___________________________________ Code of Ethics for Counselors and Marriage and Family Therapists
Analysis An ethics committee determined that incompetence could not be conclusively proven; however, both the complainant and respondent were surprised by the findings of a dual role violation. The investigation uncovered that the therapist planned their developing relationship and a longer-term continuation while the client was still in active therapy. The therapist had actually presented these facts as a defense against the client’s accusations. This case shows how personas may change from one context to another, and the resulting change may be viewed as nega- tive. The client responded well to the therapist’s authoritative personality in therapy but not in a social context. This case shows the problems that occur when personal and professional boundaries are crossed and the resulting ethical issue that harmed both client and counselor. Case 3: Bartering A counselor provided services to a man with anxiety that adversely affected his work and personal life. He eventually lost his job and his health insurance due to his anxiety. The counselor agreed to hire the client to do maintenance on his house and yard work to help him earn some money while he looked for a job. The counselor paid him minimum wage but continued the counseling sessions at no charge. A month later, the man attempted suicide and was admitted to an inpatient mental health facility. He was assigned to a psychiatrist who learned of the exchange of work for counseling services. The psychiatrist questioned the ethics of the relationship and considered it a boundary violation and an inappropriate dual relationship that caused harm to the client. He reported it to the state licensing board, and they opened an investigation. Analysis The therapist was not paying the fair market value for the labor being performed, so the relationship was not a beneficial one for the client, even though he was able to continue counseling for free. The quality and the effectiveness of the counseling services were called into question in light of the firing and subsequent suicide attempt. The ethics committee ruled in favor of the client. Professional liability insurance policies may exclude coverage pertaining to business relationships with clients. Liability insur- ance carriers may view bartering arrangements between mental health professionals and clients as business relationships and therefore refuse to defend a covered therapist if complications arise in therapy that leads to litigation. Bartering arrangements have the potential for client exploitation, impaired professional judgement and objectivity, conflicts of interest, damage to the therapeutic relationship, and unsatisfactory outcomes to both parties.
Today, some religions and segments of the population in the United States continue to view same-sex relationships as immoral sexual behavior that is pathological, sinful, and in need of therapy and counseling. In the past decade, increasing acceptance of same-sex lifestyle choices has been noted, includ- ing the number of states that recognize marriages between same-sex partners. Referring a client to someone who engages in conversion therapy signifies to the client that same-sex attraction and behaviors are deviant and need to be changed. This would violate the ACA Code of Ethics, The AAMFT Code of Eth- ics, the NBCC Code of Ethics, and the APA Diagnostic and Statistical Manual; therefore, the ethical decision would be to refuse the referral request.
DUAL RELATIONSHIPS Case 1
A professional artist complained to an ethics committee that his therapist’s actions caused him stress and anxiety when she did not carry out her promises. The therapist had treated the artist for over one year, during which time the therapist complimented the client’s artwork, attended art shows with him, and promised to introduce her art gallery contacts to her client. The client stated he began to feel so self-confident that he terminated therapy and expected the therapist’s interest in his career to continue. The therapist stopped returning the ex-client’s phone calls, which left the client frantic. An ethics committee contacted the therapist. She explained that she always provided unconditional positive regard to her clients; however, since this particular individual was no longer a client, she felt no further obligation to him. Analysis The ethics committee found in favor of the client. They deter- mined that the therapist had maintained a dual relationship by combining their professional and private lives outside of counseling together. This caused confusion and harm to the client, and the therapist did nothing to resolve the client’s distress and dependency and chose to ignore him, which increased his anxiety. Case 2 The therapist and her ex-client decided they would become friends because the past therapeutic relationship was very har- monious. A month into the friendship, the ex-client perceived that the therapist was controlling and overbearing in their new relationship. He then questioned the therapist’s overall competence and stability, to the point of distancing himself from the post-therapeutic friendship. The ex-client decided that the therapist had caused him to feel exploited, hurt, and confused. He then consulted another therapist who advised him to press charges against the previous therapist.
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