ethics code. “I’m excited to be able to have a hand in moving this very important process forward,” says Evans, who will review applications and appoint eight to 10 ACA members to the Ethics Revision Task Force before she concludes her term as ACA president at the end of June.

“It’s important to get a cross-section of counseling professionals, inclusive of those teaching and practicing, involved in the revision process because it will make for a richer review and update,” says ACA Executive Director Richard Yep. “The ACA Code of Ethics is a central part of the counseling profession, and it helps define who our members are at their very core, while also reflecting ongoing changes in society. I would encourage every member of ACA to participate in this process in some way.”

The proposed timeline for revising the ACA Code of Ethics calls for ACA to solicit input from its members this coming fall regarding new areas that the code needs to address as well as existing standards that may need to be changed in some way. After collecting and reviewing this input, the Ethics Revision Task Force will turn its attention to composing a draft revisedCode of Ethics between April 2012 and March 2013. Once the draft revision is released, ACA will issue a call for feedback from its members, and the task force will then consider this feedback in developing a final draft to be presented to the ACA Governing Council.

“The ACA Code of Ethics provides the counseling profession with our framework for acting in the best interests of clients, students and supervisees,” says ACA Chief Professional Officer David Kaplan. “As such, we have taken its revision very seriously, and President Evans has mapped out a comprehensive three-year approach for updating the code that includes expert practitioners and scholars and multiple layers of input and feedback from a variety of constituencies — the most important being the ACA membership.”

All ACA members agree to abide by the ACA Code of Ethics when they join the association, and more than 20 state licensing boards use the ACA code as the basis for their standards of practice and the adjudication of client complaints.

Jonathan Rollins is the editor-in-chief of Counseling Today. Contact him at jrollins@counseling.org.

Letters to the editor: ct@counseling.org.

 

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Editors note: the revised ACA Code of Ethics was approved and released in March 2014. See: ct.counseling.org/2014/03/2014-aca-code-of-ethics-approved-by-governing-council/

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New guidelines on dual relationships

Mary A. Hermann and Sharon Robinson-Kurpius December 9, 2006

The recent revision of the ACA Code of Ethics significantly changes the ethical guidelines related to dual relationships. Careful review of the specific ethics code language addressing dual relationships is imperative in order to navigate this prevalent ethical issue. Though the 1995 code offered guidance on the topic of dual relationships, the 2005 ACA Code of Ethics provides more explicit guidelines about which dual relationships are ethically acceptable and which are strictly prohibited.

Dual relationships exist on a continuum ranging from potentially beneficial interactions to harmful interactions. One dual relationship that is always considered harmful is a sexual relationship with a client. The 2005 revision of the ACA Code of Ethics reiterates and expands the ban on sexual relationships with clients. Under the new code, counselors are ethically prohibited from engaging in sexual relationships not only with clients but also clients’ partners or family members (Standard A.5.a.).

Another substantive revision is the extension of the time ban on sexual relationships with former clients. In the 1995 code, the specified period of waiting was two years, with extensive justification after two years that such a relationship would not be harmful to the former client. The 2005 code extends this period to five years. Echoing the previous code, the 2005 code states in Standard A.5.b. that “Counselors, before engaging in sexual or romantic interactions or relationships with clients, their romantic partners or client family members after 5 years following the last professional contact, demonstrate forethought and document (in written form) whether the interactions or relationship can be viewed as exploitive in some way and/or whether there is still potential to harm the former client; in cases of potential exploitation and/or harm, the counselor avoids entering such an interaction or relationship.”

Though sexual relationships with clients are clearly prohibited, nonsexual relationships are ethically permissible under certain circumstances. Like a dual relationship that is sexual, a nonprofessional dual relationship has the potential to blur the boundaries between a counselor and a client, create a conflict of interest, enhance the potential for exploitation and abuse of power, and/or cause the counselor and client to have different expectations of therapy. The 1995 code instructed counselors to avoid nonsexual dual relationships when it was possible to do so. The Ethical Code Revision Task Force felt that this instruction was being interpreted as a prohibition on all dual relationships, including relationships that could be beneficial to the client (see “Ethics Update” in the March 2006 issue of Counseling Today). Thus, the 2005 code revisions clarify that certain nonsexual interactions with clients can be beneficial, and therefore, those relationships are not banned (Standard A.5.c.).

The 2005 code also provides examples of potentially beneficial interactions, including “attending a formal ceremony (e.g., a wedding/commitment ceremony or graduation); purchasing a service or product provided by a client (excepting unrestricted bartering); hospital visits to an ill family member; mutual membership in a professional association, organization or community” (Standard A.5.d.). When engaging in a potentially beneficial relationship with a client or former client, however, the counselor is expected to “document in case records, prior to the interaction (when feasible), the rationale for such an interaction, the potential benefit and anticipated consequences for the client or former client and other individuals significantly involved with the client or former client.” Standard A.5.d., “Potentially Beneficial Interactions,” further clarifies that “Such interactions should be initiated with appropriate client consent,” and if harm occurs because of the nonprofessional interactions, counselors are expected to “show evidence of an attempt to remedy such harm.”

In settings such as rural communities and schools, nonsexual dual relationships are often impossible to avoid. The 1995 code provided guidance on managing unavoidable dual relationships, stating that the counselor was expected to “take appropriate professional precautions such as informed consent, consultation, supervision and documentation to ensure that judgment is not impaired and no exploitation occurs.” Though this language is no longer explicitly stated, such precautions still seem warranted.

The 2005 ACA Code of Ethics also provides guidelines for supervisory relationships, stating that “Sexual or romantic interactions or relationships with current supervisees are prohibited” (Standard F.3.b.). Furthermore, the ethics code clearly states that “Counseling supervisors do not condone or subject supervisees to sexual harassment” (Standard F.3.c.). It should be noted that not only is sexual harassment unethical, it is also illegal.

Counseling supervisors are expected to “clearly define and maintain ethical professional, personal and social relationships with their supervisees” (Standard F.3.a., “Relationship Boundaries With Supervisees”). The standard goes on to say that “If supervisors must assume other professional roles (e.g., clinical and administrative supervisor, instructor) with supervisees, they work to minimize potential conflicts and explain to supervisees the expectations and responsibilities associated with each role.” The 2005 ACA Code of Ethics also cautions counseling supervisors to remain aware of “the power differential in their relationships with supervisees” (Standard F.3.e.). The code further clarifies that “Counseling supervisors avoid accepting close relatives, romantic partners or friends as supervisees” (Standard F.3.d.).

Standard F.3.a. also advises counseling supervisors not to engage in “any form of nonprofessional interaction that may compromise the supervisory relationship.” If a counseling supervisor believes a nonprofessional relationship with a supervisee has the potential to benefit the supervisee, Standard F.3.e. provides that supervisors take precautions similar to those taken by counselors who engage in potentially beneficial dual relationships with clients. It goes on to say that “Before engaging in nonprofessional relationships, supervisors discuss with supervisees and document the rationale for such interactions, potential benefits or drawbacks, and anticipated consequences for the supervisee.”

The 2005 ethics code addresses other dual relationships as well, including relationships between counselor educators and students and relationships between researchers and research participants. Standard F.10. sets guidelines for counselor educators and students that are similar to the ethical guidelines for supervisors and supervisees. Standard G.3. virtually mirrors these rules for researchers and their research participants.

The 2005 ACA Code of Ethics clarifies that nonsexual dual relationships are not prohibited; however, navigating dual relationships can be challenging. Counselors are ethically mandated to approach dual relationships with care and caution. Informed consent is a critical component of engaging in nonsexual dual relationships with clients, and this includes specifying the potential negative consequences of such a relationship. It is wise for counselors to consult when faced with a dual relationship to ensure that clients are not harmed. Though the standards related to dual relationships in the ACA Code of Ethics have undergone significant changes, the spirit of their intent can still be summarized in one sentence: Do what is in the best interest of the client.

Mary A. Hermann, a professor of counselor education at Virginia Commonwealth University, and Sharon Robinson-Kurpius, a professor of counseling and counseling psychology at Arizona State University, are members of the ACA Ethics Committee.

Letters to the editor: ct@counseling.org