Category Archives: ethics

June 16, 2009 · 12:40 pm

Ethics Codes and Christian Counselors


Last night was the last class session of my ethics and practicum orientation classes. In both places students were discussing matters related to mandated abuse reporting, dual relationships, and attitudes towards state and professional ethics codes.

Evangelical or conservative people tend to have several responses to ethics codes that I want to highlight here.

1. Fear. Actually almost every student has this reaction. The rules can be complex and their are vague rules about everything (barter, dual relationships, advertising, competency, etc) which may even seemingly contradict other rules. While they have been written to protect the client, following them often leads to both client and counselor having vulnerable feelings (i.e., abuse reporting rules) and feeling a bit out of control.

2. Rejection (or dismissal). One’s feelings about government regulation and whether submitting oneself to a secular agency (licensing board, professional organization) may tempt the counselor to think little of the codes. In particular, the heavy emphasis on avoiding dual relationships where possible seems wrongheaded to many ministry minded individuals. It would seem that sterile counseling relationships (no touch, no informality, no friendship, keeping mental health records, etc.) run counter to the values of brother/sister relationships in church settings.

3. Fastidiousness. Maybe this is really just as number one. But some respond to ethics codes by being ethics junkies. They fastidiously keep every iota and in so doing tend to suck the humanity out of the counseling relationship.

A better way?

The first time you face something completely new, fear is common. With repeated contact, comfort can develop. At least that is what I told myself after my 3rd statistics and research design class. Remembering that these rules are designed not merely to catch you doing wrong but to help protect you and your clients might help. The more you talk about them with others (including the spirit of the rule, not just the letter), the more you will relax.

Also, paranoia is not a good character feature for counselors. Thus, if you have a tendency to see the government as all bad all the time…if you think alarmist conservative talk radio is right from God’s mouth to your ear…if you look at every psychological ethics rule as anti-Christian, you may not be right for this field. In fact, such feelings may induce pride, arrogance and forgetting that the number one goal is avoiding client exploitation and increasing client protection (yes, even from themself).  Further, 1 Peter 2 reminds you to submit to your authorities and governments–even if they are harsh…so you can silence ignorant talk and not use your “freedom as a cover-up for evil.”

Finally, don’t forget to be human. Cross your t’s, dot your i’s but do it while showing concern for the person in front of you. Some of your ethical standards may seem foreign to others. A kind explanation can do wonders.

Hey, and don’t forget to seek out consultation and/or supervision. There is NO reason you should be going this path alone.

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Filed under biblical counseling, christian counseling, christian psychology, Christianity, counseling and the law, ethics, Psychology, teaching counseling

January 19, 2009 · 5:32 am

Things that scare counselors…


There are certain things that scare counselors. Some things are real, others are mere fantasies. Some are big scares others are smaller ones. When I teach ethics and we talk about liability, the tension in the room increases. When I teach about suicidal clients and the need for a proper response, the tension increases.

What do I fear? Not remembering a client’s name when I run into them in the public. I don’t think that has ever happened but I fear it nonetheless. More real is the fear of doublebooking, of walking into the waiting room and seeing two clients there for the same time. Now, that has happened to me and sometimes it has been my own fault. Even when it isn’t my fault, my stomach does a flipflop.

But now I have a new experience…being approached by a US gov’t official who flashes a badge and requests to speak to me in private about a matter. I had the feeling that one gets when the police car behind you starts flashing their lights. What did I do? Am I in trouble?

It turned out well however. After verifying his credentials and the release of information in hand, I learned a friend of mine was seeking national security clearances for his job. A couple of questions and the officer was on his way. Pheww…I’m not in trouble.

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Filed under Anxiety, counseling, counseling and the law, ethics

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August 25, 2008 · 10:29 am

When your ancestors might not be so great…


Back from vacation and back to the heat of Philadelphia. New England was quite cool and a bit wet this summer. We still had many good experiences nonetheless.

While at my parents I read two things at the same time: a 2 volume set of the Shaw genealogy (my maternal grandfather’s heritage) and a book by Colin Woodward: Lobster Coast: Rebels, Rusticators and the Struggle for a Forgotten Frontier. Below are my thoughts from reading both documents.

I like learning about my ancestors. In past visits to my parents I’ve read my paternal grandfather’s daily diaries (more like logs of activities). This time I read about my maternal grandfather’s ancestors (family name: Shaw) back to the first immigrants to Boston in the 1630s. After a couple short generations, some of the Shaws emigrated through Maine to the Maritime provinces. Someone in the family compiled quite a history and so I learned about the hardworking, Scotch/English/Irish families. Some were Anglican, others became primitive Baptist and still others were “Orserites.” I find it fascinating to see how families lived through diseases, lost many children in their youth, and made a life out of nothing. It is also clear that back then cousins married each other. Interesting… The most peculiar thing was a story of how a young white boy was “bought” from an Indian tribe and brought into the Shaw clan.

The Scotch-Irish families in Maine and the Maritimes may not have had the greatest integrity. I didn’t learn this from the family genealogy but from “Lobster Coast” noted above. This book detailed the settling of Maine and the subsequent mis-use of the natural resources in the Gulf of Maine. I learned greater details about the use of “Scotch-Irish” to settle the Maine coast. This ethnic group was considered a ruthless and independent people and so perfect for settling Main and dealing with the native tribes. Apparently the first white Mainers lacked integrity as they would make treaties with the local Indian tribes only to welch on the treaty whenever expedient. I didn’t know that in the mid 1700s most of white inhabitants were pushed out of the land after riling the Indians for the umpteenth time. When the Mainers fled to Massachusetts for saftey, they weren’t that welcome there as they were seen to be a rather foul-mouthed, drunken crowd. I didn’t get that information in the Shaw genealogy. While I’d like to believe my family was the upright exception, it makes one wonder…

I can see my nearly genetic connection to the Mass/Maine/New Brunswick area. Whenever I return, it feels like home, even when I didn’t live in eastern Mass.

Its easy to forget that our ancestors, though strong Christians, were likely involved in stealing land from the native Americans.I suspect those who know their ancestors enslaved African Americans (or at least benefited from slavery) feel this same sick feeling in the pit of their stomachs.

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June 9, 2008 · 11:43 am

Practicum/Ethics Monday: Multiple Relationships


All counseling ethics codes address the potential problem of multiple or dual relationships (when counselors have other relationships with their clients or former clients (e.g., counseling a friend or a child of a friend, having a former client as a business partner, etc.). Some codes make it appear that dual relationships are either always or likely wrong and so should be avoided. The AACC code is a bit more liberal in that it (rightly) defines the problem as increasing the problem of exploiting or harming the client. However, this code explicitly defends the biblical nature of dual relationships since we are all brothers and sisters of the same body. Other codes have recognized that it is not possible to always avoid dual relationships. But all codes remind the counselor that it is their duty to defend the healthiness of any dual relationship. In essence, it will be “guilty until proven innocent.”

There are 3 forms of dual relationships (sexual and client; nonsexual social and client; financial and client). Not every dual relationship is with the client (e.g., a counselor has a relationship with the mother of a teen client, a client is under discipline at your large church where you provide consultation to the elders). Dual relationships may happen AFTER counseling is over (begin a friendship with a former client). Finally, it is not merely harm or exploitation that may be the negative outcome of a dual relationship. A counselor may find that a dual relationship hinders or decreases her effectiveness to provide adequate care. [See Lamb et als article in the 2004 Professional Psychology: Research & Practice (35:3), pp 248-254 for a study on these issues].

This last one is the one I want to hang out with for a bit. I had a former client who I had known and highly respected before we started counseling. At the beginning we explored the potential harm that might come from this dual relationship. Both of us deemed that we could manage the slight dual relationship. And I think we did well and the client found the counseling helpful. However, there was a period in the counseling where the client became severely depressed and suicidal. I found myself less willing to hospitalize because I had an image of this client in my head that was much more stable than was actually true. Now, I never like or want to hospitalize. Most psych hospital stays provide protection but little more in the way of healing. But, I know I would have been much quicker to pull the trigger (bad pun I guess) if I hadn’t previously formed an opinion of health before starting the counseling relationship. We should not forget the possibility of reduced effectiveness in dual relationships.

Let me take this one step further. You may have a client who shares your same faith or doctrinal positions, graduated from the same school (but a different time). Any of these connections MIGHT cause you to be less effective in your work because of bias, groupthink, etc. These are not reasons to NOT counsel them but things to keep in mind. Reduced effectiveness because of dual relationships should not be neglected just because we are too busy talking about the rare counselor who decides to have sex with his clients.

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August 24, 2007 · 5:43 am

Justifying paternalism toward clients?


Got a newsletter this week that had an article about paternalism with clients who suffer with eating disorders. The author begins with this statement:

Some clients are pressured into treatement by family, friends or physicians. Other clients enter treatment willingly because they want to make changes in their lives, but those changes may not include their eating behaviors. Still other clients profess a cincere desire to change their eating behaviors, but only if they can be assured that they will not gain a pound. Virtually all clients are ambivalent about giving up their eating disordered behaviors, and some outrightly refuse to change these self-destructive patterns.

All clinicians who work with eating disordered clients are faced with an ethical dilemma: how to attend to the well-being of clients who resist recovery from a potentially life-endagering disorder, while respecting the clients’ right to autonomy and self-determination.”

How does a counselor balance individual autonomy with protection of health and life? The author tries to distinguish between weak and strong paternalism. Weak, she says, legitimizes  interfering in with the ways a person achieves a desired goal. Strong paternalism believes that some goals are confused or mistaken and thereby require intervention.

The author does a fine job talking about the challenge of allowing clients freedom and yet strongly encouraging clients in a particular direction. Really, this raises the issue of how do we “sell” something that client yet do not know that they want? Unfortunately, little in the way of helpful answers are given.

The problem with paternalism (I know what is best for you) is that it naturally leads to coercion. Coercion, even with a smile, rarely results in positive change. Instead, we need to talk to clients about choices. We need to do so early and often. They do have choices. Sometimes many, sometimes few. However, they have them none-the-less. Our job is to help them see the consequences, the benefits, etc. Some choices made will have specific and immediate consequences. If I choose to steal a car, I may be jailed and have my rights limited for a period of time. So too with some self-harmful choices. If a client wants to kill themself, then I have the right and responsibility to stop them. This is not paternalism but momentary protectionism. I do not claim that hospitalization is what is best, but I do claim that it will extend the life of a suicidal client. By extending their life, I am providing an opportunity to return to their choices and reconsider God’s gracious hand on them rather than act impulsively to deep pain.  

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July 5, 2007 · 10:39 am

Christian Counselor as Ethicist


In chapter 8 of Christian Counseling: An Introduction, Maloney and Augsbuger take on the issues of ethics. But they are not focusing on professional ethics codes of conduct. Morality and ethics play a part in every counseling session. They remind the reader that “value-free” therapy is not possible
and authenticity without pursuit of ideals is unwise. They see the focus on “effectiveness” as
shortsighted when it ignores values and ends.

The Christian counselor however should not attempt to obligate the counselee to particular set of morals. Instead of being prescriptive (focusing on the “oughts” or boundaries of acceptable behavior), the counselor ought to be illuminative (pointing out the reality of desires, choices, etc.). To make their point about the value of illumination, they re-tell the story of Carl Rogers’ response to a woman’s request to help her stop feeling guilty for wanting to have sex outside of marriage. The woman admits her conscience accuses her. Rogers says, “You want to go against your conscience and still feel good about it? That sounds like a pretty tall order to me.”  

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Filed under book reviews, christian counseling, ethics

June 4, 2007 · 11:37 am

Science Monday: Confidentiality and Teens


Tonight in my ethics class we will be discussing the concepts of privacy, confidentiality, and privileged communications. Such fun topics to scare the students with :).

Counseling teens presents a higher order of stress and confusion when it comes to confidentiality. When should a counselor break confidence with a teen and tell his/her parents something revealed in a session? If she smokes cigarettes? Crack? If he is having unprotected sex? Continue reading →

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May 28, 2007 · 5:12 am

Unscience Monday: Insane reporting rules


At last staff meeting, Diane Langberg reviewed some new rules for PA re: abuse reporting that she learned at a recent CE seminar. Some of these make your head spin.

1. Psychologists are mandated to report to child and family any child engaging in sex (not well defined) before age of 13. Okay, this is good.
2. However, if 14, then it can be consensual (and not reportable) if the other person is not more than 5 years older. This could be considered consensual.
3. If a 15 year, 11 mo child has sex with someone more than 5 years his/her age, it is statutory rape. However, if a 16 year old has sex with someone more than five years older, this can be consensual. So a 50 year old can have consensual sex with a 16 year old. And yet, a child is still considered just that until 18. Go figure. You can have sex with anyone, but you can’t smoke, drink, vote, or go to war. Do these lawmakers have teenage daughters?

There are some good changes in other parts of the law but these just boggle the mind.  

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Filed under Abuse, ethics

May 21, 2007 · 5:27 am

Science Monday: What is the best way to teach ethics to counselors?


Saturday marked the first class of my Ethics class. In honor of that, I want to use this space to talk a bit about the teaching of ethics. What is the best way to teach aspiring counselors the ins/outs of ethical care of their counselees. Here are some options: Continue reading →

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November 1, 2006 · 8:00 am

Should leaders confess sins to followers?


Just came from a conference with pastors where we were talking about rethinking leadership in light of the cultural changes that force us back the biblical images rather than those pervasive in the church growth models. I’ll summarize a few take-aways tomorrow but wanted to highlight part of our discussion of humble leadership. I made some comments regarding the need to be leading by example in the area of repentance. I stole someone else’s line: Why is it that those who love the Reformed doctrine of depravity aren’t commonly willing to share their own depravity (and repentance!) with their sheep. One person asked the common question regarding the health of having pastors and christian leaders confess their sins. Couldn’t it harm other’s faith? Here’s some of my thoughts.

1. Sure, having the pastor confess on Sunday am that he just masturbated the night before isn’t a good idea. However, sometimes raising the obvious problem with leader confession causes us to avoid doing much at all in our present life. We might confess our old sins, but less likely our recent ones.
2. The motive for leader’s confession must be more than his/her own benefit. Leader communication should be pastoral to the hearers. This excludes narcissistic, “look at me” confession.
3. If leaders have sins that are too big to confess to their followers, its probable that they either failed to confess and be accountable to more appropriate audiences (mentors, supervisors, colleagues, etc.). We get to the bigger sins because we let the littler ones slide or we deny their presence to self and other.
4. Leaders should begin to confess the sins that everyone knows they have and not get caught up in whether or not to confess the more hidden ones. Your followers can see your failings. Did you promise something and yet fail to deliver (and then blame others for the failure)? Did you show defensiveness in the leadership meeting? Arrogance? Knee-jerk assessment or pastoral care? Did you write off a follower as unteachable without enough time? Did you neglect a follower’s gifts because they threatened yours?
5. These kind of confessions may cause some who want perfect leaders to lose heart. But, I would argue that if not this, something else will cause them to lose heart. The vast majority will feel they have a leader who understands their weaknesses and will be more ready to accept the care offered in the future.
6. Some confessions will lead to being removed from ministry for a season. There is grace in forgiveness and not having a mountain made out of a molehill AND their is grace in forgiveness and being held accountable. We leaders need to exemplify both to others and pray that others will do the same for us.

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Filed under Christianity: Leaders and Leadership, ethics, Repentance, sin