INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
ETHICS AND ISSUES FACED BY BEGINNING
• COUNSELORS
Professional Ethics – ethic codes are
fundamental component of effective
counseling:
• They are guidelines that outline
professional standards of
behavior and practice
• Codes do not make decisions for
counselors
• Counselors must interpret and
apply ethical codes to their
decision-making
TYPES OF ETHICS
Mandatory Ethics – deals with the
minimum level of professional practice
Aspirational Ethics – involves the highest
standards of thinking and conducting
Positive Ethics – an approach taken by
practitioners who want to do their best
for clients rather than simply meet
minimum standards to stay out of trouble
ETHICS VS LAW
Ethics – rules or standards governing the
conduct of members of a profession
Law – body of rules governing the affairs
of persons within a community, state or
country
HOW TO RECOGNIZE ETHICAL
DILEMMAS
• Feelings of Discomfort
• Dissonance with Moral Reasoning
• Conflict of Values (Personal and
Professional)
• Dissonance with Virtues
HOW TO COME UP WITH AN
ETHICAL DECISION?
• Identify the situation
• Gather relevant information
• Identify ethical and legal
•
standards
• Formulate and assess alternatives
considering ethical and legal
standards
• Implement
• Evaluate the result
• To the degree it is possible,
include the client in your
decision-making process
APA CODE OF ETHICS: THE FIVE
PRINCIPLES
1. Beneficence and Non-Maleficence
• Do good; avoid harm
• Strive to benefit the clients and
do no harm
• To safeguard the welfare and
rights of the clients and other
affected persons
• To guard against personal,
financial, social, organizational,
or political factors that might
lead to misuse of their influence
• Beneficence – the duty to do
good and maximize good
• Non-Maleficence – the duty to
do no harm and to minimize
harm
2. Fidelity and Responsibility
• Develop trust, uphold the ethical
standards of the profession, be
responsible
• Establishing relationships of trust
• Awareness of professional and
scientific responsibilities
• Knowing how to consult and
cooperate with other
professionals and institution
3. Integrity
• Maximize good and minimize
harm through honesty,
accuracy, and truthfulness
INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
• To promote accuracy, honesty, 2. Confidentiality: supporting the client’s
and truthfulness right to privacy
• Do not steal, cheat or engage in 3. Informed Consent: affirming the
fraud, subterfuge, or intentional client’s freedom of choice
misrepresentation of fact 4. Sexual Misconduct: violations of power
• Strive to keep their promises and and trust
to avoid unwise or unclear 5. Nonsexual and Dual Relationships and
commitments Boundary Issues
4. Justice 6. Group and Family: counseling and
• Fairness and reasonable psychotherapy: unique ethical
judgement responsibilities
• Access to and benefit from the 7. Ethics of Assessment: use of fair
contributions of psychology procedures in responsible ways
• To equal quality in the processes,
8. Other Issues:
procedures, and services being
• Advertising services and soliciting
conducted by psychologists
clients
• Exercise reasonable judgement
• Payment issues
and take precautions
• Interruptions and termination of
5. Respect for People’s Right and Dignity
services
• Respect autonomy, preserve • Keeping records
confidentiality and privacy,
maintain professional boundaries INFORMED CONSENT
• Respect the dignity and worth of
all people, and the rights of • Clients need enough information
individuals to privacy, about the counseling process to
confidentiality, and self- make informed choices
determination • Educate clients about their rights
• Respect cultural, individual, role and responsibilities
differences, and demographics • Address privacy issues with
clients, including the implications
PAP CODE OF ETHICS: THE FOUR of using technology to
PRINCIPLES communicate
• Informed consent empowers
1. Respect for the Dignity of Persons and clients and helps to build trust
Peoples with them
2. Competent Caring for the Well-Being • Should include information such
of Persons and Peoples as:
3. Integrity o Therapeutic procedures
4. Professional and Scientific and goals
Responsibility o Approximate length of
treatment
ETHICAL ISSUES
o Risks/benefits and
alternatives to treatment
1. Competence to Practice: building a
o The right to withdraw from
foundation of doing good and avoiding
treatment
harm
o Costs or fees
INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
o The counselor’s use of
supervision
o The limits of confidentiality
LIMITS OF CONFIDENTIALITY
Confidentiality is essential but not
absolute
• Client poses a danger to self or
others
• Clients who are children/minor,
dependent adults, or older adults
are victims of abuse
• Client needs to be hospitalized
• Information is made an issue in a
court action
• Client requests a release of
record
THE ASSESSMENT PROCESS
Assessment – ongoing process designed
to help the counselor evaluate key
elements of a client’s psychological
functioning
• Influenced by the therapist’s
theoretical orientation
• Requires cultural sensitivity
• Can be helpful in treatment
planning
Diagnosis – process of identifying a
pattern of symptoms which fit the criteria
for a specific metal disorder defined in
the DSM-5
• Requires cultural sensitivity
• Practitioners debate whether a
diagnosis is necessary
• Can be helpful in treatment
planning
• if used only for insurance
purposes, can lead to ethical
dilemmas
STRENGTHS OF EVIDENCE-BASED
PRACTICE (EBP)
• treatments have been validated
by empirical research
• treatments are usually brief and
standardized
• are preferred by many
insurances’ companies
• calls for accountability among
mental health providers to use
effective treatment approaches
MULTIPLE OR DUAL RELATIONSHIPS
• Not inherently unethical
• Must be managed ethically to
protect client’s well-being
• Examples are nonsexual dual
relationships include socializing or
starting a business venture with a
client, bartering services for
goods, or borrowing money
• Sexual relationships, with current
or former clients are exploitive
and can result in serious harm
SOCIAL MEDIA AND BOUNDARIES
Social media raises many ethical
concerns for practitioners regarding
boundaries, dual relationships,
confidentiality, and privacy
Counselors and therapists should:
• Limit what is shared online
• Include social networking policies
as part of informed consent
• Regularly update protective
settings because privacy rules
change
WHAT IS RESISTANCE?
• A characteristic in the client
which opposes the purpose of
counseling
• May be conscious or
unconscious
• A product either of
1. The outer defense system
(situational threats)
INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
2. The inner defense system
(core system impulses)
SOURCES OF RESISTANCE
1. Internal Resistance
• Tendency to retreat from usually
painful attempts to explore or
alter patterns of behavior;
anxiety with change in
personality/life status
• Tendency to love by one’s
facade
• Reification Anxiety – the fear that
if I put my feelings into words, it
will make the condition real
2. External Resistance
• Client resents being “drawn in” to
a close relationship and being
obligated to return helpful favor
in kind
• Therapist gets too far ahead of
the client
• Client lacks proper readiness
3. Mixed Sources of Resistance
• Fatigue, disease, mental
deficiency, language barriers
• Schiz – thru withdrawal into
hallucinations, muteness, general
negativism, and projection
• Neurotics – through rigidity,
concern over details, irritation,
and argumentation
TECHNIQUES IN HANDLING
RESISTANCE
First is, become aware of possible
external causes in what the csr is doing
1. Noting – but disregarding technique
• Mere presence of mild resistance
doesn’t mean csr has to do
something
• Use to understand the unique
defensive style/security
operations of the client
• Indicate client’s way of psychic
balance
2. Minor-Adaptation Technique
• Goal: reduce the client’s
defensiveness and keep him
exploring the problem further
a) Lessen the emotional impact
of the discussion by moving to
a more intellectually loaded
aspect of the topic
b) Change of pace
c) Judicious use of mild humor
d) Supporting and accepting
techniques
3. The Temporary Diversion Technique
• Redirect to less threatening areas
when it appears that the client
cannot protect himself
adequately by his own defenses
• Return to the painful subject at a
later time
• Change subject
• csr disengages – reduces speed
and intensity of the interview
• Cite related research findings, a
bibliotherapeutic reading matter
4. Direct Manipulation Techniques
• When the client appears to be
aware of his feelings of resistance
• Assumes a good working
relationship
Ex. “You have been spending a
great deal of time talking about
things you wanted to talk about;
now let’s talk about those things
you don’t want to talk about.”
a) Interpretation of the
resistance
Ex. “I just can’t talk about
it”
b) Reflection of the feelings
of resistance
c) Referral techniques
d) Threats – “if you don’t
want to work this out, I
INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
suggest we stop getting
together”
EXAMPLES OF RESISTANCE
“I have to leave early because I must
study for a test”
“I don’t think that applies in my case”
“I thought you were supposed to be the
expert”
• Resistance exists largely as an
unconscious phenomenon and is
manifested by an ambivalent
attitude toward counseling
TRANSFERENCE AND
COUNTERTRANSFERENCE
• Natural projective behaviors and
are to be expected in counseling
• In T and C, the past lives on as a
symbolic representation which
unconsciously displaces one’s
direct experience of the present
• A present experience is overlaid
with a constellation of
assumptions and emotions
rooted in the past
• T and C are part of the total csr-
cl relationship, an irrational part,
not justified by the nature of the
objective situation, or the actual
behavior/personality of the csr
Transference
• refers to certain unconsciously
redirected feelings, fears or
emotions from a client towards
the csr that actually stems from
past feelings and interactions
with others and is transferred into
the current counseling
relationship
• Erotic attraction towards a
therapist
• Also, a rage, hatred, mistrust,
extreme dependence,
parentification, or even placing
the counselor in a god-like or
teacher status
• These feelings are very real,
come from the center of one’s
being and are based upon past
experiences with other schemas
Ex. A grad student observed by
peers: opening session with a
client described by intake team
as belligerent and
uncooperative. He charmed him,
showed so much empathy for his
predicaments, and distanced
himself from the admin policies of
the center which infuriated the
client, and so restated the client’s
frustrations, that his anger melted
• For the client: smoothing over
difficult aspects of his
interpersonal style rather than
allowing him to project onto the
counseling arena his
dysfunctional modes of
perceiving and behaving
TRANSFERENCE (T) kept him from
coming to recognize, understand
and consider modifying his
unhelpful behaviors
Countertransference
• The projecting of a csr’s
experiences, values, and
expressed emotions that are
awakened by identification with
the client’s experiences, feelings
and situation that affect the
dynamics of the counseling
relationship
• Both transference and
countertransference occur in all
our relationships
• Consists of emotional reactions of
the csr to the cl
INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
• A csr’s emotional entanglement
with a client
• Racker – the totality of the
analyst’s psychological
responses to the patient
• How to recognize and deal with
one’s emotional reactions in
counseling
• For the csr – his need to dodge
the client’s hostility and be seen
as a nice guy, along with his fear
of having someone think badly of
him were glaringly underscored;
showed his unacknowledged
needs and fears that shaped the
session unconsciously
COUNTERTRANSFERENCE (C)
Dealing with Countertransference
• With much rapport: “You are
beginning to irritate me with your
empty smile and friendliness, I
wish you felt freer to be more
honest with me.”
• Rogers – congruence
• Developing and maintaining a
condition of communication and
understanding
• Key: for csr to acknowledge what
is
COHEN’S SIGNALS OF ANXIETY
1. Unreasonable dislike for the client
2. Inability to empathize with the client
who seems unreal or mechanical
3. An overemotional reaction to the
client’s hostility
4. Excessive liking for the client
5. Discomfort with the client, dread of
sessions with him
6. Preoccupation with the client’s
behavior trends, including fantasying
about responses to the client
7. Difficulty paying attention to client,
with mind wandering to personal affairs,
drowsiness
8. Beginning appointments late, running
over established time
9. Getting involved with arguments with
client
10. Defensiveness/vulnerability to the
client’s criticisms
11. Repeated
misunderstanding/disagreement with
client
12. Provoking effect in the client
13. Overconcern about the confidential
nature of his work with client
14. Sympathy with client in his treatment
by others
15. Impelled to do something for client
like giving advice or suggestion
16. Appearance of the client in csr’s
dreams or the csr in the client’s dreams
as himself
ISSUES FACED BY BEGINNING
THERAPISTS
1. Dealing with you own anxieties
2. Being yourself and self-disclosure
3. Avoiding perfectionism
4. Being honest about your limitations
5. Understanding silence
6. Dealing with demands from clients
7. Dealing with clients who lack
commitment
8. Tolerating ambiguity
9. Becoming aware of your
countertransference
10. Developing a sense of humor
11. Sharing responsibility with the client
12. Defining your role as counselor
13. Developing your own counseling style
14. maintaining your vitality as a person
and as a professional
15. Avoiding losing oneself in one’s
clients
16. Defining one’s role as a counselor
17. Sharing responsibility with the client
INTRODUCTION TO COUNSELING
Lesson #4 / First Semester Midterm
18. Learning to use techniques
appropriately
19. Declining to give advice
MAINTAINING EFFECTIVENESS AS
PSYCHOTHERAPISTS/PREVENTING
BURNOUT
1. Finding meaning in potentially
problematic areas
2. Remaining objective, accepting, and
confronting situations
3. Asserting own wishes
4. Grieving; adapt to losses as well as
gains
5. Associate with healthy individuals
6. Work with committed colleagues and
organization with a sense of mission
7. Use stress reduction exercises.
Periodically examine and clarify roles
and expectations; When necessary,
obtain personal therapy
8. Set aside free and private time
(balance one’s lifestyle)
9. Maintain an attitude of detached
concern with clients
10. Modify environment stressors
11. Engage in self-assessment (identify
stressors and relaxers)
12. Retain an attitude of hope
CLUES AND IMPORTANT CLUES
• Examine any strong feeling
arising during the counseling
• Strong liking/disliking for the client
• Where empathy becomes
sympathy and the csr identifies
with the client
• Irritability and impatience at the
lack of progress of counseling –
threatens the self-concept of a
successful competent csr
• Strong emotional response from
the cl
• “How does the client hide his
secret?”
• Counseling or psychotherapy is
not just to ascertain the client’s
defense system or to find out his
secret
• Forms of resistance vary:
o Rejection of counseling,
overt antagonism, subtle
forms like hesitation or
inattention

STAYING ALIVE – IT’S A

PREREQUISITE

• Take care if your single most

important instrument – YOU
• Develop self-care strategies and
a plan for renewal
• Know what causes burnout
• Know how to recognize and
remedy burnout
• Know how to prevent burnout
through self-care