BACP Codes of Ethics - Case Study Example

Introduction The most essential purpose of counselling is to offer services that encourage the clients’ autonomy and growth while heeding to the requirements of the ethical framework of the profession. As Bond, (2010) reckons a counsellor’s awareness of the therapeutic relationship into between him/her and the client as well as the awareness of the ramifications of the proceedings of every therapeutic session is what facilitates the efficacy and outcome of counselling not the counsellor’s good intentions. The ethical framework the manner in which counselling should be conducted and the counsellor acts as an instrument of facilitating the efficacy and outcome (Corey, 2001) According to the British association of counselling and psychotherapy, (BACP), confidentiality and autonomy are some of the most fundamental ethical concerns in counselling. The elementary objective of confidentiality is to protect a client’s right to anonymity and privacy by making sure that information divulged to a counsellor is not imparted to any other party devoid of informed consent of the client. The elementary objective of autonomy on the other hand, is to respect the client’s right to self-determination (Vansteenkiste et al 2005). These two provisions in the ethical framework can bring about major dilemmas in certain counselling situations. This paper analyses one such situation. The case being looked at in this paper involves my client who has contracted a sexual disease. The client continues to engage in unsafe sexual practices with his partner who is unaware of his condition. Below is a comprehensive analysis of the factors that would impinge process of counselling in this case drawing reference form the BACP codes of ethics and professional behaviour Severity Of The Case Before engaging in rush big decisions, the counsellor should first the seriousness of the client’s condition is and how it might have already affected his partner. The counsellor should first know what type of sexually transmitted disease has been contracted by the client and at the stage of the disease in the client. After gathering this information, the counsellor should consult with other medical practitioners on the repercussions of the disease and the most appropriate course of action. If the disease is treatable and is in its early stages, the counsellor should discuss with the client on the best way to handle to the situation. Similarly, if it is untreatable and in its late stages the counsellor should also discuss with the client on the best way to handle to the situation. It is very important for the counsellor to determine the severity of the case and how it affects the client’s partner as well as other third parties The Concept Of Trust In Therapeutic Relationships Baldwin, et al (2007) articulates that trust underpins the effectiveness of a counselling relationship between the client and the counsellor. In the initial stages of the relationship, the counsellor should strive at earning the client’s trust when establishing rapport. Trust between the counsellor and the client enables the establishment and maintenance of healthy boundaries, and it is also imperative in helping to build a relationship that allows autonomy and confidentiality. According to Corey et al (2011, p. 210), confidentiality and autonomy are among the vital roles of counsellor, which involve the protection any information about the clients’ private life. This is one of the counsellor’s most imperative professional responsibilities; yet paradoxically, this responsibility generates the most serious ethical dilemmas in the profession. As a corollary, there exists a great deal perplexity and anxiety about confidentiality and exceptions in the counselling realm (Fisher, 2008). In the case of my client, the information that he has contracted a sexual disease can be said to be private in nature. Drawing reference from the BACP code of ethics and professional behaviour, I as the counsellor, am not supposed to disclose this private information about him to any third party. However, the client continues to engage in unsafe sexual practices with his partner who is unaware of his condition. This poses risks to the third party (i.e. the partner) and it would beat all logic withholds such information at the expense of the third party or any other person who might get involved with the client. Due to such an ethical dilemma, the BACP code of ethics has outlined various limits of confidentiality. Below is an analysis, ethical dilemma involving disclosure of confidential information and any exceptions of the ethics pertaining to confidentiality that might help in the resolution of the dilemma encountered in the case of my client Legal Matters / Privileged Communication Privileged communication is a concept that is strongly associated with confidentiality. In terms of definition, privileged communication can be described as a legal concept that fundamentally protects the disclosure of a client’s information obtained during counselling from being divulged during legal proceedings. Nonetheless, privileged communication also has its limits. In cases of mistreatment or neglect of minors, the aged, and/or dependent adults, the concept of privileged communication does not apply. In general, the counsellor is obligated to protect susceptible and defenceless persons who do not have the ability to protect or advocate for themselves. In such a case the counsellor is usually advised to present any information of reasonable suspicions of mistreatment or neglect. The reason this obligation is because in such a case, the duty to protect is more important than the therapist’s responsibility to uphold client confidentiality (Corey et al., 2011, p. 250-251). However, on the legal matters pertaining to information about the protection sexual partners from their sexually infected partners is a little ambiguous. In the current code of ethics and statutory law, the responsibility to protect sexual partners of from their sexually infected partner is indistinct. According to Corey et al. (2011), if a counsellor finds himself in such a situation, he may be justified to infringe the client’s right to confidentiality and disclose this information to the third party at risk, but is not essentially duty-bound to take this course of action (p.261). Theoretically, however, as is the case with the decision to breach confidentiality, disclosing the client’s information to an identifiable victim so as to warn them should be considered as an option of last resort. This is because through counselling, there is a good chance the client can be encouraged to voluntarily disclose this information to their partner and this is what the counsellor in the case of my client should do. Ethical Dilemmas Involving Confidentiality And How They Can Be Resolved Ethical frameworks in counselling were established to enable the provision of focus around client protection and promoting respect between the client and the counsellor (Bord, 2002). The phenomenon of ethical dilemmas pertaining to confidentiality is not something new. Ethical dilemmas pertaining to confidentiality have persisted over the last few decades. This is because confidentiality, according to the BACP code of ethics, is not absolute. However, the situations that that may necessitate infringement of confidentiality are neither explicit nor well defined. As a corollary, the counsellor’s professional judgment about the situation becomes of the paramount significance (Corey et al., 2011, p. 221). This means that the counsellor cannot promise the client that the every information they divulge during the counselling process will not to be disclosed, particularly because there are exceptions to and limitations of confidentiality. As a result, the counsellor should make it his duty to inform the client of these exceptions and limitations prior to the onset of the counselling process, during the process of obtaining informed consent of participation (Cave, 1999). In the case of my client contracting a sexual disease and continuing to engage in unsafe sexual practices with his partner who is unaware of his condition, below are the factors that may limit the counsellor’s role in the maintenance of confidentiality. Dual Responsibility In particular, many ethical dilemmas pertaining to confidentiality arise from the dual responsibility of the counsellor. To be specific, the counsellor’s commitment is to both the society and the client. As a corollary, the counsellor has the duty of protecting other people in the society from a client who he or she deems potentially dangerous while protecting the client from himself or herself. This responsibility of protecting other people in the society from a client who is potentially dangerous is typically known as the counsellor’s duty to warn. The duty to warn requires the counsellor to consider both the client’s right to confidentiality and the safety ao0f the public then make a rational decision. This presents a momentous ethical challenge to the counsellor because the prospective outcome in such a situation is bound to be difficult outcome regardless of the decision made by the counsellor (Gaskill, 1996). This is exactly the case for the issue with my client because if the counsellor decides to uphold the client’s right to confidentiality, his partner as well as other members of the society might become directly affected by my client’s irresponsible behaviour. The partner of the client, for example, might get infected with the sexually transmitted infection which might result in dire consequences especially if not diagnosed in its early stages. On the other hand, if the counsellor decides to breach the client’s right to confidentiality and inform the client’s partner of the sexual disease contracted by the client, their trust and bond between the client and the counsellor might get affected and this might lead have a detrimental effect on the well-being of the client. Consequently, the counsellor should consult with other professional practitioners so that he/she can come up with a reasonable and professional judgment, and apply the accepted procedures of the profession exercising his/her duty to warn (Corey et al., 2011, p. 235). One of the most important rights a person has when seeing a counsellor is their right to privacy and confidentiality except in the case of the law overriding this right. Before deciding to exercise the duty to warn, the counsellor should be aware that he should only disclose the client’s information only if he/she strongly believes the client might harm another person or themselves (Bond, 2010). Drawing reference from these assertions, it is irrefutable that the counsellor in the case of my client has the mandate to exercise his/her duty to warn. However, before warning the client’s partner on the issue, the counsellor should assess and anticipate the ramifications of doing so. To minimise the damage, the counsellor should encourage the client to be the one to inform the partner about his condition through a process of psycho-education and confrontations. To facilitate this, the counsellor should set up a counselling session for both the client and his partner where they can share the information and decide on the course of action that will suit both of them after sharing the information. In the process of assessing and anticipating the ramifications exercising the duty to warn, the counsellor is supposed to evaluate how the client will be affected after disclosing the information one of the most likely effect is guilt. Below is a comprehensive coverage on how the counsellor should handle issues of grief and suicidal tendencies if they arise in the course of the counselling process Guilt And Suicidal Tendencies According to Frank (2004), the client’s portrayal of, and mindsets towards, self is that of a fragile and feeble entity. The notion of a susceptible self according to Frank, (2004) is so extensive that it controls the behaviour of an individual towards a self-centred direction in one way or another (p. 203). When the client attains self-actualization and reflects on their behaviour during the time they perceived themselves as vulnerable, guilt sets in. In the case of my client, the fact that continues to engage in unsafe sexual practices with his partner who is unaware of his condition can be a major source of grief. A joint counselling session with the partner would help the client possible receive pardon from the partner which would help him deal with his feelings of guilt. Guilt is a very strong emotion that can lead to outcomes that are even more serious such as suicidal tendencies. The counsellor in such a situation has the obligation to protect the client from himself or herself. Generally, this means that the counsellor has the responsibility to thwart the client’s suicide attempts if they can plausibly anticipate it and/or demonstrate the competence of their treatment through their consultation with other practitioners in and out of the field and through careful documentation of intervention strategies as well as rationale (Corey et al., 2011, p. 246). In general, counselling session between my client and a counsellor should be a place where the client can safely articulate what he truthfully think about what he is doing and how they sincerely feel about his deeds. According to Bennett et al. (2006), the process of the client revealing what they truthfully think about what he is doing and how they sincerely feel about their deeds may include guilt thoughts or thoughts of harming themselves for doing a despicable deed. Joint Counselling Session Between The Client And His Partner As it has been repeatedly acknowledged in the above coverage, a joint counselling session between the client and his partner is essential for the healing of both individuals. During the joint counselling session, the counsellor should engage the client and his partner the discussions of how they should both be tested so their status can both be known before intervention strategies are employed. After both are tested and statuses known, the counsellor should engage the employ an intervention strategy to help reconciliation and forgiveness. If the partner is not infected the counsellor help them come up with a solution of whether they should continue staying together or not. If the couple decides to stay together, the counselling sessions should offer clear and accurate messages about how they can prevent the partner from getting infected. However, if both are infected the counselling session should be about mitigating tension and diffusing blame. Regardless of their statuses, the theme of the session should be reconciliation and forgiveness Conclusion In conclusion, it is evident that there are no straightforward answers to the intricate issues of client confidentiality and its exceptions and limitations. In the counselling profession, ethical dilemmas will always crop up because of the conflicts inherent in the counsellor’s various obligations. This is attributable, partly, to the relatively broad parameters of acceptable codes of conduct in a counsellor life, and profession. In the case of my client, breaching client confidentiality will be an act of last resort by the counsellor. The counsellor will only exercise his duty to inform after all other less obtrusive measures have failed to bear fruits. The client will be encouraged to voluntarily disclose his condition to his partner after which a joint counselling session will be help to help the couple deal with the situation. The counsellor will be vigilant to identify and symptoms of guilt on the client so that they can prevent and counter suicidal tendencies that may arise. The counsellor will always have a nonjudgmental attitude and no advice giving will be practiced in the course of the counselling sessions. References Baldwin, S. A., Wampold, B. E., & Imel, Z. E. (2007) ‘Untangling the allianceoutcome correlation: Exploring the relative importance of therapist and patient variability in the alliance’. Journal of Consulting and Clinical Psychology, 75, 842-852. Bennett, B., Bricklin, P. Harris, E., Knapp, S., VandeCreek, L, & Younggren, J. (2006) Assessing and managing risk in psychological practice: An individualized approach. Rockville, MD: The Trust Bond, (2010) ‘Standards and ethics for counselling in action’. (3rd ed). Los Angeles: SAGE,  Bord, (2002) ‘BACP - British Association for Counselling & Psychotherapy.’ BACP - British Association for Counselling & Psychotherapy. Available at: http://www.bacp.co.uk (accessed on 28 April 2014). Cave, (1999) Therapeutic approaches in psychology. London: Routledge,.  Corey, G. (2001) Theory & Practice of Counselling & Psychotherapy, (6th Ed).. Brooks/Cole, CA. Corey, G., Schneider-Corey, M., & Callanan, P. (2011) Issues and ethics in the helping profession (8th ed.). Belmont, CA: Brooks & Cole, Cengage Learning. Fisher, M. (2008) ‘Protecting confidentiality rights: The need for an ethical practice model’. American Psychologist 63(1), 1-13. Frank (2004), Therapy culture: cultivating vulnerability in an uncertain age. London Gaskill, E. (1996) Duty to warn. Available at http://www.naswma.org (accessed on 28 April 2014). Vansteenkiste, M., Zhou, M., Lens, W., & Soenens, B. (2005). 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