Some ethical dilemmas in counselling and counselling research

This paper raises a number of dilemmas in relation to the ethical practice of counselling, counsellor training and research and evaluation of counselling which reflect the author's increasing concerns about therapeutic ethics. A number of relevant issues are explored to develop awareness and understanding of ethical matters, though this is in the spirit of exploration and inquiry rather than having definitive answers to offer. These issues include: use of training videos of therapists with real clients; informed consent; how research and evaluation changes the therapeutic process; how sensitive and ongoing consent for counselling and counselling research could be best obtained; publication of research in ways that respect the research participant; and the value and implications of the new British Association for Counselling and Psychotherapy ethical framework. Finally, the concept of 'ethical mindfulness' is considered as a creative, if demanding, response to a concern to be ethical in research and practice.     

Counselling at a distance: Challenges and new initiatives

Traditional views of the possibilities of counselling at a distance, mediated by telecommunications technology, are challenged. The current status of telephone counselling is reviewed- it is proposed that the telephone is a vibrant innovative medium for therapeutic work. Computer involvement in therapeutic work is defined, and the issues confronting computer-mediated therapy are contrasted with developments in computer-supported co-operative work. It is concluded that active collaboration between therapists, social scientists and computer scientists is required to develop therapy-specific computer applications to mediate in therapy-at-a-distance.     

Ethical Concerns of Nonclinical Forensic Witnesses and Consultants

Current research suggests that nonclinical forensic psychologists[sup1] are appearing increasingly more often in the legal arena. We argue that many of the ethical dilemmas that face these psychologists differ from those encountered by clinical forensic psychologists. To test the accuracy of this assertion, 37 nonclinical forensic psychologists were surveyed to identify some of the ethical issues and dilemmas they have encountered while engaging in expert testimony or pretrial consulting. Respondents were asked also about how they have resolved these ethical issues and whether they were aware of the "Specialty Guidelines for Forensic Psychologists" (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Results of the survey are discussed in terms of the need for additional regulatory guidelines or professional standards that speak directly to the ethical issues confronting nonclinical, forensic expert witnesses and consultants.     

Ethical Issues in Counselling in Education

It is suggested that there are two quite distinct Systems of ethics and practice in use by counsellors in education: the integrated model, which emphasises viewing the counsellor-institution relationship as theprimary ethical perspective; and the differentiated model, which emphasises the counsellor-client relationship as the starting point for an ethical understanding of the counsellor's role. The implications of these two perspectives for ethical issues relating to sources of referrai, issues of confidentiality, accountability for resources, the implications of role diffusion, and the outcomes of counselling, are examined. The ethical consequences of viewing the two Systems as reconcilable or incompatible are explored.     

What anorexic and bulimic patients have to tell: the analysis of patterns of unconscious conflict expressed in stories about everyday events

The development of European associations for counselling and psychotherapy raises questions about the challenge of producing pan-European statements of professional ethics. This article explores the range of ethical predispositions associated with different cultures to be found in Europe before examining how the European Association for Counselling and European Association for Psychotherapy have responded to this diversity. Recently produced ethical statements are examined in some detail. Both are found to be compatible with some of the culturally endorsed ethical predispositions to the exclusion of others. the article concludes by suggesting some of the issues that need to be considered in constructing a truly European ethic for counselling and psychotherapy.     

The student counsellor as a team member

Describing the future roles and services of British counsellors in higher and further education must not be done in professional isolation. We need to consider how the future roles of professional counsellors will positively affect the counselling done by academic staff Furthermore, rather than making generalisations about counselling needs, it may be better for working parties or task forces to develop counselling models which are appropriate to particular institutions. Such task forces should address some of the pressing issues confronting academic institutions: for example, (1) the revitalisation of the curriculum; (2) the improvement of the out-of-classroom relationships between academic staff and students; and (3) the development and maintenance of effective systems of academic government. If counsellors are to develop services which will help to resolve some of the problems associated with these issues, they will have to be increasingly clear about their own values.     

Ethical Issues in Marital and Sexual Counselling

RELATE's marital and sexual counselling generates ethical issues relating to the welfare of client couples and to the policy and public profile of the organisation itself. These issues are interactive and create a unique context within which volunteer counsellors work. Clients' private lives and relationships remain the prime focus of that work, but special attention is paid to the private aspects of relationships which impinge on the realities and the obligations of social living.     

The counsellor as researcher: Boundary issues and critical dilemmas

Some of the ethical issues that emerged during a study of adult male survivors of childhood sexual abuse are reviewed Some cases where boundary issues became problematical, and the dilemmas faced in working within a person-centred, qualitative approach, are discussed. Considerations for counselling researchers and their trainers when undertaking research are examined     

Barriers and challenges in the practice of multicultural counselling in Malaysia: A qualitative interview study

Counsellors face a lot of problems and stressors in their daily lives. As a person, counsellors may face challenges to deal with their personal expectations and responsibilities in life, work, family and community. As a professional, counsellors may face difficulties in dealing with professional issues and ethical dilemmas in their professional practice such as countertransference and value conflicts. These raise issues concerning their perceived multicultural competence and the adequacy of their training. Informed by a multicultural counselling perspective and drawing on semi-structured interviews with 12 professional counsellors in Malaysia, this study discusses the types of barriers and challenges faced by Malaysian counsellors and how these challenges were manifested and addressed in the cross-cultural counselling sessions. Results revealed five emerging themes based on participant counsellors’ responses on the barriers and challenges encountered in their practice of multicultural counselling in Malaysia. These were challenges related to counsellors’, clients’, presenting issues’, third-party and specific contexts’ characteristics. Research implications for the education and training of counsellors in the specific Malaysian socio-political context are also discussed.     

Professional and ethical dilemmas experienced by counselling supervisors: The impact of organisational context

This paper examines the ethical and professional dilemmas faced by counselling supervisors working in a range of diverse organisational contexts. Questionnaires and interviews were used to explore supervisor experiences of working in counselling agencies, industry, education and health service settings. Ethical and professional dilemmas outlined by supervisors were examined in connection with their role within the organisation. It was found that both external and ‘in‐house’ supervisors were exposed to dilemmas focused around issues of responsibility, confidentiality, boundaries, professionalism, relationships, contracts and ethical practice. Supervisors were divided in their opinions about playing a more active, educative role within organisational systems. There was considerable support for the construction of more explicit relationships between supervisors and their employing organisation.     

Ethical Practices and Beliefs of Psychopathology Researchers

Ethical guidelines are vague concerning how situations should be handled when researchers encounter participants in preexisting psychological distress. Ethical issues of beneficence, autonomy, and the nature of informed consent may arise in these situations. This study investigated the ethical practices and beliefs of 84 psychopathology researchers when confronting research participants in distress. Results indicated that psychopathology researchers in general engaged in diverse ethical practices in providing debriefing, treatment referrals, and providing for distressed participants. Characteristics of the designated studies and of the researchers accounted for significant differences in ethical practices. In addition, the type of psychopathology being assessed accounted for significant differences in ethical practices and beliefs. Guidelines are offered to aid researchers who encounter participants in preexisting distress.     

Ethical practices and beliefs of psychopathology researchers

Ethical guidelines are vague concerning how situations should be handled when researchers encounter participants in preexisting psychological distress. Ethical issues of beneficence, autonomy, and the nature of informed consent may arise in these situations. This study investigated the ethical practices and beliefs of 84 psychopathology researchers when confronting research participants in distress. Results indicated that psychopathology researchers in general engaged in diverse ethical practices in providing debriefing, treatment referrals, and providing for distressed participants. Characteristics of the designated studies and of the researchers accounted for significant differences in ethical practices. In addition, the type of psychopathology being assessed accounted for significant differences in ethical practices and beliefs. Guidelines are offered to aid researchers who encounter participants in preexisting distress.     

Modern medicine and biotechnology: an ethical conflict of interest?

When confronting the issues related to developments in modern medicine and biotechnology, we must repeatedly ask ourselves anew what can and cannot be justified in an ethical sense. For radically new ethical questions seem to arise through innovative techniques such as stem cell research or preimplantation diagnosis — and with them new areas of conflicting interests. If one scrutinizes the previous positions related to this subject, it becomes conspicuous that a multitude of questions has quickly piled up — however, (as in the case of Germany) comprehensive and differentiated views have mostly been lacking. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Some uses of simulation in an in-service counselling training programme

In an in-service, pre-professional training programme offered in Gwent, a variety of simulation techniques are used to promote an understanding of the core facilitative conditions of counselling and to enable participants to experience their importance in counselling situations. In this paper, eight specific simulation techniques are described in terms of their objectives and procedures. The advantages and disadvantages of each technique are explored. Teaching and ethical issues raised through the use of such simulations in training programmes at this level are also discussed.     

Audiographic communication for distance counselling: a feasibility study

To explore the feasibility of conducting counselling or therapy that involves image making via the Internet, and simultaneously to identify new issues to consider when implementing online counselling services, 10 people selected for their relevant expertise were invited to use an audiographic telecommunication system and to comment on it. Content analysis of focus group discussions and interviews yielded the following significant issues: (a) concerns about technical failure, (b) relevance for people with disabilities, (c) the need for clinical procedures and communication guidelines, and (d) lack of shared physical presence. The co-researchers considered this form of distance delivery to be viable, and identified parameters that would ensure safe and ethical delivery. Implications for practice and future development are discussed.     

Research as therapy, therapy as research: Ethical dilemmas in new-paradigm research

Ethical dilemmas are raised by changes in research paradigms which encourage the development of a relationship between researcher and participant. In such contexts it becomes increasingly difficult to tell the difference between a therapeutic relationship and a research interview. The rapid development of research within the therapeutic world of counselling and clinical psychology poses further ethical issues relating to the use of clients as participants in research studies. It is concluded that there must be an increased awareness of these issues and a need to accept responsibility for relationships with both participants and clients.     

Ethical Issues in Counselling and Pastoral Care

The historical and contemporary context of pastoral care and counselling within the judaeo/Christian tradition is reviewed. Three kinds of pastors who use counselling in their work - Christian, specialist, and generic - are identified and the ethical problems of their positions clarified. The ethical principles of autonomy, beneficence, non-maleficence and justice are applied to the counselling work of pastors. Theology's definition of various ethical levels, and the impact of these upon the professional ethics of pastoral carers and counsellors, are explored, and some conclusions for the future drawn.     

Prädiktiver Gentest für Chorea Huntington

The development of predictive tests for genetic diseases such as Huntington’s chorea, not only raises new ethical and psychosocial issues for people at risk for genetic diseases, but also poses a challenge for the professionals treating them. The number of patients facing these issues will grow considerably with future advances of the human genome project. While there is general agreement among geneticists and neurologists that concurrent psychosocial and psychotherapeutic counselling for patients considering getting tested should be a prerequisite for predictive test-ing, much less agreement exists in the field of psychotherapy on the form and content of psychotherapeutic counselling for patients with a genetic risk factor. By their very nature, hereditary genetic conditions are a family affair. Whatever the test result will be in the end, it will have repercussions on other family members. In conse-quence, this article argues in favor of a counselling approach that is family and re-source oriented. From their experience with a collaborative treatment project, the authors present the major topics which psychotherapists need to address when working with patients at risk.     

Challenges to providing a support group for HIV-positive prisoners in South Africa

In prison populations around the world, the prevalence of HIV is often higher than that of the general population. The prison population is at high risk for HIV infection, particularly through the sharing of contaminated needles and high-risk sexual activity. Counselling is regarded as a key element in the prevention and treatment of HIV infection. Support groups provide essential supportive counselling for HIV-positive individuals struggling to cope. This paper looks at the challenges to providing a support group for HIV-positive prisoners. The author's experience of attempting to provide a support group highlights two key challenges: organisational issues which lead to disruptions for the group; and challenges to ensuring confidentiality, a core ethical principle in HIV counselling.     

Ethical beginnings: Reflexive questioning in designing child sexuality research

Background: Counselling young children referred for sexualised behaviour can challenge therapists' ideas about childhood and sexuality. This area of practice is complex and sensitive, and calls upon collaboration with a range of significant adults in children's lives. Purpose: This paper examines a researcher's process of movement from counselling practice into qualitative research practice, and the use of reflexive questioning to explore ethical issues within the study. Design: Shaped by social constructionist ideas and discourse theory, ethical questions are outlined within the design stage of a doctoral research project on sexuality in children's lives in Aotearoa New Zealand. Limitations: This paper explores ethics in the design of a current study: there are no results or conclusions.