Tag Archives: Ethics & Legal Issues

Ethics & Legal Issues

Counselors in the courtroom

By Margaret Taylor May 10, 2017

Counselor educators are responsible for ensuring that students are sufficiently prepared for entry into the counseling profession. It is challenging for counselor educators to include all areas of preparation because numerous content and curriculum standards must be met. One topic that often gets neglected is preparing counselors for testifying in court. In a paper presented at the 25th International Play Therapy Conference in 2008, Marilyn Snow and Ruth Ouzts Moore found that counselors were increasingly being called on to testify in court, especially in child custody cases. But most counselors are not well prepared to serve as competent witnesses or represent the counseling profession adequately.

Inadequate knowledge about the judicial system and process regarding court testimony may place counselors at risk for ethical violations. Therefore, I believe it is crucial that counselor educators prioritize educating students about testifying in court. The first time that I testified in court as a beginning counselor, I found that I had been poorly prepared by educators and attorneys. The experience nearly traumatized me. I was not ready for the questions that were asked of me or the grueling process of cross-examination. As a result, the client’s case suffered and the counseling profession was misrepresented.

After this initial experience of testifying in court, I vowed never to be caught unprepared again. I also determined to use my negative experience to better equip counselors for testifying in court.

 

Legal and ethical responsibility

Counselor educators are expected to be knowledgeable about ethical and legal issues in the counseling profession and recent changes in the field of counseling. Standard F.7.a. of the American Counseling Association’s 2014 Code of Ethics states, “Counselor educators who are responsible for developing, implementing and supervising educational programs are skilled as teachers and practitioners. They are knowledgeable regarding the ethical, legal and regulatory aspects of the profession; are skilled in applying that knowledge; and make students and supervisees aware of their responsibilities.” This section of the ethics code applies to the fact that counselors are frequently subpoenaed to testify on behalf of their clients. Accordingly, counselor educators are ethically obligated to educate students about their ethical and legal responsibilities when testifying in court.

The Council for Accreditation of Counseling and Related Educational Programs (CACREP) Standards (2016) also address the ethical and legal responsibilities of counselor educators in preparing their students for practice. Two CACREP Standards apply to the issue of counselors testifying in court. Standard 2.F.1.b. states that programs must include, “the multiple professional roles and functions of counselors across specialty areas,” whereas Standard 2.F.1.i. specifies that training must be provided in “ethical standards of professional counseling organizations and credentialing bodies, and applications of ethical and legal considerations in professional counseling.”

Together, the ACA Code of Ethics and the CACREP Standards would appear to require that counselor education curricula incorporate training in the roles and responsibilities that come with testifying in court and otherwise acting in the best interests of clients.

 

Competence as a counselor educator

Counselor educators are not only responsible for providing students with material on courtroom testimony and other aspects of law pertaining to their clients; counselor educators are also to be knowledgeable about the topic themselves. Counselors and counselor educators should seek guidance from counseling professionals who have served as witnesses in court.

As reported in the Counseling Today article “Your witness” in 2011, George Cyphers, a counselor educator at Kent State University and owner of a consulting business, made this statement about testifying on behalf of clients: “I have learned over the years that this is a serious business because it involves a person’s life. You cannot afford to hold yourself out as an expert unless you are willing to invest time and effort to prepare thoroughly for the challenge of cross-examination.”

Experience from practicing counselors reiterates the importance of preparing students for courtroom testimony. Time and effort should be placed into designing a curriculum that includes education about testifying in court on behalf of counseling clients. Students who are well-educated and prepared in this area are able to represent themselves, their clients and the profession effectively.

If we agree that counselor education programs need to prepare students for court testimony, the question becomes what should counselor educators include in the curriculum, and how are these competencies best attained? Various expert witnesses, attorneys and counselors have provided suggestions on what is important to know prior to entering the courtroom. Writing for the Journal of Counseling & Development in 1990, Jan La Forge and Phyllis Henderson suggested four categories: the role of the counselor in the courtroom, pre-court preparation, courtroom etiquette and strategies for answering questions.

 

Role of the counselor in the courtroom

The role of the counselor while in the courtroom is that of a witness. Forge and Henderson asserted that the counselor serves as an educator to the jury and the judge, providing factual and neutral information. It is important that counselor educators distinguish between an “expert witness” and a “witness of fact.”

To testify as expert witnesses, counselors must first be qualified as such by the judge. Demonstration of knowledge and experience may include publications, presentations and specific training in the area of expertise. The prosecuting attorney will ask counselors questions about their qualifications. Counselors answer these questions by demonstrating their knowledge and expertise. After presenting their qualifications, it is possible that the opposing attorney will call those credentials into question. Counselors should be prepared for this possibility. If they are not challenged, it is likely that the judge will qualify them as expert witnesses, meaning these counselors can offer an opinion on the case.

Valuable witnesses are typically well-educated, intellectual individuals who are able to educate a jury about their expertise as it relates to the case. Expert witnesses should be skilled at teaching a jury, using short statements rather than long uninterrupted assertions.

Conversely, “fact witnesses” provide testimony about what has been observed, heard or known as true events during the course of counseling. Michael Puhl of Puhl Law Group explained (2014) that fact witnesses do not have a particular expertise; therefore, they are not permitted to offer opinions about the facts of the case. Counselors working with children are often called to testify as fact witnesses because of disclosure statements made by children during session. As fact witnesses, counselors may repeat statements made by the child but not offer an opinion about the truthfulness of the statement.

Various resources exist for counselor educators and counseling professionals when preparing to be called as expert witnesses. The following is a list of books and articles on testifying as an expert witness:

  • “The Ten Commandments of Testifying at Trial” by David Benjamin
  • “Expert Witnesses, Courts and the Law” by Elizabeth Butler-Sloss and Ananda Hall
  • “Working as an Expert — Tips for Expert Witnesses” by Aaron Larson
  • “May It Please the Court: Testifying Tips for Expert Witnesses” by Laurence Miller
  • “Courtroom Survival Guide” by Patrick J. Walsh
  • Feder’s Succeeding as an Expert Witness, fourth edition, by Harold A. Feder and Max M. Houk
  • The Portable Guide to Testifying in Court for Mental Health Professionals: An A-Z Guide to Being an Effective Witness by Barton E. Bernstein and Thomas L. Hartsell Jr.
  • Clinicians in Court: A Guide to Subpoenas, Depositions, Testifying and Everything Else You Need To Know by Allan E. Barsky and Jonathan W. Gould

This list is not exhaustive, but it serves as a good starting point for counselor educators to incorporate material into a course for counseling students. Material on courtroom testimony can be infused into different courses of a master’s counseling program for clinical mental health or school counseling. Orientation classes on the counseling profession or for clinical mental health counseling or school counseling would also be appropriate courses to include material on expert testimony. In a counselor education and supervision doctoral program, a course on contemporary issues in counseling would be a fitting place for information on counselors serving as expert witnesses.

Counselor educators can also provide opportunities during practicum classes for students to meet with counselors who serve as expert witnesses. These expert counselors could answer students’ questions and concerns. Counselor educators can also arrange for an attorney or expert witness to attend class to demonstrate various court proceedings that counselors may encounter, including depositions, cross-examination, criminal trial and custody hearings. Role-plays of legal proceedings can also serve as an excellent method for educating counselors about what to expect in the courtroom.

Likewise, educators may arrange for students to observe a court hearing or attend a mock hearing or trial. A study conducted by Carol R. Colby and Lynn Landis Long in 1994 found mock trials to be a useful teaching method for graduate counseling students who are learning about ethics and legal proceedings. Legal and counseling ideas are integrated in a mock trial, providing students experiential learning and practical application. A mock trial helps students understand the functions of all people involved in the law, including judges, attorneys, mental heal professionals, jury members and court reporters. Educators can best prepare students for possible legal proceedings by pairing knowledge from lectures with experiential learning, such as roles-plays and mock trials.

 

Pre-court preparation: Documentation

Proper documentation is one of the many important tasks in preparing for court. Outside of the court setting, counselors are ethically obligated to maintain appropriate documentation of all clients. Therefore, preparing documentation for court should not pose a challenge.

Attorneys vary in what they request in a subpoena for records. Counselors should be prepared to provide all of the client’s records. However, counselors may be asked to present only records pertaining to a certain allegation or custody matter.

Many court cases do not occur until long after a counselor has terminated with the client. Being meticulous and cautious about documentation is crucial for counselors. It is generally recommended that counselors maintain detailed documentation of any action in a client case, including meetings with parents and client disclosures. Counselors should be aware that if an activity is not documented, then there is no hard evidence that it happened. This aspect is important to keep in mind when a client misses appointments.

Moore and Laura R. Simpson suggested in a 2012 VISTAS article that when writing case notes, counselors should be careful to use definitive descriptive language. For example, rather than stating, “It appears the child was neglected by family,” a counselor should state, “The child disclosed that the family withheld food for three consecutive days.” Careful language prevents the counselor from being trapped on the stand by a statement made in documentation. An attorney cannot challenge the counselor on a statement made by a client; however, an attorney can question a counselor about an opinion given in documentation.

Once records are subpoenaed by the courts, counselors should document the subpoena in their records and then should immediately contact clients to inform them of the breach of their confidentially. Clients have the right to know when their confidentiality is broken because of legal proceedings. This phone call or meeting to inform clients of the subpoena should be documented too. Thorough documentation of the limitations to confidentiality will help prove the counselor acted ethically should a client seek legal counsel.

 

Pre-court preparation: Conference with attorney

Counselor educators should inform students of the necessity of meeting with the attorney who issued the subpoena so that both the attorney and the counselor are well-prepared for possible testimony. Forge and Henderson explain that during this conference, counselors can be informed about particular documents that will be needed and what questions will be asked of them during testimony. Counselors can also inform the attorney of any concerning issues about the case to prevent the attorney from being surprised during the hearing.

Cross-examination will occur from the opposing attorney during the course of a court hearing. Meeting with an attorney in advance can provide opportunities to cover questions and strategies that may be used during cross-examination. Knowing ahead of time that attorneys are being compensated to discredit the witness prior to a court hearing can keep counselors from panicking or answering defensively while testifying.

Counselor educators are likely to have little experience with cross-examination. Inviting guest speakers such as community attorneys and counselors with expert testimony experience to counseling classes can provide students with concrete examples of the cross-examination process.

 

Courtroom etiquette

Etiquette in the courtroom may appear commonsense, but it is a topic that is often overlooked. Appropriate dress and behavior should not be disregarded when preparing counselors for court because these are signs that will indicate the professionalism of the counselor. Suits or work attire is recommended. Also limit accessories that may cause a distraction. Dressing properly is one of the simplest ways a counselor can establish credibility in the courtroom.

Body language is equally significant. Body language can communicate strength or weakness. It should communicate that the counselor is confident, knowledgeable and strong. Jamie Hamlet asserts (practicenotes.org/vol12_no4/testifying.htm) that language can establish counselors’ credibility with the jury and deters the deference attorney from antagonizing them. Body language is an important component in training to be a counselor. Therefore, counselors should already be familiar with the significance of communicating positive body language on the stand as a witness. By displaying the proper posture of sitting straight and leaning forward, counselors will express assertiveness and professionalism. Facial expressions should demonstrate genuine concern and thoughtfulness.

Furthermore, counselors should speak clearly and politely to those in the courtroom. Counselors should declare with authority and conviction if they are confident about a conclusion made regarding their case. Conversely, it is recommended that counselors refrain from being argumentative or defensive if challenged by an opposing attorney. Being argumentative may be perceived as disrespectful and unprofessional.

Frequently, witnesses are not permitted in the courtroom until it is time to give their testimony because attorneys do not want proceedings from the hearing to contaminate witnesses. Therefore, counselors should be careful who they speak with and limit their conversations. Forge and Henderson warn that speaking with a witness on the opposite side of the case could cause a mistrial.

 

Answering questions during testimony

Responding to questions asked by attorneys during testimony can be very challenging and intimidating. But with proper preparation, this process doesn’t have to be so daunting. Counselor educators should teach counseling students various strategies related to answering questions in the courtroom.

Always tell the truth. This is the No. 1 concept to remember when testifying in court. Do not waver from this. Do not embellish your statements during testimony. Simply tell the truth and state the facts. If a question is asked that you do not know, merely state that you do not know the answer. Often witnesses think that they must have an explanation for each question asked of them and then feel pressured to speak. Counselors must understand that making an untruthful statement can ruin their credibility and harm the client’s case.

Community members who serve as jurors often place their trust in expert witnesses such as doctors, counselors, police officers, etc. Therefore, jurors will do their best to believe an expert’s testimony if credibility is established. If an expert witness betrays this trust by being dishonest or disrespectful on the stand, Laurence Miller states (in “May It Please the Court: Testifying Tips for Expert Witnesses”) that jurors are likely to disregard the witness testimony, harming the client’s case. Being honest and truthful increases the possibility that jurors will believe the testimony of the counselor.

Witnesses should take time to listen to the attorney’s questions and to formulate their responses. Simplicity is key. The more words that are spoken, the more questions that can be asked. If a yes-or-no question is asked, simply answer yes or no. Furthermore, the language that witnesses use should be simple. Laypeople will not typically understand the jargon used in the counseling field. Speak in a way that will be easily understood by someone outside of the profession.

Cross-examination is designed to be confrontational, causing one to feel pressured. Counselors should expect to be challenged on the witness stand. Learn not to take such challenges personally and to exhibit grace under pressure without becoming flustered or annoyed or losing your temper. Well-prepared counselors are ready to defend their opinions and remain firm on the conclusions made while testifying. This stance exhibits confidence, expertise and assurance to a judge and jurors.

Attorneys may attempt to fluster witnesses. This may involve asking numerous questions rapidly, speaking loudly and acting in an intimidating manner. When training to work with clients, counselors are expected to remain cool, calm and nonjudgmental during counseling sessions. These same skills should be applied during courtroom testimony. Educators should prepare counselors for this tactic and provide them with techniques to remain calm.

 

Conclusion

It has been established that counselor educators play a significant and vital role in educating and preparing counselors for testifying in court on behalf of their clients. Including material on court testimony in counselor education curricula protects both students and their future clients. Incorporating the topics discussed in this article into class syllabi and the overall curriculum is essential to preparing counselors to serve as competent witnesses and exceptional representatives of the counseling profession.

 

 

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Margaret Taylor is a licensed professional counselor and supervisor in Alabama, having served as a counselor for more than 10 years. In addition, she is enrolled as a second-year doctoral student in the Auburn University counselor education and supervision program. Margaret has advocated for children and testified as an expert witness in numerous courts, including in criminal trials, custody cases and juvenile hearings. She has presented at state and regional conferences, providing counselors with the necessary tools to serve as effective witnesses in court for clients and the counseling profession. Contact her at barnema@auburn.edu.

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

The case for including animals in counselors’ duty to report

By Troy Gregorino April 12, 2017

This past year, the American Counseling Association Governing Council endorsed formal competencies for the practice of animal-assisted therapy in counseling. The authors of the standards, and the coordinators of ACA’s Animal-Assisted Therapy in Mental Health Interest Network, contend that the competencies (available at counseling.org/knowledge-center/competencies) represent a key step forward in both the protection of clients and the promotion of therapy animals’ well-being. My own contention is that the adoption of these competencies additionally points to a need for ACA to endorse a “duty to protect” that applies to animals.

As a doctoral student in counselor education and supervision at University of the Cumberlands in Williamsburg, Kentucky, one of my areas of interest is animal-related counseling issues. I have become increasingly convinced that the human-animal bond is for many people an integral aspect of wellness, recovery, purpose and hope. Furthermore, I contend that it is misguided for the counseling profession to advocate for the protection of animals that we happen to use in our interventions but to take no stance in the protection of other animals whose lives are intertwined with the people we serve. Anecdotally, I have encountered significant support for this sentiment, both within and outside of the counseling profession. I offer a rationale for it here, not merely as a philosophical concept to be considered hypothetically, but as an invitation and a call to action for ACA decision-makers.

Tracing back to the Hippocratic oath, doctors and mental health counselors are required to maintain the confidentiality of information disclosed to them in the context of the therapeutic relationship. An exception for counselors is their “duty to protect” potential victims from the anticipated violent behavior of a client. I’d like to make the case that a client’s anticipated violence toward animals ought to be included on the counseling profession’s list of actions that require mandatory reporting.

Applying counseling’s code of ethics to animals

Animals are already protected by existing state, national and international laws, and I think that adapting the ACA Code of Ethics to reflect adherence to those laws is both a logical extension of our ethical framework and in keeping with the spirit of our duty to report.

The intention of mandated reporting, dating back to the California Supreme Court’s landmark 1974 Tarasoff ruling (amended in 1976 to replace “duty to warn” with “duty to protect”), was to impose a legal obligation on psychotherapists to notify individuals who might potentially become victims of violence perpetrated by a counselor’s client.

The ACA Code of Ethics names “serious and foreseeable harm” (Standard B.2.a.) as an exception to maintaining confidentiality. In full, the standard reads: “The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues.”

To elevate that standard to afford protection to nonhuman victims, it could be amended to read, “… clients or identified others, including animals protected from cruelty by applicable state laws …” Imagine the profound impact our profession could have on alleviating undue suffering with the addition of those nine words. Our responsibilities as counselors would remain essentially just as they are, but without a pass for ignoring instances of “serious and foreseeable harm” to animals protected by law. The ACA Governing Council’s endorsement of competencies that, in part, safeguard the comfort and well-being of animals used in therapeutic interventions is laudable; extending those concerns to protect the most defenseless victims from the most egregious acts of cruelty seems to me to be a reasonable and much-needed next step.

It is worth noting that animal protection laws vary considerably from state to state. For instance, according to the Animal Legal Defense Fund, all but two U.S. states impose felony-level penalties for severe forms of animal abuse, and some states allow for the inclusion of animals in domestic violence protection orders. Additionally, some states require mental health evaluations or counseling for animal-abuse offenders. My proposed amendment to our ethics code is intended to be both comprehensive and flexible enough to accommodate the multitude of variations in state laws.

A likely objection to this suggested modification to our code of ethics might involve concerns about damaging client-counselor rapport. However, the same philosophical justification that applies to our current “duty to protect” mandate applies here too. The amended code would simply reflect the standard established by existing law by identifying and protecting those against whom acts of violence constitute legal violations. As it stands now, the ACA Code of Ethics does just that by protecting humans from illegal acts of violence, but it in effect flouts the law when it comes to protecting animals.

In addition to reconciling this disparity in our duty to report, this amendment would be congruent with our duty to take seriously behaviors that are likely to place both the client and the victim in harm’s way. After all, as counselors, we would be hard-pressed to conceive of the therapeutic value of not intervening in the commission of a violent crime. In the case of child abuse, for instance, it would neither contribute to the protection of the victim nor to the progress of the perpetrator to not treat the crime as being of paramount and urgent importance. The same can be said for the significance and immediacy of animal cruelty.

Extending our duty to report to include acts of animal cruelty is a logical and consistent next step because, unlike with other criminal acts (knowledge of which does not warrant breaching confidentiality), animal cruelty is a crime that involves intentional bodily harm. From that perspective, our failure to include it in our duty to report would seem an ethically arbitrary exclusion.

Clinical implications of animal cruelty

Entities such as the U.S. Department of Education, the National Crime Prevention Council and the American Psychological Association agree that cruelty against animals is a warning sign for at-risk youth. Since 1987, the American Psychiatric Association has included animal cruelty as a symptom of childhood conduct disorder in its Diagnostic and Statistical Manual of Mental Disorders. It defines the disorder as a “repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.” According to the American Psychiatric Association, additional implications of such tendencies include an increased likelihood for exhibiting similar symptoms in adulthood, sometimes resulting in meeting the criteria for antisocial personality disorder.

Dating back to the early 1960s, researchers have strived to clarify the role that childhood animal cruelty might play as a predictor of subsequent violence against humans. John Macdonald sampled 48 patients with psychotic symptoms, and 52 without. He determined that three primary characteristics — fire setting, enuresis and childhood cruelty toward animals — were consistently discovered among the individuals considered to be the most sadistic. Although he concluded that this combination of traits could serve as a strong predictor of homicidal behavior, he noted that the presence of this triad alone was of minimal value in foretelling such acts.

More recent scholarly literature has increasingly suggested evidence for a connection between animal abuse and either co-occurring or subsequent forms of interpersonal violence. Researchers are divided over the legitimacy of this supposed link. In 2001, Frank Ascione published a thorough overview of psychological, psychiatric and criminological research linking animal abuse to acts of violence against humans. He asserted that animal abuse is an often overlooked warning sign that, in addition to helping to identify youth who are themselves victims, “could help identify youth at risk for perpetrating interpersonal violence.” In 1997, Ascione and colleagues also examined the prevalence with which victims of domestic violence report various forms of cruelty perpetuated by their abusers toward their pets. In 2008, Christopher Hensley and Suzanne Tallichet emphasized an exploration of the motivations behind animal cruelty by interviewing inmates about their childhood animal cruelty crimes.

These and myriad other studies have been met with a range of criticisms, from failing to establish a verifiable link between human and animal violence to applying flawed methodologies. Regardless of what one may think of the reliability or validity of the research to date, a wholesale dismissal of the apparent relationship between animal cruelty and violence against humans seems unwise. More important, however, is that the strength of this proposal does not rest on the legitimacy of such data. Reliance on the supposed link unnecessarily detracts from the central argument that a wanton act of cruelty against a defenseless other is, on its face, egregious enough in my opinion to trump a counselor’s duty to protect a client’s confidentiality.

Why amend our duty to report?

The most obvious beneficiaries of this change in the short term would, of course, be those animals who stand to be spared from enduring abusive acts. But is it not also in the long-term interest of the perpetrator, at least potentially, to have the opportunity for reform sooner rather than later? Cultural anthropologist Margaret Mead famously commented in 1964 that cruelty toward animals “could prove a diagnostic sign, and that such children, diagnosed early, could be helped instead of being allowed to embark on a long career of episodic violence and murder.”

Furthermore, is it not ultimately in the interest of the counseling profession as a whole to err on the side of empathy for the most vulnerable and to draw an ethical distinction between the importance of confidentiality and the urgency of violent crime? Are we not all made better by extending and explicitly endorsing the reach of our ethical consideration to protect even (and, indeed, especially) those with no voice in the matter? Although none of us is currently prohibited from reporting acts of animal cruelty, I have no doubt that adding the amendment proposed here to the ACA Code of Ethics would over time contribute to the prevention of incalculable instances of undue harm.

As counselors, we are called to reflect on the broader implications of our work and on how the changes we help to facilitate contribute to a healthier quality of life. That means considering broadly the wellness of people and, from my viewpoint, the animals with whom people’s lives are so frequently intertwined. ACA’s historic endorsement of competencies for animal-assisted therapy is a heartening step forward as we adjust continually to the social, cultural and philosophical shifts of our times. I hope we will seize on the momentum of this achievement by embracing an amendment to our ethics code that is consistent with our recent progress.

This proposed amendment is consistent with our profession’s historically responsive adjustments to the societal implications of our work and to our forward-thinking recognition of the impact it can have on the world around us. As with past adjustments made to our ethics code, it is incumbent on mental health professionals to remain at the forefront of measures aimed at cultivating justice and advocacy in our service to others. The amendment proposed here would be one more step in the spirit of that legacy.

 

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Troy Gregorino is a licensed professional counselor and certified wellness counselor.
He is a doctoral student in counselor education and supervision at University of the Cumberlands. Contact him at tgregorino@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Radical alignment: A psychospiritual approach to conflicting values

By Carol ZA McGinnis August 25, 2016

Standard A.4.b. of the 2014 ACA Code of Ethics notes that “counselors are aware of — and avoid imposing — their own values, attitudes, beliefs and behaviors” in an ethical practice. Counselor educators and students often need a practical approach for accomplishing this goal when it comes to conflicting religious or spiritual perspectives in the counselor-client relationship. Through a process of radical alignment, this ethical mandate can be accomplished.

Despite recent legislative trends, most notably in Tennessee, the prohibition of referral due to counselor-client value conflict may present a problem for practitioners who need additional help in adopting a genuine empathetic orientation.

One way to approach this potential dilemma is to adopt a psychospiritual approach that is oriented toward the identification of “common ground” or universal themes that are likely to exist in any counselor-client relationship. This kind of self-awareness and exploration is found in pastoral counseling programs that have a vested interest in integrating a religious or spiritual view in counselor training versus secular versions that tend to view this aspect of the client simply as a component of client diversity. The problem with the latter view is that it discounts intellectual and emotional aspects of religious or spiritual beliefs that inform the counselor photo-1462663608395-404cb6246eaffrom a holistic level. When we are not able to bring our full capacity into the session — if we merely bracket, ignore or set aside this part of our humanity — it would seem implausible to fully attend to a client’s needs.

No empirical research has been conducted on the term “radical alignment.” The idea is supported, however, by the collective works of Kenneth Pargament, Henri Nouwen and Pierre Teilhard de Chardin, each of whom contributed to a wider understanding of how religious and spiritual views intersect with human interaction. They determined that religious and spiritual beliefs are an invaluable part of daily living oriented toward meaning, spiritual growth and our identity as a member of a larger community.

Recognition of universal themes that connect all people regardless of faith tradition, spiritual orientation or creed can provide the counselor with valuable insight into the inner workings of the client without compromising the counselor’s core beliefs.

 

Authenticity and trust

The idea of radical alignment begins with the premise that the humanistic principles of authenticity and trust must reside at the core of the counseling relationship. We find these same fundamental principles in the ACA Code of Ethics as veracity and fidelity, which seem difficult, if not impossible, to promote when personal values have been completely removed from the interaction.

Although counselors are health professionals much like physicians and nurses, we rely on the establishment of rapport in the counseling relationship, which is more akin to religious confession than a physical checkup. In this complex aspect of the counseling relationship, only the affirmation of commonly held beliefs and values can provide a tangible path to an ethical practice.

The crux of the problem then becomes more about the “how” of finding solid ground when a counselor’s and client’s beliefs and values clash. How does the counselor begin to determine these elements to connect, or align, with the client? The answer is to return to the fundamentals of what it takes to provide a comprehensive counselor education: the development of appropriate awareness, knowledge and skills (http://www.cacrep.org/wp-content/uploads/2012/10/2016-CACREP-Standards.pdf).

 

Awareness, knowledge and skills

To accomplish this, counselors-in-training need practice in exploration and self-awareness activities that will help them to identify and validate their own beliefs and values. These activities will increase their knowledge of religious or spiritual language and behaviors that may alienate clients who hold very different views, while also helping them develop skills for determining universal themes through which radical alignment can occur.

Awareness in this capacity might involve exploration of previous beliefs and values that have stayed consistent or changed over the counselor-in-training’s lifetime. Core values may be highlighted through activities such as journaling, digital storytelling and discussion board exchanges in an online environment. Through these activities, counselors-in-training can learn how to communicate specific meanings, values and beliefs that they have attributed to specific life events and that might guide their day-to-day decisions.

Face-to-face exploration might involve dyad or group activities that include the creative expression of core beliefs. This could involve sharing symbols, rituals, sacred texts or even types of food that help to bring about deeper awareness of how beliefs and values are affirmed and communicated.

Gaining knowledge of what others believe, with attention given to ritual, family tradition and sacred texts, can help counselor-in-training learn about language and actions that clients could interpret as hostile or distancing. When structured responsibly, respectful exposure to various religious and spiritual views can help affirm the belief systems of counselors-in-training and provide a deeper understanding of how these values may fit within the larger context of other worldviews.

This process should not be part of a master plan to bend or subordinate individual beliefs. Rather, it should highlight similarities and differences that can be important in counseling. For example, the concept of prayer may seem universal to one student until further exploration highlights how this term can mean very different things to different clients, or even potentially have no connection to clients who hold Eastern religious/spiritual views.

To determine universal themes, the counselor-in-training must learn to identify client beliefs and values that may be related to the client’s presenting problem without feeling threatened. Although it is still possible for unexpected countertransference to occur, previous exploration and awareness of counselor beliefs will mitigate this response and allow the counselor to focus on determining underlying universal themes. Even if these themes are not completely consistent with the client’s views, recognition of these elements can help the counselor to align with the client in a radical way.

Let’s say, for example, that the counselor-in-training is a Pentecostal Christian with devout beliefs that relate to the sanctity of marriage. The client, meanwhile, professes no particular faith and engages in casual sex with many partners. Further exploration of the client’s values may result in the prioritization of truth as a core belief. This value would be understood as a universal theme that cuts through religious and spiritual orientation and can provide the counselor with a platform to align with the client. The counselor-in-training may not be able to genuinely empathize with the ramifications of the client’s sexual promiscuity, but her desire for truth in all relationships would be a place where radical alignment could occur.

So too might a Muslim counselor-in-training who possesses a strong religious belief to honor his father and mother connect with a client who regularly lies to his parents through a shared universal theme of a desire for justice. This focus would permit the counselor-in-training to be genuine in his empathy for the client who feels bullied and ignored by those people who are closest to him in his life. Through radical alignment, the counselor-in-training could build trust with this client. That sense of trust would be needed by this client to help him move away from self-destructive behaviors and toward healthier goals that have been identified in an authentic counseling relationship.

In short, this process occurs through three steps:

1) Collect and identify client beliefs and values associated with the presenting problem.

2) Determine a core belief that can be understood as a universal theme that is shared by the counselor-in-training.

3) Engage in radical alignment with the client to promote fidelity and trust in the counseling relationship.

 

 

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Carol ZA McGinnis, a licensed clinical professional counselor and national certified counselor, is a pastoral counselor and counselor educator who specializes in anger processing. Her passion involves teaching with attention paid to religion and spirituality as positive factors in both counseling and counselor development. Contact her at cmcginnis@messiah.edu.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

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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

 

The case for animal-protective counseling practice

By Peter Wollheim October 27, 2014

As counselors know, the ethical and legal requirement of the “duty to warn” has been adopted as a standard of care across many helping professions. It probably represents one of the most universal Photo of dog with personelements of counseling ethics regardless of cultural or national identity. Based on the Hippocratic notion of “first, do no harm” or avoidance of malfeasance, this duty is considered strong enough to override considerations of client confidentiality. In the 2014 ACA Code of Ethics, Standard B.2.a. notes that confidentiality is not guaranteed “when disclosure is required to protect clients or identified others from serious and foreseeable harm.”

Unfortunately, the ACA Code of Ethics does not define harm, which could conceivably encompass financial fraud, verbal abuse, sexual seduction or unjustified termination of employment. But even more noticeably absent is any explicit duty to warn or protect should a client self-disclose current or future intent to maliciously injure animals or elements of the natural environment. These are excluded from the category of “identified others.”

I would like to present the case that a species-centric definition of such “others” requires serious re-examination given a number of important developments:

  • Neurobiological research on animal consciousness and experiences of pain
  • The promotion of animal-assisted psychotherapy and counseling
  • The growth of the animal rights movement and increased attention to humane slaughtering practices
  • Greater awareness of the mental health benefits of animal companionship

In general, it appears contradictory, if not hypocritical, to employ animals as co-partners in counseling and therapy while not defending their welfare within the context of counselor-client relationships.

Extending our ethical considerations

Much of our profession’s ethics, such as the core value of autonomy, rests on the formal philosophy of Immanuel Kant. His theories taught that moral agents should be treated as ends in themselves rather than means to an end. Avoiding exploitative relationships, maintaining confidentiality, providing competent services, avoiding and correcting discriminatory practices, and respecting the rights of research participants all reflect the Kantian emphasis on the intrinsic value of the individual as an ultimately self-defining “who” rather than a “what.” Even the use of the term duty in ethical codes comes directly from Kant.

The injunction to recognize and respect the subjectivity of each client argues for the most basic ethical adage, “Do unto others as you would have them do unto you.” It also encourages those empathic insights and sense of “fellow-feeling” that are so crucial to the therapeutic alliance. You cannot act upon the Golden Rule without a basic recognition that others experience pain in ways similar to, if not identical to, you.

A similar idea underlies Martin Buber’s distinction between relationships based on the authentic “I-Thou” and the impersonality of “I-It.” That existential perspective has also shaped much of psychotherapy. In terms of psychopathology, the inability to experience interpersonal empathy often indicates narcissistic, sociopathic and antisocial personality disorders. Even Kant argued that cruelty to animals deadens feelings of compassion in people.

Unfortunately for animals, Kant did not extend his ethical considerations to non-human beings. Like most Enlightenment thinkers, he believed that only humans demonstrate the logical capacity and free will to act as moral agents. This line of thought was preceded by rationalist philosophers from Aristotle to Descartes, and metaphysicians from Plato to Judeo-Christian theologians who denied that animals possess consciousness or a soul.

But surely we as counselors should refute this perspective. For starters, the standard of full rationality and free will doesn’t entirely fit clients who are dealing with thought disorders, depression, developmental disabilities, schizophrenia and schizoaffective disorder, autism spectrum disorders, Alzheimer’s, states of intoxication or, for that matter, childhood and adolescence. Yet those whom philosophers ill-advisedly called “marginal human beings” enjoy full respect and protection under the ACA Code of Ethics.

Furthermore, current research in ethology, primatology, comparative neurology and consciousness studies increasingly demonstrates that moral consciousness is a difference of degree rather than kind. An increasing number of studies provide evidence for various dimensions of mental complexity across several species, including schema construction, tool making and use, abstract reasoning, self-consciousness and mathematical abilities. Highly social and mutually cooperative animals such as those that congregate in extended families, herds or troops demonstrate empathy, altruism, forgiveness, levels of ethical decision-making and perhaps that most social and moral emotion of all — shame. Examples include rodents, canines, elephants, chimpanzees, orangutans and baboons.

The evidence that animals experience pain is growing rapidly as well, even as it still generates considerable debate. Whatever one’s personal stance on this issue, modern animal-handling techniques recognize the importance of considering such questions in actual practice. The increased use of humane slaughter and hunting techniques, championed by Temple Grandin and others, is based on measurable indicators of suffering such as neurochemical stress reactions and learned avoidance of pain. The American College of Veterinary Anesthesiologists has also considered this matter deeply and issued a list of behavioral and physiological indicators of animal distress.

Protecting our counseling colleagues

Even more directly, the use of non-human beings as adjuncts or co-therapists is acknowledged under labels such as “animal-assisted activities” (AAA) and “animal-assisted therapy” (AAT). It has Young child receives animal-assisted therapy from counselor and doglong been noted that the simple companionship of domesticated animals helps reduce human stress levels, lowers blood pressure and elevates morale and feelings of well-being. Animal-based counseling practices take these benefits to higher levels. AAA and AAT currently employ a long list of species, including dogs, horses, rabbits, birds, reptiles and fish.

Section D of the ACA Code of Ethics (“Relationships With Other Professionals”) lays out specific obligations counselors have to their professional colleagues. The introduction to this section states in part, “Counselors develop positive working relationships … with colleagues to enhance services to clients.” Standards D.1.b. (“Forming Relationships”), D.1.d. (“Establishing Professional and Ethical Obligations”) and D.1.h. (“Negative Conditions”) carry these implications forward as well.

To pose the question directly, how have animals not served as colleagues to the counseling profession? From the development of behaviorist theories to clinical trials of psychotropic medications, from Harry Harlow’s experiments on social isolation with rhesus monkeys to neurosurgery studies on brain function, animals have been recruited to provide important insights into learning, sociability, substance and process addiction, and the proper use of psychopharmaceuticals.

In practice it seems difficult to defend any human counselor who employs non-human adjuncts yet fails to act on behalf of their welfare. The continuity and emotional bonding of the client-assistive animal relationship obviously depends on the health and longevity of the animal in question. In these sorts of relationships, animals are not interchangeable. Clients would surely suffer from grief reactions due to the sickness, injury or death of individual non-human companions or co-therapists.

Moral considerations aside, it’s self-defeating to ignore the documented and even predictive associations between animal torture and serious psychopathology. There are high levels of uncertainty in forecasting client violence, but a growing body of evidence links animal cruelty to antisocial personality disorder, antisocial personality traits, polysubstance abuse and potential for serial homicide. Malicious harm to animals also appears indicative of early childhood trauma, current domestic violence and developmental disabilities. Animal hoarding often symptomizes obsessive-compulsive or borderline personality disorders. The extent of these associations is so high that many states mandate psychiatric assessment for all individuals charged with violating animal cruelty laws.

Other considerations

Critics may object that an animal-protective policy fails to respect cultural sensitivities. So-called blood sports have enjoyed popularity around the globe. The animals involved in staged gladiatorial contests range from bulls and cocks to dogs, rats, fish and even insects. The most hotly debated example remains the corridas, or bullfights, that some have branded as sadistic but that proponents defend as central to Spanish and Mexican national identity. Fox hunting has raised parallel concerns in the United Kingdom. Animal racing and rodeos are subject to similar controversies.

Yet amateur and professional associations of hunters, anglers, circus owners, race course owners, rodeo and bull fight organizers and even pest exterminators have published ethical guidelines meant to minimize pain to creatures that are either used for sport or subject to systematic killing. Fans of corridas, for example, prize the “clean kill,” just as ethical hunters advocate the doctrine of “fair chase.” Fly fishers argue for “catch and release,” while the United Kingdom’s Masters of Foxhounds Association insists that quarry be “quickly and humanely dispatched.” If such organizations provide ethical protection for animals, why should the American Counseling Association lag behind?

It must be noted that attention to the welfare of animals does not guarantee empathy for fellow human beings. One of the strictest and most comprehensive pieces of governmental legislation in this area was the 1933 law on animal protection, enacted by the top leadership of Nazi Germany. Almost immediately after coming into power, the Third Reich banned vivisection and tail docking, animal trapping, the killing of wolves and inhumane slaughter practices. The Nazis also promoted public school education in support of these policies.

Thus, extending consideration to animals does not by itself ensure the ethical treatment of people. But with the ACA Code of Ethics so firm in its resolve to underscore the universality of human rights and welfare, this historical aberration need not determine the limits of moral discourse. To the contrary, it should encourage a greater respect for the variety and multitude of creatures that experience a demonstrable inwardness and subjectivity.

Considering animal welfare encourages more deliberate and contextual thinking about how counseling clients function within their own web of significant relationships that includes family, occupation, political structures, mental health care delivery systems and the natural environment. But the counseling profession, like so many others, generally operates in an urbanized society characterized by an increasing separation of people from nature. Consider that even in the “Dimensions of Personal Identity” document that used to be offered on the ACA website, relationships with biota were never specified. And the place of animals in people’s lives was barely touched upon in the CACREP-accredited program from which I graduated. Yet, ironically, ecotourism opportunities and appeals to travel to unspoiled wilderness areas are sometimes touted in advertisements for ACA annual conference sites.

What all of this argues for is incorporation of animal-related considerations into any future drafts of the ACA Code of Ethics. At the very least, it urges all counselors and counseling agencies to adopt specific policies within their practices. For example, under my personal “statement of clients’ rights” Dog being pettedthat each client signs after review, we list the standard reasons for violating confidentiality. But we also add the following: “Please note that if clients reveal current or intended malicious harm to animals such as torture or neglect, we will need to consider reporting such activity to law enforcement or animal protection agencies.”

To date, I have never had to violate confidentiality on the basis of any client self-disclosing deliberate and malicious harm to animals. But at the very least, the policy does serve as a reminder of the essential “creatureliness” that clients and clinicians share as we engage in treatment together. It also reminds us that the genuine love that clients and animals often share for each other offers a model for experiencing trust, deep connection, unconditional love, pleasure, play and perhaps even joy. Such a wellspring of healing deserves the protection of ethical principles and professional practices.

Perhaps ACA will eventually recognize this in formal policy terms, having missed the opportunity in the 2014 revision of its ethics code. Until that day, those of us in private and agency practice can move ahead on our own.

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Peter Wollheim is a licensed professional counselor in Idaho and the founder of Mental Health Boise. Contact him at peter@mhboise.com.

Letters to the editor: ct@counseling.org

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