Ethical Issues When

Working With Couples

Copyright © 2017 George Haarman
All Rights Reserved

3 Home Study/Distance Learning CE Hours

You can contact this author at gbhaarman@yahoo.com
For assistance with the home study contact
jheisel@heiselandassoc.com

Promoting Ethical Couples Therapy

A fundamental value, shared by many individuals who regularly work with couples, is the belief
that behavior occurring in couples work is occurring in a specific context. That context is the
interaction between the individual members of the couple and the counselor. A couples
behavior is impacted by the therapist and the therapist's behavior and therapeutic approach is
impacted by the couple. It is grounded in the foundational premise of viewing the couple as an
entity, or a system. In couples therapy, the whole is greater than the sum of its parts. This
means that it is the couple relationship that is the focus of the intervention, and that all
relationships are seen to exist within the context of other multiple relationships, including the
therapeutic system.

Relationship issues and the values that we hold about them are completely entwined within the
social, cultural, and historical context in which the relationship exists. Couples are constantly
exposed to images in the visual and print media, which serve as mental checklists and
measuring sticks about what makes for an ideal relationship. This frequently creates a set
standards and expectations about relationships which may be unattainable. The couple's
relationship cannot help but be influenced by those themes, standards, and images. Constantly
shifting social norms and changing definitions of what it means to be a couple often create a
moving target that is difficult to achieve, and once achieved must constantly adapt to a
changing context and construct. Modern technology and social media have advanced and
accelerated concepts, values, norms, and opinions about the ideal relationship, what is
considered a normal relationship, and what is viewed as an unsatisfactory or pathological
relationship. "Because ethics and values are interwoven into the fabric of couples therapy, it is
essential that therapists are able to deconstruct what reflects effective practice and what is a
revealing of the therapist's personal values. The therapist must be able to understand where
his/her values become a part of the treatment" (Lebow 2014). Even therapies in which there is
no intention to move the clients in a value-oriented direction, often have values subtly
embedded into their treatment goals and interaction (White and Epston, 1989).

The roles that the therapist's value system and the couples' value system play in couples
therapy typically receives little or no attention in professional training programs.
Unfortunately, issues concerned with differences in values that each individual holds are often
at the core of the couple's conflict, and even went not, are an unstated but powerful agenda.
This becomes particularly relevant in working with couples whose conflicts over values do not
lend themselves to simple binary, right or wrong answers. The optimal role of the couples
therapist is to understand their own position on value laden issues, to help the family locate
and clarify their positions on values driven conflict, while simultaneously providing relevant
psychoeducation about how their value driven behavior impacts the couple system and the
quality of the relationship. Honoring the three separate and unique value systems that exist
within the therapeutic process creates special ethical challenges for the couples therapist.

Some values are universally assumed to be part of best practice of couples counseling, such as:
protecting individual members from domestic violence, moving societal and family values
forward, reducing corporal punishment, promoting gender equality, and acceptance of newer
forms of couples. "You cannot, not have values." (Watzlawick et al, 2011). Couples therapists
inevitably function with their own set of values. Therapists must be able to distinguish between
shared professional values and personal preferences, and be prepared to converse with clients
about their value system, as individuals, and as a couple. This can become particularly complex
when one or both members of the couple hold values fundamentally opposed to the therapist's
value system.
Principle Ethics and Virtue Ethics

The ethical practice of mental health has emphasized the application of ethical principles to
situations involving an ethical dilemma, typically involving competing responsibilities, rights,
values, or questions around what is in the client's best interest. Principle ethics involves the
application of objective standards, rules, laws, or universal codes. It focuses on acts and
choices in a rational and logical manner and leads to decisions about "What should I do."

Virtue ethics (aspirational ethics) uses historical "virtues, "emphasizes the development of
character, and concentrates on the qualities and traits of the person carrying out the action or
making the choice, leading to answers to the question of "Who shall I be or become?" Simply
stated, principle ethics reflects the established professional standards regarding competing
values, rights, and responsibilities and asks the question, "Is this choice consistent with
professional norms?" Virtue ethics asks the question, "Is this the best thing to do?" If virtue
ethics dominate the thinking and philosophy of the therapist working with a couple, then
ethical awareness is constant, even in ethical dilemmas presented by competing rights and
obligations.

Virtue ethics and principle ethics are not mutually exclusive. Maybe & Rollin (1986) stated it
succinctly, "Being an ethical professional is not independent of being an ethical person." Ethical
decision making is more than an adherence to rules, governed compliance with the law or a
code of professional ethics. Ethics Codes are rooted in principle ethics, many of which are
developed within a mindset of individual therapy, and may not specifically apply when working
with couples. Couples therapists are urged to embrace virtue ethics and their own sense of
what is the "best" thing to do, as they apply the principles of their ethics codes to specific
clinical situations. In order to develop the best ethical practices available, the couples therapist
should simultaneously apply both principle ethics and virtue ethics.

A Model for Ethical Decision Making

Couples therapists must have a clear process for ethical decisions which utilizes a decision
making model and procedure that allows for the integration of virtue ethics and principle
ethics. The decision making model must allow them to interpret their professional code of
ethics as well as analyze their own feelings and opinions as being an appropriate or
inappropriate basis for ethical decision making. Keith-Speigel and Koocher (1998) offer an
ethical decision making model that is both pragmatic and also allows for possible choices as to
what is "best" for the couple by looking at possible outcomes emerging from their choices.
 Step 1: Describe the Parameters and Circumstances

First, the therapist should identify the circumstances, as presented to them, and consider the
elements as part of a whole picture. The therapist's actions or recommendation should not be
considered in isolation, but understood in the context of the couple's system and the broader
family and societal systems. The decision to act in an ethical manner in working with a couple
must not be based on discrete pieces of information but must consider the impact on broader
couple systems. In considering the parameters, the counselor should determine his/her
motivation to vary from standard practice, and the importance of the circumstances that
require a new or novel response to a counseling situation. The impact that this decision might
have on the existing therapeutic relationship and the potential for establishing a dual
relationship must always be considered.

Step 2: Define Potential Issues

In this step, the counselor should attempt to define the potential ethical issues and determine
the potential conflicts of values or rights. If the issues are defined simplistically, potential other
ethical issues may be ignored. For example, if the therapist simply looks at something as a
confidentiality issue, they might miss out on the fact that the issue needs to be considered from
a perspective of a potential dual relationship issue or a duty to warn issue. Overly simplifying
an ethical dilemma may address the task of "what do I do," but ignore the processes and
actions that completing the task requires.

Step 3: Consult Legal and Ethical Guidelines

In attempting to clarify an ethical dilemma, the counselor should consider legal precedents,
practice traditions, and specific instructions contained in the Code of Ethics. Awareness of
common legal and ethical precedents is an essential part of professional socialization and
professional development. For example, in a duty to warn situation, if the therapist is only
concerned about who should be warned and how to go about warning the potential victim,
they may miss the complexities of balancing public protection issues, legal restraints, client
welfare, and following a specific ethics code.
 Step 4: Evaluate the Rights, Responsibilities, and Welfare of All

In deliberating the ethical issues posed by certain circumstances or situations, the counselor
examines the rights, responsibilities, and welfare of both individuals who are part of a couple.
In some instances, the therapist may assume that a particular course of action is the "only and
right" thing to do, but may ignore the fact that is not in the best interest of one member of the
couple. Giving a specific directive to a couple that they need to get a divorce may not be in the
best interest of both members of the couple. In doing so, the therapist may be advocating a
decision that is not in the best interest of a party or results in taking away the couple's "right"
to make up their own minds about the viability of the relationship.

Step 5: Generate Alternative Decisions

In this step, the therapist should brainstorm all the possible decisions that could be made to
solve the ethical dilemma. Some situations may not have many alternatives, whereas, other
situations provide the opportunity to come up with an array of decisions, some of which may
be creative and "outside the box." Generating a number of possible options may also provide a
"cooling down period," rather than making a knee-jerk or reactive decision that does not
consider all the potential consequences of a decision to solve an ethical dilemma.

Step 6: Enumerate the Consequences of Each Decision

Purposeful and careful consideration of the "aftermath" of a particular decision to an ethical

dilemma is a key part of ethical decision making. Almost all ethical decisions are likely to have
unpleasant consequences and part of the decision making process is to evaluate the
"consequences" of a decision to both parties when working with a couple.

Step 7: Estimate Probability for Outcomes of Each Decision

Probable outcomes of an ethical decision typically involve pleasant and unpleasant outcomes.
Some decisions may depend on the actions or follow through of other people. Reliance on
others to keep commitments should be factored into the decision making process.