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Error Avoidance in Post Modern/Complex Adaptive Systems

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Counselors Responsibility and Ethics Paper

By

Jennifer Ewings Willis

PCN 505 Professional Ethics in Counseling

Boundary Issues and Dual Relationships

In the Counseling field, Counselors will encounter many instances of boundary

issues. These types issues will occur when practitioners establish more than one

relationship with clients. These relationships can be come professional, personal

and work related. In our field of work, boundary issues will occur when mental health

professionals encounter a potential or actual conflict in the professional, personal an or

business relationship. A prime example of this boundary crossing/dual relationship is

when a client is also a business associate, close friend, or family member of the

therapist.

In this situation, It would become difficult when conflicts arise for the therapist to look

at things in an objective fashion.

The therapist must attempt to evaluate the conflicts using the Ethical

Decision Making Model. In the Ethical Decision making model, Zur, O (2011), the

therapist must evaluate the situation by giving clear and accurate facts, and gather

information and questions about boundary and dual relations. The therapist must

determine how the relationship will affect him/her professionally, personally, and in the

business setting. The therapist must also look at how to objectively remain neutral and

attempt to eliminate potential, impractical and improper alternatives. Having these facts

in mind, the therapist must make an informed judgment based on whether or not the

client being served is treated fairly and their services beneficial to the course of their

treatment.

In the second scenario, I interviewed a Counselor who informed me of

a colleague who allowed her clients to buy her illegal drugs, i.e. cocaine to indulge

her own recreational purposes. This is an example of an unethical dual relationship

because the therapist who is deemed the professional, violated boundary lines by

encouraging her clients to bring in illegal substances for the therapist to indulge in. This

is also deemed an ethical violation because the therapist’s behaviors have become

reckless and endangered her license to practice. The therapist behavior was reported

within that year, the therapist was fired for doing drugs with her clients, and falsifying

documentation for the purpose of continuing client treatment.

In this particular situation, the Ethical Decision Making Model is applicable. The

therapist should evaluate the clear facts: The therapist crossed boundaries with Client

by allowing the client to buy illegal substances for the therapist to indulge. The

code of Ethics guidelines clearly prohibits the professional to engage in illegal activity

resulting in the loss of license. In this scenario, it is unfortunate that the

professional in the case lost the right to practice and was fired from her job as a result of

her ethical misconduct.

In the Institutional setting, therapist are often seen in the dual relationships

because they are considered mandated to serve as evaluators for the facilities they

serve. In many of these facilities, the therapist serving in the dual role capacity

tend to serve many of their clients simultaneously for several treatment issues.

In this situation, the Three Ethical Questions would apply:

• Are you treating others as you would want to be treated?

• Would you be comfortable if your reasoning and decision was publicized?

• Would you feel comfortable if your children were observing you in this capacity?

With these questions in mind, the therapist must devise a plan as to how to

maximize the benefits of treatments and minimize the cost and risks of

treatment. The therapist would need to monitor the efforts of the decision.

Dual relationships in the rural Community are unavoidable. In the small

communities, practitioners serve the community in several capacities because

their access to resources are limited. In this situation, the three ethical questions would

apply to this situation:

• Would you treat this client as you would want to be treated?

• Would you feel comfortable in your reasoning and decision were publicized?

• Would you be comfortable of you children were observing you in this capacity?

In conclusion, in the work that we do as Counselors, we should be mindful

that we all face dilemmas. It is our personal responsibility that we do all that

we can as professionals to serve our clients with dignity and respect. It is also

our personal responsibility that we conduct ourselves in the highest regard and

avoid potentially unethical situations.

As a Service Provider, there are many issues that I would encounter. In this

paper, I would attempt discuss the following issues. I will take them each one by one

and discuss my point of view for each one and discuss how I would precede to service

my Client in his/her predicament.

The First Topic and the One I have Chosen are closely linked together in my

Opinion. The topic of Assisted Suicide is very controversial because, it deals with

peoples’ thoughts about taking their own lives especially in situations in which terminal

illness is present. The scenario that was present was that of an 87 year old woman who

has terminal Cancer and has made her decision to die. She has not informed her

family of her decision and does not care to revisit her decision to end her life. Here’s my

position on this scenario: Considering the Woman’s Age , physical and mental state;

quality of life would be a grave issue for because if the Client is terminally ill and is going

through Chemotherapy, and is faced with other heath issues the quality of life would

determine the Clients will to live or die. As a Counselor I speak with the Client to

determine mentally if all of her mental faculties are present and to find out reasons why

she wants to end her suffering via Assisted Suicide. I would then ask the Client if she has

made final arrangements such as a Living Will or Advance Directive in place so that

there would be no conversations among family members regarding end of life issues.

Assisted Suicide/ Living Will Advance Directive

I feel that having an Advance Directive or Living Will is very important because

when life changing medical issues occur such as Terminal Illness or in the case of

Irreversible Brain Damage, Advance Directive or Living Will, when done properly in a

competent state, will allow the Client to make their own decision about end of life

issues. Many families may argue that keeping a loved one on life support would be in

the Client’s best interest and the family’s welfare, when in fact, the family of the loved

one may not have considered the overall quality of life for the Client, and whether or

not client has chosen to die with dignity and have taken measures to have written

consent of end of life issues.

I personally feel that everyone should at least have a Living Will in place in case

of illness or in an accident that would declare them to be Brain Dead. This is needed

event that the Client has minor children that they were taking care of and arrange

that care made on their behalf for their welfare and safety. This process would

alleviate the family’s pain while watching their loved one slowly and painfully

slip away. In my opinion, it would end the need to advocate on the Client’s behalf

and the Client‘s wishes would already be addressed in writing.

Gay Adoption:

What determines a family, Is it deemed man, woman and child or woman and child.

Who is to say that Gay Couples shouldn’t adopt children? Traditionally, a definition of a

family is man, woman and child, but in Today’s society, children are growing up in

the Foster Care System, there is a great need for Foster Parents to take in children.

Many would argue that Gay couples are not equipped to take in Foster Children yet

alone adopt. Many would also argue that children who are adopted by Gay couples

would heavily influence whether or not the child becomes homosexual . The issue in

my opinion is whether or not homosexual couples can provide a loving and stable

home environment.

Many may also feel that the child would be ridiculed by his or her peers if one or both

parents show up on the child’s behalf. Gay rights activist would also argue that many

gay couples are in a committed relationship and have expressed a genuine desire to

adopt a child.

Client Rights:

As a Mental Health professional, I have an ethical obligation to see that my Client has

been treated fairly and with dignity and respect. In this case, regardless of the Client’s

status. The Clients still have rights. The Following describes the Client’s hierarchy of

rights:

Confidentiality:

The client has the right to keep the cause of events in the Counseling Session private.

No One is allowed to have access to your clinical record with out the written signed

consent of the Client. There are several exceptions to the Client’s right s on

Confidentiality. They are the following:

A counselor may consult with the Client’s treating physician to coordinate care for the Client.

If the Client poses a threat to him/her self or others.

In the case of Psychiatric Hospitalization.

If reporting information regarding abuse of a child, elderly/disable person is suffering.

Court order issued by a judge that could require that information contained in the

Clinical record, or could require a therapist to testify.

It is mandated by an administrative or management authority to seek an evaluation.

I can recall an experience that I had with Confidentiality. I was working for an

Organization that mentors children. I was responsible for recruiting children for the

program and volunteers for the program as well. Part of my job responsibilities were to

screen the volunteers and write an evaluation of the character for this person. There

was one instance in which I was interviewing a volunteer when I inadvertently disclosed

what the reference said abut the person when I should have said what said not

revealed who said it. This huge mistake cost me my first real job in the Social Service

Field. When ever I am faced with a dilemma in which confidentiality is compromised, I

would always refer back to this life changing experience.

Release of Information:

The Right to disclose with the counselor what is in the clinical record. Release of

information gives the counselor permission to share information with outside services.

The client can disclose what information is to be released. The client also has the right

to be informed about the services made available to client unless it is an

emergency and can have the right to consent or refuse treatment. The Client also has

the right to present a complaint should they feel like they are not been treated fairly.

The Client has the right to have all contact number accessible to him in order to file a

complaint.

Client recordkeeping:

The Client’s clinical record is held to a clinical and ethical standard and is subjected to

court action. The Purpose of the clinical record is to provide quality of care by

documenting the plainful nature of intervention and goals towards established goals.

Documentation is agency based and requires that documentation be kept in

compliance with agency guidelines and standards. The Client records should be

accurate, objective and clear in purpose. It should provide professional actions and

demonstrate the clinician’s knowledge and professional development growth and

development. The Records should always reflect the therapeutic relationship, legal

responsibility such as a duty to warn others, reports of abuse, court orders and any

supervisor’s consultation or coordination of care for the Client.

Confidentiality and Security:

Privacy of the clinical record is a fundamental issue and should be considered in all

recordings. When the Client is allowed access to his/ her records in regards to their

recovery, the client must legally sign a form giving access to his/her clinical records.

The Client should be aware that they have a right to request to see what is in their

Clinical record as long as they sign a release form stating interest to see record. Many

may argue that It a mental health Client ask to see the record and is not in the best

state of mind to receive what is written about them and their course of treatment, the

client may place his/her sensitive information in the wrong hands and it may be used

against them at a later time.

Duty To Warn And Protect:

As a Services Provider, I have an obligation to my client to not only protect, but to warn

any potential victims of any harmful or maltreatment towards them. In most cases, in

situations in which there was a crime committed and the Client, although in treatment

for this behavior, may have the propensity to may become violent again towards the

person or person who was offended. The Counselor has a duty to warn the Victim or

Victims of the possibility of harm.

Self Assessment:

As I continue to with this class I find that I am a work in process in the field of Counseling.

I have learned that in working in this field that there are all types of people with serious

issues and all should be treated fairly , with dignity and respect not matter how we

personally feel about the Client. I have learned that as a Service Provider, I have a

professional obligation to the Client to ensure that he or she is getting the best possible

course of treatment to aide in their recovery of becoming productive function

members of society. At this time I would like to rate myself as A 6 ½ in this course

because I feel that I still have a lot to learn and am eager to also take constructive

criticism of how I can improve my craft in the Helping Profession.

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