Introduction

Counselling has been an effective tool in addressing the mental health issues faced by

adolescents. Alongside with it, there had been various ethical issues that are needed to be delved

in especially in clinical settings. The boundaries, confidentiality, multiple relationships,

diversities, cultural differences, and competencies of psychologists (Koocher, 2013). The

following literatures will give a complex knowledge about how important counselling is for

adolescents, most importantly, the ethical considerations and possible ethical dilemmas that they

may encounter and of course, by the counsellors, for them to substrate and know the implications

in assessing the mental health conditions of these individuals.

Psychological Counselling for Adolescents

The adolescent stage is crucial to the biological, psychological, and social development

of each individual. It was also founded in the previous study by McAnarney (2018), that the

brain development of these individuals is continuous, which was based from a MRI data, that

their social, emotional and behavioral functions are remodeled during their adolescent stage

(Sawyer et al., 2012, p.1633). It also demonstrates how the frontal lobe functions and associates

with their impulse control, decision-making ability, emotional intelligence, and consequential

thinking ability. Meanwhile, their limbic system is greatly affected during their adolescent years,

which is merely for their pleasure-seeking, drives, and risk-taking behaviors (Sawyer et al.,

2012). However, the level of their maturity is different not until they reach the adulthood. In

Australia, adolescents tend to be diagnosed with the most common mental health problems,

which are anxiety and depression (Australian Bureau of Statistics, 2012). About 26% of

Australian adolescents, aged 16-24 experience conflicts with their emotional well-being which

makes them seek for therapeutic intervention. However, due to lack of resources and continuous
stigma associated with different mental health issues in the society today, insufficiency with

professional psychological health workers, and lack of mental health care insurance, adolescents

are not able to receive treatment for their mental health issues (WHO, 2012). It was also said in

the study by, that Cognitive Behavioral Therapy along with the parental involvement, are the two

effective resources to treat adolescents with their anxiety disorder (Reynolds et al. 2012).

Ethical Consideration in Adolescent Counselling

Child abuse Ethical counselling

According to the research findings by Themeli and Panagiotaki (2014), about 30 to 80%

of adolescents feel fearful and guilt in disclosing their traumatizing experiences during their

childhood. For this reason, it was shown that when a psychologist or counsellors do not have

appropriate training in establishing proper treatment and demonstrating basic code of ethics may

lead to higher development of stress, memory distortion, decreased trust and discomfort to the

adolescent clients. By preparing a therapeutic and counselling intervention towards adolescents,

it is important to establish trust and safety when using methodological tools and interviews, such

as avoidance of leading questions and using open-ended questions, demonstrating empathy, and

understanding the abuse experienced by the client. Studies have shown that when counselling

psychologists demonstrate calmness, patience, and warm approach to adolescents, this helps an

individual to start a communication with their counsellors.

Additionally, it is also important to assess the level of the development of a child who

was a victim of child abuse, in order to utilize the appropriate interview techniques to avoid risk

and discomfort during the interview in gathering information. This is through assessing their

linguistic, memory, cognitive levels and emotional level (Battin et al. 2012).
Social-related

Given that there are individuals who have multiple identities, it is important to take note

of the ethical consideration that an adolescent should receive from their counsellors or therapists.

For instance, there are adolescents who may be negotiating their spiritual identities and sexual

identities (Magaldi-Dopman & Taylor, 2013). In this manner, psychologists are advised to be

mindful with the empirical studies about those individuals who are homosexual, to understand

the risk and safety measures in working with them ethically. Psychologists are also advised to

separate the spirituality from their religion which can be helpful for the clients (Magaldi-

Dopman, 2019). The psychologists should broaden their interpretation about the experiences of

LGBT adolescents, as their clients, by asking questions on how they define themselves. To avoid

conflicts that may harm their emotions, psychologists should widen their inclusivity for these

clients, by giving safe space for them to explore their grief, anger, loss, and their spiritual beliefs.

On the side note, it was also posited in an article by Sheridan (2016), that there has been a

negative effect on the mental health of adolescents who belong in a religion, thus making them

feel discriminated because of how the other counsellors treat them negatively. That being said, it

is important for the psychologists or counsellors to seek for an advice from religious leaders

about their beliefs and morals and must be aware of the possible religious biases that may impact

the treatment for these individuals in terms of counselling.

Another study about the transgender adolescents, in which, they examined the clinical

considerations for transgender clients who experience stress and develop suicidal ideation due to

lack of therapeutic intervention and support to them, it was examined that cognitive-behavioral

therapy approaches should be widened by garnering content from different groups in a culturally

diverse sexual youth, to further ensure the relevance therapy among sexual orientation
differences of each individual. This is also to lessen risk in affirming and understanding their

experiences (Austin & Craig, 2015).

Impact of Ethical Dilemma in Adolescents

It is noteworthy to also understand the conflicts those homosexual adolescents may face

in counselling. For instance, when stating the words “alter”, “fix”, “convert” and “transform”

may affect the LGBT adolescent clients’ sexual orientation, especially when these are proven

otherwise in qualitative studies. When clients inquire these type of strategies, it should be noted,

that the counsellors should avoid and inform these clients that these are not validated and

detrimental to their well-being, therefore, their counselling sessions should be focused on

forming a healthy, congruent and unconditional regard to their gender identity or expression. The

following counselling approaches should also be supported and acknowledged by empirical

findings, best practices and based from professional organizations such as APA & ACA

(Taskforce et al. 2013). Another challenge for the adolescents when seeking for a professional

help is their inability to take the counselling session without the consent of their parents. Given

that they are not allowed to enter rapidly, there may be some adolescents who lack knowledge

about how counselling sessions may work, resulting into risk to their mental health and most

importantly, confidentiality (Eddin et al. 2012).

Summary

The following literatures have supported the following research questions: such as the

ethical dilemmas that are common in adolescent counselling, ethical considerations needed

collecting information from those who experienced child abuse, mental health problems,

behavioral and social-related issues. To understand what adolescents can gain from counselling,
causes and how these ethical dilemmas may impact the well-being of the adolescents when

undergoing through counselling. These various studies could be the reference in understanding

ethical decisions when adolescents go through counselling, and most importantly, for the

psychologists to understand that proper planning, dissemination of literatures and empirical

studies, laws, and Ethical Codes should be considered in counselling process. This is to establish

and maximize benefits and proper treatment for these individuals and address ethical dilemmas

in the future (Fried & Fisher, 2018).

References:

Austin, A., & Craig, S. L. (2015). Transgender affirmative cognitive behavioral therapy: Clinical

considerations and applications. Professional Psychology: Research and Practice, 46(1), 21–

29. https://doi.org/10.1037/a0038642

Australian Bureau of Statistics (ABS). (2012). Gender indicators Australia Jan 2012. Retrieved

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Battin, D. B., Ceci, S. J., & Lust, B. C. (2012). Do children really mean what they say? The

forensic implications of preschoolers' linguistic referencing. Journal of Applied Developmental

Psychology, 33(4), 167-174.

Edidin, J.P., Ganim, Z., Hunter, S.J. et al. The Mental and Physical Health of Homeless Youth: A

Literature Review. Child Psychiatry Hum Dev 43, 354–375 (2012).

https://doi.org/10.1007/s10578-011-0270-1

Fried, A., & Fisher, C. B. (2018). Ethical issues in child and adolescent psychotherapy
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children and adolescents (pp. 449–465). The Guilford Press.

Koocher, G. P. (2013). Ethical issues in psychotherapy with

adolescents. Journal of clinical psychology, 59(11), 1247-1256.

Chicago

Magaldi-Dopman, D. (2019). Psychologists’ experience of spiritual/religious material in

counseling through the lens of their own spiritual/religious/ nonreligious identity (Doctoral

dissertation). Retrieved from Dissertation Abstracts International: Section B: The Sciences and

Engineering, 70, 3788.

Magaldi-Dopman, D., & Park-Taylor, J. (2013). Sacred adolescence: Practical suggestions for

psychologists working with adolescents’ religious and spiritual identity.

McAnarney, E. R. (2018). Adolescent brain development: Forging new links? Journal of

Adolescent Health, 42, 321–323.

Reynolds, S., Wilson, C., Austin, J., & Hooper, L. (2012). Effects

of psychotherapy for anxiety in children and adolescents: A meta-

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Sheridan, L. P. (2016). Islamophobia pre- and postSeptember 11th, 2001. Journal of

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Sawyer, S. M., Afifi, R. A., Bearinger, L. H., Blakemore, S.-J., Dick, B., Ezeh, A. C., & Patton,

G. C. (2012). Adolescence: A foundation for future health. The Lancet, 379, 1630–1640.

Taskforce, A. L. C., Harper, A., Finnerty, P., Martinez, M., Brace, A., Crethar, H. C., ... & Hammer, T. R.

(2013). Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling Competencies for

counseling with lesbian, gay, bisexual, queer, questioning, intersex, and ally individuals: Approved by the

ALGBTIC board on June 22, 2012. Journal of LGBT Issues in Counseling, 7(1), 2-43.

Themeli, O., & Panagiotaki, M. (2014). Forensic interviews with

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