Lecture 9 Ethical Decision MakingLaw for Counsellors

Kevin Standish

Learning outcomes

• To articulate a model of ethical decision making that counsellors can use in thinking through challenges they meet in their practice

• To base action that counsellors take, to be ethically justifiable to clients, the profession and society in general.

This lecture is based on

Towards ethical practice in counselling and psychotherapy

• moral principles that govern a person's behaviour or the conducting of an activity

• Ethics has been defined as ‘the science of morals’ and ‘is concerned with human character and conduct’ (Chambers, 1993).

• When faced with challenges or dilemmas, practitioners need to make decisions and take actions based on their professional obligation to provide adequate care and attention to clients.

• Practitioners will encounter a wide range of ethical concerns in the course of their professional life.

• Ethical mindfulness requires practitioners to identify their own contextually appropriate standards and to decide what decisions and actions to take

• Responses should be both considered and managed

What are ethical decision-making models?• Support and guidance should be drawn from one’s theoretical orientations,

and the ethical framework for good practice

• The model is a clear, rational framework through which effective decision-making can occur. The models draw on core principles and values held central to most helping professions

• While the BACP Ethical Framework outlines the ethical values, principles and personal qualities that represent and promote good quality practice, ……

• it is the responsibility of the counsellor to understand how these apply.

• The type of decision-making model that might help to address personal and professional matters is one that offers a multidimensional approach to dealing with the complex, diverse and conflicting aspects of human experience that are encountered in therapeutic work.

Identifying and dealing with ethical challenges and dilemmas• Counsellors will inevitably meet ethical dilemmas in their counselling

work, which might be small and subtle, or large and obvious.

• An ethical dilemma is regarded as a state of uncertainty or perplexity, especially requiring a choice between two equally unfavourable or favourable options, where a choice must be made.

• “What if” questions is one way of identifying ethical dilemmas in advance.

• For example, consider questions such as:

What if...my client decides they want to commit suicide and refuses to give me permission to break confidence?

What if...my client wants me to hug her/him?

A 10 step process model for ethical decision-making

1. Stop, think and identify the situation or

problem

2. Construct a description

3. Whose problem is

it?

4. Review in terms of the

Ethical Framework

5. Consider legal

requirements, moral

principles and values

6. Identify the support

that is available

7. Identify courses of

action

8. Select course of

action

9. Evaluate the outcome (with

the use of supervision )

10. Regularly check the personal

impact of these events

1. Stop, think and identify the situation or problem

2. Construct a description

3. Whose problem is it?

4. Review in terms of the Ethical Framework

5. Consider legal,moral principles and values

6. Identify the support that is available

7. Identify courses of action

8. Select course of action

9. Evaluate the outcome (with the use of supervision

where appropriate)

10. Regularly check the personal impact of these

events

A 10 step process model for ethical decision-making

1. Stop, think and identify the situation or problem

Stop, think, consider the facts and identify any feelings

and initial thoughts about the situation.

Check whether it is capable of resolution.

It may be helpful to discuss this stage with a supervisor or experienced colleague.

Address the issue directly with the client where possible first

2. Construct a description

• This important initial step helps to clarify the situation and minimise confusion.

• It is especially helpful to have formulated an outline of the situation before discussing it with a supervisor or experienced colleague.

• Essentially, this step of the process model identifies the contextual features of the issue or dilemma.

• For example, are there unique cultural, race, sexual identity, or other contextual features involved in the situation?

3. Whose problem is it?

The counsellor? ; The client? A joint problem? An agency/organisation problem?

Personal, professional and organisational features can all come into play and thus need to be considered in any decision-making processes. This step considers the ‘players’ involved and seeks to identify some of the relational features.

• Where there are complex relational features, consider questions such as:

• Who is involved in the situation?

• Who are the main players and stakeholders?

• What personal and/or professional issues do they bring to the situation?

• What values, assumptions, attitudes are/appear to be prevailing?

• What are the individual’s roles / responsibilities / obligations / expectations?

• Are there any relevant contractual or legal matters underlying this conflict?

• How might these help/hinder the situation?

• What are the individuals’ perceptions of the situation?

• Might there be any unspoken or hidden motives?

• What are the main points of tension, conflict or paradox?

4. Review in terms of the Ethical Framework and Legal requirements

• Consider all relevant sources of guidance including: The BACP Ethical Framework; appropriate Information Sheets and Guidelines for Good Practice; relevant legislation and literature.

Consider, if appropriate:

• What actions are prohibited/required according to professional ethics and practice guidance?

• What actions are prohibited/required by law?

• What actions are required in this working context?

• Reflect on these and also consult with a supervisor or practice consultant

• Identify any possible conflicts between ethical principles and the law and take advice on these

5. Consider moral principles and values• Moral principles provide a way of evaluating the

critical relationship, context and stakeholder dimensions of a given ethical and professional issue or dilemma.

• Moral principles and values can compete or conflict and reaching a decision on an ethical or professional issue can demand considerable courage and commitment on the part of the practitioner.

• It is important that the practitioner can clearly account for any decisions reached and actions taken.

• Ultimately, the practitioner has to live with their decisions and actions and deal with any associated personal or professional consequences

6. Identify the support that is available

• Identify who is available to offer support, guidance or other types of help (for example, supervisor/ supervisory consultant, colleagues, mentor etc);

• think about any other resources that can be drawn upon (e.g. the BACP Ethical Helpline).

7. Identify courses of action• Consider as wide a range of

options as possible;

• these can be reviewed, reformulated or discarded as appropriate.

• Depending on circumstances, this step will be carried out with the input, support and cooperation of the client/supervisor/experienced therapist colleague.

• Consider the impact and likely consequences of each action identified.

USE THE PROBLEM SOLVING APPROACH TO IDENTIFY THESE

8. Select course of action

Given the Contextual and relational features; Ethical and moral dimensions; Available literature; Review of the situation with supervisor(s) and therapy colleagues consider the following:

• What is the best, most appropriate course of action on this occasion?

• What are the likely consequences of action or inaction in the short, medium and long term?

• Consider what advice and guidance might be needed to help make a decision, and from whom.

• You need to have: 1. Justification: how would decisions be accounted for and

2. Universality: would a chosen course of action be recommended to others?

Would the chosen actions be followed /condoned if a colleague were to follow the same course?

9. Evaluate the outcome (with the use of supervision where appropriateWhen reviewing and assessing the outcome of decisions and actions, consider the following:

• Was the outcome as imagined or hoped for, or expected?

• Had all relevant factors been considered with the result that no new, or surprising, factors emerged?

• Would the same course of action be taken in the future?

• Feedback should be sought from a supervisor and colleagues asking them to suggest what, if anything, might have been done differently

• If the answer to any of these is unfavourable, consider what could be done differently should the situation arise again.

10. Regularly check the personal impact of these events

• Throughout the decision-making process practitioners should remember to check out from time to time how the situation is affecting them.

• Check out whether the situation has identified any skills or knowledge areas that need to be developed

• Depending on the impact of the situation, it might be useful to consider personal therapy

1. Stop, think and identify the situation or

problem

2. State the options

3. Review in terms of the Ethical Framework

4. Make a decision5. Implement the decision

6. Evaluate the outcome.

Summary chart

Reflect and learn: Personally and Professionally

Conclusion

• The ideas presented here are neither radical nor daunting –they simply invite and encourage practitioners to mobilise and develop their capacity for good quality work and to place client protection at the centre of helping relationships

• The Framework constitutes a reflexive and pragmatic approach to dealing with ethical and moral issues.

• This approach can help to contain some of the chaos and conflict that can be present in problematic situations.

• Clearly, the more complex the ethical issue, the greater the need for supervisory or consultative support.

Useful reading on EBSCO

Bond, T. (2010):

• chapter 15 ethical problem solving

• chapter 16 implications for practice

BACP P4 Information sheet

Core reading