Becoming an Ethical Helping Professional, with Video Resource Center

RITA SOMMERS-FLANAGAN, PhD, is Professor of Counseling and Director of Women's Studies at the University of Montana.JOHN SOMMERS-FLANAGAN, PhD, is Assistant Professor of Counseling at the University of Montana and a mental health consultant with Trapper Creek Job Corps. He also maintains a private practice.Rita and John are the authors of two previous texts: Clinical Interviewing, now in its fifth edition, and Counseling and Psychotherapy Theories in Context and Practice: Skills, Strategies, and Techniques, now in its second edition (both from Wiley).

• Acknowledgments xviiAbout the Authors xixAbout the Contributors xxiPreface xxiiiSection One: The FoundationOne Counseling Ethics and the Big Picture 3Chapter Orientation 3Defining the Terms 4Ethics and Morals 4Morality, Ethics, and Essence 5The Role of Ethics in the Professions 5The Role of Morality in Human Culture 6Are There Universal Morals? 9Tension between Relativism and Absolutism 9The Dialectic of the Moral Life 9Global Human Rights 11Moral Values, Rules, and Principles 12Professional Identity: Power and Peril 13Attributes of Professional Helping: Common Ground 14Professional Organizations and Associations 15And Who Is the Client? 16Chapter Wrap-Up 19Two Philosophical and Culture: Roots and Prisms 20Chapter Orientation 20Exploring Moral Philosophies 21Character or Virtue Ethics 24Defining Virtue 25Character Development 26The Golden Mean 26Rationality, Emotions, and Habits 27Doing the Right Thing 27Current Expressions of Character Ethics 28Deontological Ethics 28Kant and Moral Duties 29John Rawls and Social Justice 31Utilitarian or Consequentialist Ethics 32The Contributions of Jeremy Bentham and John Stuart Mill 33Current Adherents and Approaches 33Situation Ethics 34The Principles Approach 35Bioethics and Mid-Level Principles 36Alternative Cultural Views on Morality and Ethics 37Religion’s Interactive Relationship with Ethics 37Traditional Asian Ethics 38African Ethics 44American Indian Ethics 45Feminist Ethics and the Ethics of Care 48Chapter Wrap-Up 51Three Ethics Codes, Codes of Conduct, Employer Policies, and the Law 53Chapter Orientation 53Why Codes? 54Recognizing the Moral Dimensions of Professional Knowledge 54Legal Concerns and Fears as a Driving Force 55Functions of the Codes 56Distinctions between Codes and Laws 58Policies and Practices 59Policies within Schools and Agencies 59Standard of Care or Acceptable Practices 61Guidelines, Codes of Behavior, and Mission Statements 61Mission Statements 62Ethical Decision-Making Guides 68Decisions about Decisions 68Ethical Considerations in Crisis Counseling 71Using Ethical Principles to Guide Crisis Work 74Beneficence 75Nonmaleficence 76Justice 77Autonomy 77Fidelity 78Chapter Wrap-Up 80Four Professional Identity Development: Values and Definitions 81Chapter Orientation 81The Intricacies of Helping 82Why People Become Professional Helpers 83Motives for Helping and the Golden Mean 83The Intersection of Motivations and Values 85When Values Contrast in Interesting Ways 90When Values Clash 90When Shared Values Present Challenges 90Moral Sensitivity and Clinical Concerns 91Choices about Displaying Values 92Care for the Caring 93Anxieties That Are (or Should Be) Common to Graduate Students 94The Imposter Syndrome 96The Invisible Knapsack 97Burnout Awareness and Prevention 98Factors and Symptoms of Stress and Burnout 99Resilience and Hardiness 102Weaving the Strands Together 103Chapter Wrap-Up 104Section Two: The Day to Day Challenges Common to AllFive The Helping Relationship: From Beginning to End 109Chapter Orientation 109Before the Beginning 110Portraying Yourself and Your Services 110Officing Yourself 111Informed Consent and Informed Refusal 113Autonomy for All? 114Informed Refusal 116The Nuts and Bolts 119Legal Concerns 122Considerations for Particular Populations 122The First Session: Competency and Referral 126When Your Skills and Client Needs Do Not Match 128Technology Rears Its Ugly (Beautiful?) Head 130Ending Well 131Chapter Wrap-Up 134Six Confidentiality and Trust 135Chapter Orientation 135Confidentiality and the Therapeutic Relationship 136Professional Dimensions of Confidentiality 136Why Confidentiality? 138The Limits of Confidentiality and Their Evolution 140Categories of Exceptions to Confidentiality 141Protection of Self and Others 141Communication with Office Staff and Other Professionals 147Communication with Funding Sources or Third Party Payers 148Depositions, Subpoenas, and Court Orders 149Summarizing the Limits and Exceptions 152Technology and the Internet 152Particular Populations and Confidentiality Concerns 154Children and Adolescents 154Confidentiality Concerns in Families, Couples, and Groups 155Mandatory or Involuntary Clients 157Professional Record Keeping 157Chapter Wrap-Up 159Seven Boundaries, Roles, and Limits 160Chapter Orientation 160Introduction to Roles, Boundaries, and Relationship Rules 161Why All the Fuss about Boundaries and Relationships? 162Distinctive Aspects of Professional Helping Relationships 163Transference 164Countertransference 166Client Indignation or Relief 168Ethics Codes and Terms 168Boundaries, Roles, Timing, and Informed Consent 171Boundary Overlaps That Predate the Professional Relationship 172Boundary Overlaps During the Professional Relationship 174Postprofessional Relationship Boundary Considerations 175Practices and Techniques with Boundary Implications 176Gift Giving and Receiving 176Self-Disclosure 178Considerations about Touch 179Assessing Potential Benefit and Harm 179Little Communities, Big Boundaries? 182Romance, Sex, Love, and Lust 183Sex Before or After? 186Chapter Wrap-Up 187Eight Assessment, Evaluation, Testing: Peering Through the Right Lenses 188Chapter Orientation 188The Roots and Nature of Assessment 189The ABCs of Ethical Assessment 190Assessment Requires Judgment 190The Assessment Continuum 191Practitioner as Instrument 192Informed Consent and Confidentiality 192Multi-Method, Multi-Source Assessment 195Informal Assessment 195Observational Strategies 196Using Art and Drawings in Assessment 196Clinical Interviewing 197Assessment and Science 198Testing 199Formal Evaluations 201Psychological Evaluations 201Social, Learning, Career, and Need-Based Evaluations 202Diagnosis and the DSM System 202The Purpose of Diagnosis 204The XYZs of Ethical Assessment 206Be Mindful of Issues in Technology and Setting 206Use the Least Severe Diagnostic Label 206Recognize That All Assessment Procedures Are Flawed 207Honoring Client Perspectives 207Be Attentive to Diversity Issues and Potential Misuse 207Chapter Wrap-Up 210Nine Competence, Accountability, and Research: How We Know What We Should Know 211Chapter Orientation 211Competence: You’ll Know It When You See It? 212Defining the Minimal Boundaries of Competence 212Education and Training 213Supervised Experience 213State and National Professional Credentials 213Appropriate Professional Experience 214Specialties, Specialization, and Competence 214Ongoing Competence and Self-Assessment 215Competence, Accountability, and Research Evidence 217Counseling and Psychotherapy Outcomes Research 218Searching for Compromise: Evidence-Based Practice Principles 221Evidence-Based Mental Health Practice 222Evidence-Based School Counseling Practice 223Outcomes Research on Divergent Minority Groups 225Ethical Concerns in Research and Publication 226Research with Multicultural and Vulnerable Populations 227Research and Informed Consent 228Ethics in Qualitative, Quantitative, and Mixed Designs 229Ethical Concerns with Funding and Findings 229Research Topics: Choosing Wisely 231Chapter Wrap-Up 232Section Three: Specific Specialties and Professional IdentitiesTen Counseling in the Schools 235(By John Sommers-Flanagan, Nancy Bodenhorn, and Rita Sommers-Flanagan)Chapter Orientation 235Professional School Counseling 236The History 236The Transformations 237Why Are School Counseling Ethics So Challenging? 239A School Is a School Is a School . . . 240The Role and Function of the Professional School Counselor 245General Guidelines for School Counselors 246Confidentiality: A Common Conundrum 247Sexual Abuse 248Sexual Harassment 249FERPA, Records, and Sole Possession Records 249Informed Consent(s): An Increasingly Important Practice 250With and For Students 251For Parents 251Legal Concerns 252Subpoenas and Testifying 252Negligence 253Multiple Relationships: Many Hats, One School 253With Students 253With Colleagues 254Managing Consultation Relationships 254Assessment and Accountability 254Hot Counseling Topics and Concerns 255Counseling in the Event of an Unwanted Pregnancy 255Dangerous Behaviors: Sex, Drugs, Eating Disorders, and More 256Suicidal Threats or Behaviors 258Career Counseling and College Guidance 259Diversity Issues 259Working Ethically with Groups in Schools 260An Ethical Decision-Making Model for School Counselors 262Chapter Wrap-Up 262Eleven Psychotherapy, Mental Health Counseling, and Career Counseling 263Chapter Orientation 263Mental Health Counseling: Roots and Directions 264Distinguishing and Common Features Among Mental Health Professions 264Nature of Human Health and Distress 265Educational Backgrounds 265Terminology Distinctions 269Professional Organizations 270Issues in Agency and Independent Practice 271Health Insurance, Managed Care, and Fees 271Self-Pay Issues and Problems 275Confidentiality with Other Professionals 278Competence and Supervision 279Professional Representation 281Ethical Concerns in Career Counseling 283Speciality Competencies and Credentials 284Specific Ethical Concerns and Challenges 284Chapter Wrap-Up 286Twelve More Specialties: Families, Couples, Rehabilitation, Addictions, Pastoral 287Chapter Orientation 287Introduction: Why These Specialties? 288Couple and Family Therapy 289Definition and Origins 289Professional Identity 290Specific Ethical Concerns and Challenges 291Rehabilitation Counseling 295Definition and Origins 295Professional Identity 295Specific Ethical Concerns and Challenges 296Addictions Counseling 298Definition and Origins 299Professional Identity 300Specific Ethical Concerns and Challenges 300Pastoral Counseling 303Definition and Origins 303Professional Identity 304Specific Ethical Concerns and Challenges 305Beyond Specialty 307Personal Coaching 308Spiritual Direction 309Chapter Wrap-Up 310Thirteen Teaching, Mentoring, Supervision 312Chapter Orientation 312Alpha, Omega: Beginning and End 312Moral Philosophy and Professional Elderhood 314Deontological Dimensions 314Utilitarian Usefulness 314Character Concerns 315Teaching: The Transforming Force of Knowledge 316Client Welfare 316Teaching Competence 317Teaching Relationship 318Teaching and Technology 321Supervision: Undergirding and Oversight 322Client Welfare 323Supervision Dimensions and Competencies 324Multicultural Competence 327Supervisory Relationships 329Technology and Supervision 331Chapter Wrap-Up 331Epilogue 333A Life-Long Balancing Act 333No One Is Perfect 333Unreported, Unaccused, but Unethical 334If You Are Accused 334If You Know of Unethical Behavior 335Best Practices and Likely Concerns 336A Fond Farewell 337References 339Appendix A: Universal Declaration of Human Rights 367Author Index 373Subject Index 385About the Video Resource Center 393