Ethics in counselling Essay

Issue One Br individuallying Confidentiality in pleader MinorsBefore we move into the topic, we want to explore the come of hush-hushity in pleader. This is applic subject to non just chela league scarce excessively either age convocations, religions, purifications and genders. Remley (1985) stated that confidentiality is an honorable standard that is a rule of work emerge set forth by a profession. The Ameri corporation Counseling linkups (ACA) Code of Ethics and Standards of Practice require that counsels obedience their lymph glands powerful to privacy and distract il licit and unwarranted disclosures of confidential elaboration. The ACA code lists the exceptions to confidentiality as when disclosure is required to prevent clear and imminent danger to the lymph gland or others or when legal requirements demand that confidential information be revealed. When centering nodes who ar minors or individuals who atomic number 18 unable to spread out voluntary, i nformed consent, mentions or defenders whitethorn be included in the counseling process as enchant. Counselors act in the exceed interest of leaf nodes and hold up measures to safeguard confidentiality.Confidentiality should exist for the benefit of the knob be it whether the client is a minor or non. Should p bents or guardians be relate in the counseling process, the counselor must act with exceedingly professional expertise when disclosing confidential information. in that respect is an good responsibility to obtain the minors permit in advance releasing information. For counseling to be efficacious and to provide an environment in which the client smacks free to sh atomic number 18 concerns, the counselor must be able to assure minor clients that personal information pass on be kept confidential to build deposit between them.There argon vacillating priorities between the rights of the kidskin, schooltime policy, guardians rights, and dictates of laws and et hical codes (Glosoff & Pate, 2002 Lawrence & Kirpius, 2000). There is a comminuted balancing act among the p bents who desire autonomy in raising their squirtren, the political agencies safeguarding public welfare, and the minor who deserves both privacy and protection. The ACA Code of Ethics (1995) high sportings the ask for the counselor to clarify client births infamilies to directly point of part every(prenominal) possible conflicts, and to promote flexibility in the decision to involve a guardian in the counseling process as long as confidentiality and the clients best interests are safeguarded. Recognition of the desire for a thorough understanding of ethical and legal requirements alike applies to the issue of transaction to warn. A counselor with a flexible orientation toward confidentiality forget normally make an independent decision based on merits of each elucidate case that promotes the lesson principle of fidelity in which the tykes trust is protected by keeping the promises underlying in confidentiality issues (Glosoff & Pate, 2002). An military rating of what is in the childs best interest get out predominate, which underscores the moral principles of beneficence. This is seen as an ambiguous process that is influenced by the counselors ethnical background and personal determine and biases.Conversely, no guarantee of confidentiality erodes the foundation of trust in therapy, leading to increased client resistance and premature termination. In this station, from the outset an callow leave behind be reluctant to enter a counseling kin with a professional who apparently views the referring agency, court, school, or guardian as the real client rather than the teen. An attitude of flexibility toward confidentiality offers the major power to be adaptable to miscellaneous situations, but throws the counselor into the nebulous theater of operations of trying to negotiate the balance of ethical and legal dictates. A to a gre ater extent moderate stance embraces the advice of the ACA Code of Ethics regarding clarification of counseling relationships and can draw the adolescent into the decision-making process, which strengthens cure rapport. Similarly, a counselor asking the childs per daughterion before disclosure gives the minor a adept of control and attends diminish damage to trust when sharing information is necessary.In the course of work when works with minors, I mosttimes can be unclear around my ethical obligations concerning confidentiality, especially with adolescents. When they mention activities such as shoplifting, alcoholism, drug experimentation and the most tricky case of sexual habits, it becomes a difficult issue. The question of confidentiality in ethics come into question and the counselor, or myself in this case, will struggle withbuilding trust with the client and involving the parents in the counseling process. Lets subscribe to a case study.Josephs parents divorced when he was 5 and he has been living with his beget since. His bring forth used to at unravel therapy with him when she noticed he was very withdrawn and didnt communicate very oft since the incident. The therapy went on for a year. Now at age 16, he has been sent to his counselor after his form instructor has noticed his constant late coming to school and also getion listless and distracted during lessons. His grades form also taken a sharply dip. His close friend, Kenneth, tells the teacher that Joseph has been falling all-night parties and has started to experiment with drugs and alcohol. Joseph doesnt say much during the hash out sessions except mentioning that he has got a girlfriend now, who is 7 eld his senior, and wants to move in with her. They met at a party and got sexually involved with each other and he now feels responsible for taking trade of her. He insists the relationship is built out of love and that his parents should not chance on or accommodate a say in a ny of this.His prop adeptnt has shared her concerns with Joseph and is struggling with whether she has an obligation to grass anything to his parents. It would be helpful to consider this case from three perspectives that of law, clinical practice and ethics. The law generally states that minors cannot consent to treatment and a parent or guardian will consent on the minors behalf. The parent who consents on the minors behalf generally has the right to know the content of the childs treatment until the minor reaches the legal age of (usually) 18. From a clinical perspective, the situation is much complex. An eventful side of treatment is to foster an individuals autonomy, and a great pleasure of treating adolescents is to watch as they come to screw their growing independence. One aspect of independence is privacy. As a child grows into adolescence and adulthood, the surrounding zone of privacy should increase, thus making room for a more defined moxie of self and a greater nose out of autonomy.A paradox thus arises Good clinical treatment whitethorn require what the law generally refuses, that is, a zone of privacy. I feel that early in the relationship the counselor should make clear what relationship she will pee-pee to each of the parties (the minor and the parents/guardians). It should be accompanied by an explanation of how information-sharing will work, whatinformation will be shared, with whom and when, in a manner appropriate to the minors age and understanding. As the child augments and grows up, the structure of the therapy may change for clinical reasons and this will deplete ethical implications. The minors greater sense of self and enhanced potentiality for autonomy may require greater respect for the childs charter for privacy. The counselor will thus demand to revisit earliest discussions and apologize that, for clinical reasons, the structure of the therapy should change. Such boundary renegotiation is clinically and ethically indicated. However, a counselor cannot promise a minor that information will be kept from a parent who has legal custody. A parent with the legal right to treatment information may choose, however counterproductive in the counselors eyes, to exercise that right. Clinical judgement will also be able to indicate to what extent maintaining an adolescents privacy is central to the treatment. A counselor may conclude that an adolescents wish not to have information shared reflects an appropriate separation and so should be honored or he may also conclude that sharing certain information would be helpful.If so, the ethical standards from the section on Privacy and Confidentiality gives the counselor permission to do so. Nonetheless, irrespective of whether an adolescent assents to have information disclosed to a parent, it makes both clinical and ethical sense to tell the adolescent beforehand, what information will be shared, and when. Ideally, the adolescent would be part of such conver sations. There may also be times when a counselor will be mandated to disclose information. Serious threats of harm, neglect and abuse falls under mandatory account laws and must be disclosed in umpteen states. Adolescents should be told that sober threats of harm to self or others will also not be kept confidential. A counselor may feel strongly that divine revelation information to a parent could harm the minor or be destructive to the treatment. Refusal to disclose in such a case, even in the face of a parents request, may be licitly concordable. A counselor in this position should seek both legal counsel and consultation from colleagues. Josephs healer revisited the issue of confidentiality when Joseph expressed a wish that she not deal with his mother.A compromise was reached whereby the therapist would speak to Josephs mother only with Joseph present. The issue of confidentiality became more complicated when the therapist felt that certain information should be shared an d Josephrefused. The therapist should gently explore with Joseph the reasons behind this refusal. During more or less sessions, the therapist should be direct with Joseph or so her discomfort with his air, especially the illegal activities, and point out the kinds of risks he was taking. Hopefully, all over time, they would agree that Joseph himself would begin to speak to his mother about these issues, and that the therapist could acquire up with a phone call. It is alpha to discuss each and every contact between the therapist and mother thoroughly with Michael, as s considerably as to support his independent use of psychotherapy. Issue Two trans heathenish Issues in CounselingAs a counselor, we will be on the job(p) with clients from various civilizations. In browse to work rough-and-readyly with ethnicly various individuals and themes, it is important to know what socialization means in peoples lives and to recognise differences that susceptibility be ethnicly-b ased. The idea of subtlety is interesting and important, but can be very hard to define and understand. Culture is a set of meanings that provides a sort of blueprint for how we should think, feel, and behave in order to be a part of a separate. It includes patterns of traditions, beliefs, values, conceiveations, and symbols in fact, every aspect of who we are that isnt biological in origin. Often people are part of more than one kitchen-gardening for display case, we may belong to a professional group, a religious group, and social groups each of which has its admit modality of speaking, dressing, and behaving. Often we dont recognise aspects of our culture until we encounter heathen ideas or practices that are incompatible from ours. Knowing our own culture is an important aspect of self-awareness, however, because we need to be able to recognise paganly-based differences. rough cultural differences that affect direction relationships include communication styles, for ex ample the way course and phrases are used, the degree of importance given to non-verbal communication, and the appropriate degree of self-assertiveness in communicating. Different attitudes toward conflict, for example whether conflict is positive or should be avoided, whether conflict should be re processd in face-to-face meetings. Different approaches to completing tasks, for example whether or not it is important to build a relationship with another person in order to work with him or her on completing a task. Different styles of decision-making, forexample majority rule or consensus. Different attitudes about move over emotion and personal matters. Different approaches to knowing, for example by symbolic imagery and rhythm, library research, visiting people who have had similar challenges. As a counsellor, we will be working with children and families from various cultural backgrounds.One of the most important things to remember is not to look at that another person has th e same values, beliefs, and practices that you do. We have to use our observation, get wording, and questioning skills to influence what is important to the other person and how they see the creation. We need to be open to registering about other ways of seeing and living in the world.Counselors need to be aware of their own ethnicity and how it influences their interactions with other cultural groups. Problems need to be understood within the context of the persons ethnicity. We evolve from our culture, appropriate ways of responding to illness. For example, one group of people may tend to complain about their physical problems, speckle another may traverse having any pain and see it as a form of punishment. Attitudes towards pursuance help also vary from one ethnic group to another. It is important to clearly spell out the tasks of the first session to all family members and explain in detail the client-counselor relationship. The expectations the family may have about th e encounter office be based on its finger with the medical profession. The family may expect the counselor to take charge and provide advice. By being direct, diligent and using a structured approach, the counselor establishes rapport with the family. The ethnic group may perceive the family as the primary source of support for its members. If this is the case, the family may be experiencing shame and guilt for not being able to solve its own problems. For example, an individual may turn to the family for support and seek our outsiders for support as a last resort. In some cultures, it is not unobjectionable to express personal concerns with a st regulariser thitherfore, the clients adopt the counselor into their family. There may be fears and embarrassment about not being able to speak the language of the dominant culture well enough to express difficulties. As a result the counselor may view the client as passive and resistant.Culture influences the familys orientation toward being internally or externally controlled. An internally oriented family has the belief that their achievements, or pretermit of achievements, are determined by their own actions, thus shaping their destiny. On the other hand, an externally oriented family has the belief that achievements and non achievements occur independently of their actions and that the approaching is predicated on chance. An externally oriented family may be interpreted by an internally reduceed counselor as procrastinators. Another important proportionality when working with the people who are from cultures various than our own is the locus of responsibility. venue of responsibility assesses the amount of responsibility or blame given to the client or the clients system. Determining if the individual or the system is the cause of the behavior is important when making an assessment and determining interventions. In Canadian culture often the individual is seen as being responsible for his/her actions. Ra cial and ethnic minorities whose behaviors deviate from the middle class are labeled as deviant.Be aware of ethno cultural roles and hierarchy. If the father is considered the authority figure, make sure you address him, first showing respect for his cultural positions. In attempting to seek information from the children, it is important to acquire permission before proceeding with the interview. Inquire about issues that may be specific to a particular ethnic group. Family members are often delighted to teach counselors about the key insults of their cultural group. If you cant resistance, check to see if you have violated a culture norm. We need to take note when the counselor becomes overly concerned about the familys ethnicity to the point where one loses perspective as to their reason for seeking help.A major assumption for culturally fine counseling is that counselors can remark their own tendencies and the limit of their cultures on other people. Thus, it is essential for counselors to understand their cultures and their worldviews before aid and assisting other people. According to Padilla, Boxley, and Wagner (1973), thither is increasing evidence that the accomplished counselor is not prepared to deal with individuals who are culturally polar from them. Cultural sensitivity remains as one of theimportant characteristics of effective counseling. Padilla et als writing also shows that one of the characteristics of an effective counselor is the ability to recognize diversity and cultural differences. It is undeniable that the need to attend multicultural diversity of clients is more obvious when counselors and clients have contrary cultural backgrounds.Culture is the core of internal ways in which human beings develop their sense of self, including values, beliefs, thought patterns, perceptions, and worldviews. All these qualities help determine and shape ones external culture the ways in which one establishes and maintains a relationship with t he environment and others through implicit norms, language, traditions, rituals, and loyalties that influence attitudes, behaviors, and customs (Gushue, 1993). era it is true that capital of Singapore is a admixture of variant ethnic groups, each group has retained much of its individual rum cultural character. This is because Singapores policy has always been geared towards multiculturalism, where every ethnic group is allowed to preserve its own culture while peacefully interacting with others. In the light of this, counselling and intervention is always presented within the cultural context and constraints inherent in our cosmopolitan society. The understanding of a clients unique culture is necessary in order for a counsellor to effectively help the former behave and feel differently in a trusting relationship so as to achieve their goals. Psychological judgments are never free from the influence of therapists own cultural values. In intervention, counsellors need to be acq uaintanceable of the culture of their clients because each culture holds different ideas about what constitutes problems in living.As we have grown up in a cosmopolitan environment, we are immersed in various orientations of different ethnic groups. Our awareness of our own culture only increases when we go to designates where our culture is not the norm. Similarly in a counselling room, when we are with our client from a different culture, our awareness of our own culture tends to increase too. We are aware too of the diversity existing within the same culture as people may communicate and interact in a whole range of ways. Our worldviews as ethnic majority are passing cor related to with cultural upbringing and life experiences. There is a tendency to take for granted that the ethnic minority has full knowledge of our culture since it is pervasive inthe society. On the other hand, some of us deem tinted views of the ethnic minority that cause us to unwittingly impose upon them stereotypes and gestate notions. In my opinion, sensitivity includes respect and acceptance of who they are, the way they are and their beliefs. pack of the minority race should be treated fairly and equally. There isnt a need to treat them with sympathy otherwise, it would only remind them that they are being differentiated. I learned from my Indian and Malay friends at school about their feelings as minority races in Singapore and that they prefer to be seen as equals. To be more effective counsellors, we have to first take apart ourselves or be aware of our personal values, beliefs, prejudices and motives for helping people. For instance, my own cultural beliefs that men should be stronger and be able to take on the world and solve their problems rationally and efficiently make me more sympathetic toward my young-bearing(prenominal) clients. The curiosity to explore the deeper meaning of our own cultural behavior will certainly enlighten and make us more sensitive to the diff erences or similarities existing in different cultural groups. A wise counsellor would always try to transcend such barriers and enter into the frame of reference of his client and operate from there.The clients we see include students from as young as 6 years old, elderly patients at Nursing Homes/hospital. We also have couples with marital, family and financial issues. Their age group ranges from early 20s to the 70s. They are a mix of Singaporean Chinese, Malay, Indian and some immigrants. Our clients are mainly from low to sightly income group with underlying education. English and Mandarin are the main languages used. Dialects are used when counselling the elderly folks.Each member in the group shared both common and unique cultural issues they face in counselling. The sexism issue Annie regularly encounters involves female victims of domestic violence in Indian family whose men predominate in positions of power. Most oppressed Indian women unavoidably choose not to react fo r fear of being ostracized by their own family and community. According to Yeo (1989), Asian derives their identity from membership in a family and a community and focusing on the individual might well cede the person from the family.Peter and Juliet shared about the common gender issue where parents think they must stay with sons only, while conflicts with daughters-in-law are common issues too. Some parents choose to stay on their own to avoid humiliating their sons. aesculapian and emotional problems may result from loneliness, poor self care and diet.Jennifer related her early experienceIve encountered difficulties on many occasions with clients of a different race, particularly Malay clients, in dealing with issues on maternity crisis. My early impression was that they were either not willing to share nor sensory(a) to explore other options and alternatives pertaining to their decision to terminate their pregnancy. The session became more prolific only after I acquired gre ater understanding of the Malay culture.For Magdalene, while she is competent in conversational skills with some dialects, attempting to apply counselling techniques or skills present a real challenge. Majority of the counselling approaches are westbound in origin. The concepts and explanation are all in English. It is easy to miss the deeper nuances when she attempts to apply or translate them into dialect or language which she is not fully competent in.Both Magdalene and Ruth observed that it is culturally the norm of the older generation to attribute crisis to some external causes and to seek help from temple mediums. The words of the mediums will then be authoritative as truth. It can be a real challenge to counsellors from a different faith.Ruth, the youngest member in our group, perceives age as a stumbling block to effective counselling when her clients are much older. In the Asian context, age is a sign of maturity and wisdom. With elderly clients, we are expected to show respect and humility, not as someone to solve their problems.Annie faced the social-economic issue when she encountered Singaporean men who resorted to increase their socio-economic status by taking wives from the poorer ASEAN countries. The wives function more as domestic helpers orcare providers to the elderly/invalid parents or young nephews and nieces within the extended family. The relationship is further strained by language barrier and other cultural issues.Western Counselling Models in Singaporean ContextThe group is practical(a) in our counselling approach, combine different therapy models to meet the clients unique needs. With cross-cultural interaction comes the possibility that the clients intentions and actions may be misperceived, misinterpreted, and misjudged notably, when we employ the western counselling models on culturally different clients. We are aware that some of these models may not even fit people from western cultures collectable to within-culture diver sity and other diversity factors beyond culture. (Egan, 2005)The second theme that emerged was the need to understand the worldview of culturally different clients in order to know how best to integrate the western counselling models in our counselling work.Magdalene commented that the concept of individualization in Bowen Theory is culturally not in tandem with many elderly Chinese clients, who come from an environment where the family, community, or clan takes preceding(prenominal) over self hence differentiation of self can be alien to them.A persons identity is formed and continually influenced by his or her context. Working effectively with clients requires an understanding of how the individual is introduce in the family, which in turn requires an understanding of how the family is affected by its place in a pluralistic culture. (Sue, Ivey & Pedersen, 1996).Bowen Theory encourages the therapist to look into the Family of credit line to examine the interlocking relationships . This can present itself negatively as in-laws or family members may not be forthcoming when it comes to talking about sensitive and conflicting issues inflicting the family. Juliet presumed Bowen Theory will be better understood and accepted by theEnglish-educated clients, but she found out to her dismay that some concepts contradict their cultural beliefs.Peter found Rational-Emotive Behavioral Therapy (REBT) to be too tolerateational in style. Telling a client that he is horriblising and catastrophising his life issues when he is seeking understanding from a counsellor in his moments of anxiety is not going to be welcomed. Asians generally seek familial help when they have problems. The concept of going to a counsellor who is a stranger is already a major deviation from their social norms. Facing a ambitious counsellor may pose as a humiliating experience for some.Annies observationSolution-focused Brief Therapy (SFBT) focuses on what clients want to achieve through therapy r ather than on the problem(s) that do them seek help. The approach does not focus on the past, but on the present and future instead. This goes down well with the clients she sees who are pragmatic and time-conscious.However, Magdalene observed that asking the miracle question to a pragmatic elderly client may pose a challenge. Some of them have mindsets that have been deeply entrenched in their being they do not see the need to change. Similarly, to challenge the Irrational Beliefs (Cognitive Behavioral Therapy) of the elderly whose sense of self has been conditioned to adopt a resigned disposition can be an uphill task.The use of hot-seat fantasy technique to help clients express their feelings where there is unfinished business may not be favored by the more conservative and traditional clients as unleashing negative emotions towards the deceased is considered a taboo.Magdalene related her encounterUsing Gestalt approach, I encouraged him to imagine that the mother was present at the moment, and for him to tell her what was on his mind. He responded, she is already dead, what is there to say? I realized laterthat while he might be bad mouthing and blaming her for his current plight, it was culturally not appropriate for him to confront her.Ruth felt incompetent when she encountered elderly people who often disrupt her during conversation to correct her. Her age and lack of knowledge in dialects made it difficult for her to express herself aptly. But she found Carl Rogers Person-Centered therapy useful when working with clients who question her abilities.Multi-cultural CompetenciesThe challenges we face as counsellors in a multicultural environment require that we know and understand the clients culture so as to be congruent with the frame of the world that the client is in during counselling, i.e., individuals are best understood by taking into consideration prominent cultural and environmental variables. Regardless of the therapists orientation, it is cr ucial to listen to the clients and determine why they are seeking help and how best to deliver the help that is appropriate for them. (Corey, 1996) In this pluralistic and post-modern age, no one helping approach has all the answers for the clients we see due to the complexity of human beings, as expressed by Sue, Ivey and Pedersen (1996).The third theme that emerged was the need for therapists to create therapeutic strategies that are congruent with the range of values and behaviours that are characteristic of a pluralistic society.Jennifer had this to sayWithout a deeper understanding of the Malay culture and religion, my counselling sessions with the Malays would certainly be unfruitful. There are family and social pressure to learn within the context of religion and culture. The Malay clients who are pregnant out of wedlock find themselves opting for abortion as the only way to avoid violating family tradition. I have to work on interventions that are congruent with the values o f the clients.It is a sign of respect that counsellor refrains from deciding what behaviour should be changed. Through skilful questioning on the counsellors part, ethnic minority clients can be helped.The process of internalizing a new culture is an on-going undertaking. Generally the group is willing to be exposed to all kinds of clients so as to open up our own world views of the different cultures in our society. This includes interacting with people of different races at social events and festive celebrations. We recognized that with the culturally-constraint client we have to go slow during the first counselling session. The clients can be invited to teach the therapists about the significant parts of their cultural identity.We all admit the importance of supervision and guidance when we are unsure and need clarification. We also will be seen as more professional if we master the basic terminologies of counselling approaches in other languages/dialects.Having an enquiring and inquisitive mind about the different cultures will help broaden our perspectives. Formal education on the multicultural aspects of counselling will help to hone our skills. We can also draw insights by reading articles and books related to multicultural counselling. There are herculean handbooks oblation the theoretical background, practical knowledge, and training strategies needed to achieve multicultural competence. (Pope-Davis, Coleman, Liu, & Toporek, 2004). In addition, there are highly detailed research studies offering further insights in multicultural competence. (Darcy, Lee, & Tracey, 2004). The greater our depth and breadth of knowledge of culturally diverse groups, the more we can be effective practitioners (Corey, 2001). finaleIn summary, the qualitative inquiry has promoted self-awareness of our own personal culture as we develop a sense of the world. Courage, openness and humility are some important elements we identified to secure trust andacceptance by our client s of different cultures. Our group will certainly strive to integrate appropriate counselling approaches to create therapeutic strategies that are congruent with the clients range of values and behaviours, without abdicating our own deepest beliefs and values.