Counselor Ethical Reasoning: Decision‐Making Practice Versus Theory

Counselors’ decision‐making processes have received little attention in the literature. The purpose of this study was to ascertain the ethical decision‐making practices of counselors working in the field. The results of a phenomenological study indicate that linear models and an orientation to professional ethical guidelines learned in graduate training serve as a foundation, yet not a practical guide, in professional ethical decision making. The authors found that 4 themes guide counselors’ ethical decision making: personal values, clients’ best interest, transparency in decision making, and perceptions of formal training and practice. Implications for practice and counselor education are provided, with recommendations for future research.     

Ethical and Professional Challenges Posed by Patients with Genetic Concerns: A Report of Focus Group Discussions with Genetic Counselors, Physicians, and Nurses

Ninety-seven physicians, nurses, and genetic counselors from four regions within the United States participated in focus groups to identify the types of ethical and professional challenges that arise when their patients have genetic concerns. Responses were taped and transcribed and then analyzed using the Hill et al. (1997, Counsel Psychol 25:517–522) Consensual Qualitative Research method of analysis. Sixteen major ethical and professional domains and 63 subcategories were identified. Major domains are informed consent; withholding information; facing uncertainty; resource allocation; value conflicts; directiveness/nondirectiveness; determining the primary patient; professional identity issues; emotional responses; diversity issues; confidentiality; attaining/maintaining proficiency; professional misconduct; discrimination; colleague error; and documentation. Implications for practitioners who deal with genetic issues and recommendations for additional research are given.     

Counselor Empathy; Religiosity; and Lesbian,Gay, and Bisexual Perspectives

Values-based conflicts, such as between counselor religiosity and ability to work with lesbian, gay, and bisexual (LGB) clients, can present a challenge for counselors and trainees who seek to provide ethical and competent care. Because empathy can facilitate understanding a client's frame of reference, the authors examined the relationships between counselor religiosity, empathy, and LGB perspectives, as well as the potential mediating effects of empathy on values conflicts. The authors discuss implications for counselor education and practice.     

A Qualitative Analysis of Home‐Based Counselors' Experiences in a Rural Setting

This qualitative study sought to understand the experiences of home‐based counselors working in a rural setting. In‐depth interviews were conducted with 12 counselors who were asked to describe their experiences in the areas of preparedness, professional development, challenges, and gender‐specific experiences. Fourteen coding categories emerged from the interviews, which led to the findings of 3 overarching themes: shared isolation, ethical ambiguity, and the high‐intensity nature of the job. Recommendations for home‐based counselors, agencies, and professional counseling associations are discussed.     

The Use of Touch in Counseling: An Ethical Decision‐Making Model

Although some counselors have advocated for the limited use of touch in counseling, others have argued that touch has no place within the counseling relationship. Despite the controversy, the use of touch has been shown to have a number of therapeutic benefits; however, there are few ethical decision‐making models that are appropriate for considering the use of touch in counseling. The authors discuss the controversy surrounding the use of touch and the benefits/contraindications of touch. The 5 ethical principles of counseling are also examined; a new ordering of the principles is presented as a useful ethical decision‐making model when considering the use of touch in counseling.     

A Path of Counselor Self‐Awareness

This article explores self‐reflection and self‐awareness from an ethical standpoint, proposing that counselors have a responsibility to themselves, their clients, and the profession to engage in these practices. The authors propose a path to counselor self‐awareness and a 2nd process that assumes counselor mastery.     

An Ethical Decision‐Making Model to Determine Authorship Credit in Published Faculty–Student Collaborations

Publishing research is imperative to both counselor educators and students in counseling programs. Furthermore, faculty–student publication collaborations can often be a mutually beneficial professional endeavor. However, determining order of authorship can be a complex ethical issue. The authors review prior research to illustrate the complexities of authorship and suggest a decision‐making model and considerations for preventing and resolving these ethical dilemmas. Implications for counselors include future research studies on complex issues regarding authorship of faculty–student collaborations, future incidence studies investigating occurrence of ethics violations, and incorporation of publication ethics into course work in counselor education programs.     

Conflicts Between Ethics and Law in Counseling and Psychotherapy

Codes of ethics are designed to guide and govern the behavior of the professional for whom they are written. In such fields as counseling, psychology, and social work, ethical standards are necessary to protect clients, guide professionals, safeguard the autonomy of professional workers, and enhance the status of the profession. Sometimes, however, the professional worker finds that the ethical standards of the profession seem to be in conflict with the law. These conflicts may arise in such areas as advertising, confidentiality, and clients' rights of access to their own files. The authors discuss the nature, ramifications, and implications of ethical-legal conflicts in the helping professions.     

counselors' collective self‐esteem mediates job dissatisfaction and client relationships

Given the central role of professional identity (i.e., collective self‐esteem in this study), the authors examined whether collective self‐esteem mediated or moderated relations between job dissatisfaction and client relationships in a sample of 132 professional counselors in the United States. Results indicated that collective self‐esteem partially mediated the relationship between job dissatisfaction and client relationships. Furthermore, job dissatisfaction was negatively related to greater levels of private collective self‐esteem, and greater private collective self‐esteem was positively related to better client relationships.     

Professionalism,Ethics, and Value‐Based Conflicts in Counseling: An Introduction to the Special Section

This introduction to this special section of the Journal of Counseling & Development explores the importance of a code of ethics to the establishment and maintenance of a profession. Recognizing a code of ethics as a communication of a profession's collective values and expectations, the editors of this special section acknowledge the dilemmas that arise when a counselor's personal values do not align with the profession's collective values. The authors of each article address value‐based conflicts in counseling.     

Multicultural Counseling and Intrapersonal Value Conflict: A Case Study

The internal conflict between professional and personal values that counselors can experience when working with clients whose culture and values are different from their own is discussed. This is not a conflict between the counselor and the client, but is a conflict experienced within the counselor who is attempting to help resolve problems within the client's frame of reference, or worldview. A case study is presented that illustrates the senior author's experience in coping with a specific value conflict. It is suggested that as counselors become more proficient in multicultural counseling and more able to promote decision making from another's point of view, feelings of internal conflicts will decrease. Means of decreasing the likelihood of value conflicts are offered.     

Accepting Fallibility: A Model for Personal Responsibility for Nonegregious Ethics Infractions

The profession's ethics standards require counselors to self‐monitor their professional actions and take responsibility for misconduct. However, the professional literature has focused on preventing misconduct and on response to serious violations and has offered little guidance regarding the minor infractions that all professionals are vulnerable to committing during their careers. The author presents a 4‐element model to guide counselors in ethically repairing damage when they recognize they have violated ethics codes or ethical principles in minor ways. The model uses the ethical principles that underlie the American Counseling Association's (1995) Code of Ethics and Standards of Practice and J. R. Rest's (1983, 1994) model of moral behavior as a foundation.     

The Role of Innocent Guilt in Post‐Conflict Work

The phenomenon of ‘innocent guilt’ regards cases where people feel guilty without being responsible for the wrongdoing or suffering at which the guilt is directed. The aim of this article is to develop a consistent account of innocent guilt and show how it may arise in the aftermath of conflicts. In order to do this, innocent guilt is contrasted with guilt and collective guilt, and the account is substantiated by drawing on the writings of Ludwig Wittgenstein and Emmanuel Levinas, who both consider the phenomenon of innocent guilt a necessary element in the fundamental structure of the ethical subject. These thinkers, furthermore, show a connection between guilt and possible victims of wrongdoing, rather than between guilt and personal acts of wrongdoing. Innocent guilt may thus appear in the aftermath of conflicts as an ethical and emotional response to the fact of finding oneself in a post‐conflict situation still marked by suffering. It thus reveals a fundamental need to contribute to the relieving of such suffering.     

Reconciling Spiritual Values Conflicts for Counselors and Lesbian and Gay Clients

Counselors and lesbian and gay clients experience parallel values conflicts between religious beliefs/spirituality and sexual orientation. This article uses critical thinking to assist counselors to integrate religious/spiritual beliefs with professional ethical codes. Clients are assisted to integrate religious/spiritual beliefs with sexual orientation.     

Student Counselors' Moral,Intellectual, and Professional Ethical Identity Development

Professional identity is characterized by the integration of individuals' professional and personal selves. The authors used a multiple regression design to examine counselor professional ethical identity development, with specific attention to moral and intellectual development. Student counselors (N = 59) completed the Modified Subject‐Object Interview (Monson & Hamilton, 2010 ), Defining Issues Test–2 (Rest, Narvaez, Bebeau, & Thoma, 1999a ), and Learning Environment Preferences scale (Moore, 1987 ). Moral development was the most significant predictor of professional ethical identity development. Preparatory and research strategies to enhance professional ethical identity formation are discussed.     

Critical Race Theory as a Decisional Framework for the Ethical Counseling of African American Clients

The authors introduce critical race theory as a decisional framework for ethical counseling, with a focus on racial disparities when working particularly with African American clients. The authors provide a fictional case example that explains how this framework can be implemented when conducting cross‐cultural counseling with African American clients. Implications for counselors are provided.     

End‐of‐Life Care: An Overview for Professional Counselors

Although “End‐of‐Life Care for Terminally Ill Clients” is a section of the ACA Code of Ethics (American Counseling Association, 2005), neither the Code nor the counseling literature provides much direction for counselors who work with clients who are dying and with the clients' loved ones. The authors provide counselors with an overview of the issues that may be relevant when working with such clients.     

论医务社会工作中的价值观冲突和伦理困境

医务社会工作遵循着社会工作专业的一般价值观和伦理守则,并在此基础上,发展出其特有的价值观和职业伦理。对医务社会工作实践中的价值冲突和伦理困境及解决这些难题的指导原则等问题进行探讨,以期使医务社会工作者对工作实践中可能遇到的相关问题有初步的认识,并为他们在行动决策时提供参考和借鉴。     

A Cross‐Cultural Exploration of Perceptions of Altruism of Counselors‐in‐Training

This study explored altruistic development as perceived by counselors‐in‐training from diverse cultures. Twenty‐two counselors‐in‐training from 4 countries participated in semistructured interviews about altruism. Using consensual qualitative research methodology, the authors identified 6 domains: biological, cognitive, social learning, religious/spiritual, counseling, and empathy. Findings and implications for counselor education are discussed.     

A survey of genetic counselors' strategies for addressing ethical and professional challenges in practice

There is limited research about ethical and professional dilemmas that genetic counselors encounter in their practice and their strategies for addressing them. In this study, 454 genetic counselors rated the frequency with which they encounter each of 16 ethical/professional challenges identified and categorized previously (McCarthy Veach P, Bartels DM, LeRoy BS (2001) J Genet Couns 10(2):97–119). Over 40% indicated these issues occurred frequently: patient emotions, diversity, financial constraints, uncertainty, and colleague error. Two hundred and fifty-five respondents provided personal anecdotes describing exceptionally challenging situations and recommended strategies for addressing them. Most of their anecdotes involved informed consent, value conflicts, confidentiality, colleague error, withholding information, and resource allocation. The most frequently recommended strategies were further discussion with patient, consultation with other professionals, and referral to other health sources. Thirty-five respondents were unable to/did not offer strategies. Respondent demographics were not related to frequency of issues, type of anecdote, or recommended strategies. Practice, policy, and research implications are discussed.