■ Nonmaleficence: avoiding actions that cause harm ■ Justice: treating individuals equitably and fostering fairness and equality ■ Fidelity: honoring commitments and keeping promises, including fulfilling one’s responsibilities of trust in professional relationships ■ Veracity: dealing truthfully with individuals with whom school counselors come into professional contact h. Determine potential courses of action and their consequences. i. Evaluate the selected action. j. Implement the course of action and analyze the outcome. k. Identify any inconsistencies in school/district policy for potential revision. The model is client centered and encourages them to take different or alternative perspectives to redefine the problem, consider, and choose solutions they will test in a real-world setting. The counselor is there to assist and guide the process, but the client assumes the major responsibility in the decision-making process in each phase. Taking control to reach a solution may empower the client and build confidence for future decision making and problem solving. This model may help the client take ownership of their actions by taking responsibility for the decisions they make and the solutions they choose. This process may lead to improvements in behavior for clients that previously blamed others for their actions or felt powerless to make changes in their life. ● “There is no rush, we have time to talk this through.” ● “Can we talk through some pros and cons you are thinking about?” ● “Can we come up with a next step?” ● “Do you need more information on ____ or is something unclear?” ● “Do you see a path forward? What does it look like?” ● “What would be the best-case scenario? What would be one step in that direction? Or the next step to move forward?” Counselors must plan and prepare to provide evidence- based information to support the client and guide them through the SDM process. This involves researching the positive and negative components for the courses of action being considered, strategies to clarify values, and assist in weighing “pros and cons” for example. As in all counseling methods, SDM models depend on creating a supporting atmosphere that encourages open expression of feelings, shows empathy, is nonjudgmental, and communicates support for the client’s feeling, concerns, and values. After the decision is made, the counselor will need to guide and assist the client to implement the plan and evaluate the course of action. Assessments on the progress and effectiveness of the course of action should be ongoing and inform future counseling sessions. The client and counselor can work together to adjust or reinforce positive outcomes moving forward. The SHARE Approach: Essential Steps of Shared Decision-Making The Department of Health and Human Services, Agency for Healthcare Quality and Research (AHQR) developed the
a. Define the ethical dilemma. b. Identify potential cultural, religious and worldview factors and power dynamics that are present within a potential ethical dilemma. c. Apply the ASCA Ethical Standards for School Counselors and the relevant district policies and procedures. d. Consult with appropriate professionals (e.g., supervisors, other student service professionals, school counseling peers, cultural experts). e. Consider the student’s chronological age and developmental level. f. Consider parental/guardian and student rights. g. Apply the ethical principles of: ■ Beneficence: working for the good of the individual and society by promoting mental health and well-being ■ Autonomy: fostering the right to control the direction of one’s life American Psychology Association The American Psychology Association (2023) defines the decision-making model of counseling as: An approach that envisions counseling as a process with three stages: the problem definition phase, the work phase, and the action phase. The problem definition phase considers alternative definitions of the client’s presenting problem and encourages him or her to commit to one of these. During the work phase, the counselor helps the client to look at the problem from different perspectives and to consider solutions to it. In the action phase, the client chooses a solution and tests it in the home environment. Shared Decision Making Shared decision-making (SDM) models involve the counselor working together with the client to make decisions. The counselor’s role is to assist or guide the client to choose solution(s) to their problem after working through a decision-making process that relies on evidenced-based information shared by the counselor. The client considers their needs, opinions, values, and preferences as they work through the decision-making process to clarify the problem and identify possible solutions. The counselor can present information on alternatives for possible solutions, help the client investigate options, and create an atmosphere of support that encourages the client to express their feelings and concerns. Counselors should answer questions without showing bias toward a particular course of action and help the client compare different alternatives. If the client is having difficulty deciding on a course of action, the counselor may guide them to discuss their concerns or confusion, to help them overcome barriers to reach a decision. Clients may need help to prioritize or clarify their values so they can move forward with a decision. The counselor may assist the client to identify alternatives that align with their values or determine which course of action will help them reach the desired outcome. Some simple, open-ended sentence stems to help client move past a barrier and express their feelings might include: ● “Let’s talk about what is most important and make list.” ● “What seems best to you … why is it best?” ● “What makes the most sense to you?” ● “Can we talk through your concerns about _____?” ● “Can we talk about what you are thinking about that is keeping you from a decision?
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Book Code: PCTX1325
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