WHEN ARE COUNSELLORS AT RISK OF ETHICAL MISCONDUCT?

Dr. Cristelle AudetDr. Glenn Sheppard

Canadian Counselling and Psychotherapy Association

Annual Conference

May 14-17, 2013

Halifax, Nova Scotia

OVERVIEW

• Ethical practice & fiduciary relationship

• But…misconduct happens

• Working outside areas of competencies

• Unintentional awareness

• Identifying ethical vulnerability

THE BASIS FOR ETHICAL PRACTICE

Intentionality

Knowledge of ethics, standards, the law, and school board policy

Skill in making ethical decisions

Courage to act on our ethical obligations

Tolerance for ambiguity

NATURE OF COUNSELLOR-CLIENT RELATIONSHIP

Fiduciary Relationship

Counsellors have a fiduciary duty to their clients.

It is “a relationship in which one person is under duty to act for the benefit of the other on matters within the scope of the relationship.”

A fiduciary is “one who owes to another the duties of good faith, trust, confidence…one who must exercise a high standard of care…” (Blacks Law Dictionary 1999)

NATURE OF COUNSELLOR-CLIENT RELATIONSHIP (cont’d.)

ETHICAL MISCONDUCT

In the US…• 6 - 10% counsellors affected

Nuekrug et al. (2001)• 34 states report 1,018 complaints• Inappropriate dual r/s (24%)• Sexual r/s with client (7%)• Breach of confidentiality (5%)• Failure to report abuse (1%)

COMPLAINTS

Theme

Informed Consent & Client Confidentiality

• Couples counselling

Boundaries • Working outside areas of competency/expertise

• Socializing the therapeutic encounter

• Multiple roles/multiple clients

COMPETENCE

“Render counselling services to a degree

of skill and knowledge commonly applied

under all circumstances in the community

by the average prudent reputable member

of the profession.”

BOUNDARIES OF COMPETENCE

Counsellors limit their counselling services and

practices to those which are within their

professional competence by virtue of their

education and professional experience, and

consistent with any requirements for provincial

and national credentials. They refer to other

professionals, when the counselling of clients

exceed their level of competence.

CCPA Code of Ethics, 2007

COMPROMISED JUDGEMENT

• Gap in professional knowledge

• Personal issues / wounded healer / burnout

• Unconscious, feeling-based actions not sufficiently accounted for

SELF-AWARENESS EXERCISE:Identifying Potential Vulnerability

(Brennan, 2009)http://www.counselingoutfitters.com/vistas/vistas09/

Article_13_Brennan.pdf

Conscious good intention

Preconscious/unconscious needs, wants, motivations

GOAL: Identifying PAST developmental themes

TASK: Apply 2 adjectives/phrases to each period

• Childhood• Adolescence• Adulthood to this time

GOAL: Identifying PRESENT developmental themes

TASK: Apply 2 adjectives/phrases to each period or position of adulthood

• Professional identity• Personal/intimate identity• Social identity

GOAL: Identifying HOT issues

TASK:

• What events or issues arouse your passion?

• What kinds of people raise your blood pressure?

• What kinds of clients make you sad?

Based on the above: What kinds of clients or issues are most likely to raise a red flag for you?

GOAL: Identifying COLD issues

TASK:

•What events or issues leave you cold, uncaring, without any passion?

•What kinds of people induce boredom, lethargy, lack of concern or interest?

Based on the above: What kinds of clients or issues are most likely to raise a red flag for you?

MECHANISMS OF IMPAIRMENT

Countertransference

• Feelings toward client triggered by counsellor’s past

Splitting

• Mental process enabling the co-existence of two separate yet competing desires

High Risk Situations =

Developmental theme + HOT/COLD issue + countertransference

OR

Developmental theme + HOT/COLD issue + splitting

“PREVENTION”

Focus on feelings, fantasies, personal historyAnalyze occurrences of countertransferenceIdentify areas where ethical violations are most likely

to occurProcess/consult in individual or group supervisionMaintain an ethics notebook/journalConnect with an ethics mentorMove beyond rule-based discussionBe open to feedback

RESOURCES

http://www.ccpa-accp.ca/en/resources/

•CCPA Code of Ethics•CCPA Standards of Practice for Counsellors•Ethics Casebook•Notebook on Ethics•FAQ 7. Ethics