Ethical Dilemmas in Counseling - Research Paper Example

 Ethical Dilemmas in Counseling: Working with Diverse Clients Introduction Counseling is one of the most essential aspects of mental health care. It helps resolve emotional and mental issues which can eventually make a difference in a client’s health and well-being. There are however, various ethical issues which surround the counseling process. These ethical dilemmas often make a difference in the approach used by the counselor and the eventual recovery of the client. Clients however can also be diverse. They may be of varying cultural or ethnic backgrounds and such diverse backgrounds can also impact on the counseling process. This paper shall discuss the different ethical dilemmas in counseling focusing on working with diverse clients. Various scholarly studies and researchers on the topic shall be evaluated for this study in the hope of coming up with an academic evaluation of this subject matter. Discussion In a paper by Sadeghi, Fischer, and House (2003), the authors discussed how the lack of culturally sensitive materials taught in counseling programs can make multicultural counseling ineffective. Many counseling programs which are taught to counselors still do not consider the issues which refer specifically to ethnic minorities (Sadeghi, Fischer, & House, 2003). In instances when the counselors are not properly trained and equipped with the expertise to handle multicultural or multiethnic clients, they cannot also deal with or interpret the client’s situation with racial and ethnic sensitivity. One dilemma is when the counselor fosters independence in the client in order to deal with problems and conflicts. Setting forth this solution is not a welcome solution for some clients when the latter’s culture relies on a collective approach to solving problems (Sadeghi, Fischer, & House, 2003). Western culture, admittedly, focuses on a person’s independence, individualism, empowerment, and on taking responsibility for one’s own life. However, in some Asian cultures, this is often not sound advice because they are family-centric and they are collective in their decision-making and in handling their problems and issues. An American counselor advising an Asian client must not allow his personal preferences and what he has been taught in counseling programs to dominate his session with his client (Sadeghi, Fischer, & House, 2003). Another dilemma which is faced by counselors in a multicultural setting is the fact that more often than not, the personal preferences or opinions of the counselor comes into conflict with the values and practices of the client. “This may mean that counselors are conflicted when trying to remain genuine and provide unconditional positive regard to clients who hold different cultural values” (Sadeghi, Fischer, & House, 2003). Counselors may find it difficult to compartmentalize their feelings and values in counseling clients with beliefs different from theirs. In case a counselor would now fail to compartmentalize his feelings and values and use his own values to counsel the client, the multicultural client may now feel that he is misunderstood, that the counseling session is ineffective, or that counseling is a discriminatory practice as it fails to consider his values or culture (Sadeghi, Fischer, & House, 2003). In these instances, counseling then becomes about the counselor, not anymore about the client. In a paper by Muller and Desmond (1992), the authors set out to assess the ethical dilemmas counselors face in counseling the Chinese. One of the main dilemmas is on issuing bad news or revealing an unfavorable medical diagnosis. In most cultures, relaying the news directly to the family is often preferred and is expected. However, for the Chinese, it is not a favored practice because they believe that when a person is sick, he should be treated like a child (Muller & Desmond, 1992). They believe that acknowledging or mentioning the fact that a person is about to die or is really sick is a bad omen; it is as good as goading fate into taking the patient’s life or making his condition worse. The dilemma for some counselors and for others in the health profession is on being honest, and on living up to the principles of full disclosure; this is weighed against a patient’s values and beliefs – which may not be true – but because he believes it to be true can still make the patient even more anxious and desperate about his health situation. Another dilemma for a counselor is on value conflicts between himself and the client. In a case illustrated by Merali (1999), she discusses how an East Asian woman who has low self esteem and is being emotionally abused by her husband may approach a counselor asking advice on how to improve her self-esteem. The client may view her situation as one where she needs to gain more self-esteem in order to change her reaction to her husband’s emotional abuse. She sometimes does not even see her situation as abusive. However, for a counselor with Western values, he may view the client’s situation as abusive and may focus on changing the marital situation, not the abused client (Merali, 1999). In this case, there is a conflict of beliefs and values, and the counselor is in a situation wherein he feels he needs to treat the relationship as abusive when the client does not view it as such. Some topics are also taboo in some cultural settings. This is another dilemma in counseling diverse and multicultural clients. For example, in some cultural settings money is a taboo subject (Houser, Wilczenski, & Domokos-Cheng Ham, 2006). This situation becomes conflicted when discussing fees for counseling services. Some counselors may feel comfortable about discussing it and may declare fees up front with the clients – and the fees may often shock or surprise some clients because it may be too expensive for them (Houser, Wilczenski, & Domokos-Cheng Ham, 2006). Yet, they can hardly be open with the counselors about their financial concerns. In this case, the counselor needs to be culturally sensitive; and to reassess his practice and his fees depending on the culture of his clients. In evaluating the racial application of counseling in a multiracial setting, it is inevitable that the Black American and White American culture be brought up as a concern. Some experts point out that a counselor has to be highly conscious of the underlying tension between races – especially if he and the client are of different races. For example, some white counselors view themselves as good people, and essentially not racists. They do not however take into account the experiences and cultures which they have been exposed to as whites (Palmer, 2002). And such behavior can often prove to be detrimental in a cross-culture counseling session. After exposure to actual situations in the practical world, these white counselors can often feel strong feelings of guilt and their black counterparts may feel depressed or feel anger in the midst of counseling (Palmer, 2002). With these contrasting emotions, there is a need for counselors to live a life and a practice based on their full awareness of all the cultural and racial aspects of their practice and personality. In considering the possible alternatives to treatment and counseling, there is often a bias against the alternative and complementary forms of therapy. This bias is mostly seen among some counselors in the Western nations and societies. A counselor, at any point during his practice may come to face the dilemma wherein the client would prefer the complementary forms of treatment. Since, the counselor hardly believes in such forms of therapy, he may not express his support for it (Pedersen, 2007). Nevertheless, the client may still opt for alternative methods and the counselor’s attitude against the client’s choices may ultimately affect the client’s recovery. Having an unsupportive counselor may affect the client’s belief in the therapy. In the end, such lack of support may ultimately affect the client’s recovery. Personal Opinion Based on the above discussion, I was able to deduce that every client is different. Based on such differences, a good counselor must make the necessary adjustments in order to accommodate such differences in his counseling process. The ethical dilemmas which a counselor may face in his practice points out the importance of establishing as much information as possible about different cultures and counseling practices in order to achieve maximum efficiency as a counselor. A client is not apart from his environment and the years of his life he has lived, therefore the counselor must take these factors into consideration before a planned counseling session can be implemented. I found out through the discussion above that the counseling process is dynamic and above all, must be client-centered. And no amount of knowledge, even in the theoretical or the practical aspects of counseling can actually prepare the counselor for an actual application in the multicultural setting. Only by actively engaging with the multicultural client can an effective counseling process be achieved and implemented. Works Cited Houser, R., Wilczenski, F., & Domokos-Cheng Ham, M. (2006) Culturally relevant ethical decision-making in counseling. California: Sage Publications Merali, N. (1999) Resolution of Value Conflicts in Multicultural Counselling. Canadian Journal of Counselling, 33(1) Muller, J. & Desmond, B. (1992) Ethical dilemmas in a cross-cultural context. A Chinese example. Western Journal of Medicine, 157(3): 323–327. Palmer, S. (2002) Multicultural counselling: a reader. California: Sage Publications Pedersen, P. (2007) Ethics, Competence, and Professional Issues in Cross-Cultural Counseling. Sage Publications. Retrieved 17 May 2010 from http://www.sagepub.com/upm-data/15654_Chapter_1.pdf Sadeghi, M., Fischer, J., & House, S. (July 2003) Ethical Dilemmas in Multicultural Counseling. Journal of Multicultural Counseling and Development, 31(3): pp. 179-91 Read More