Ethical Decision Making Paper – Scenario 2

19 May No Comments

Ethical Decision Making Paper – Scenario 2

Liberty University

Abstract

Dual relationships between counselor and client occur when multiple roles between the pair develop. These types of relationships may form into a friendship (i.e. whether in person or online) or a business partnership, or they may already be established within the context of a professional (i.e. colleagues) or communal (i.e. attend the same church) type setting. Regardless of how these dual relationships may form or presently exist, it is still the counselor’s obligation to maintain his ethical compass and proceed with caution as not to cause an ethical dilemma that could bring harm to the client. The American Counseling Association does not necessarily forbid non-sexual dual relationships, but it does provide guidelines in which counselors should give careful consideration to when faced with this kind of ethical decision. This paper examines the following scenario using the Ethical Decision Making Model offered by Holly Forester-Miller and Thomas Davis (1996):

  1. John is a counseling intern working for an outpatient facility that specializes in alcohol and drug addiction recovery. John has been interning with the facility for 9 months. He is particularly involved in co-leading many of the groups at the facility and has gotten to know many of the clients. Overall, John really likes most of the clients at the center. One evening, while checking his email, he notices a friend request for his personal Facebook account. John recognizes the email as originating from Ben, one of the clients at the center. John has enjoyed his interactions with Ben, so he grants Ben his request. A few days later, Jeanne, another client at the center, emails John with her request to befriend John on Facebook. John is not as fond of Jeanne because she is often argumentative in group. John decides to deny the request, explaining to Jeanne he does not befriend women. (Liberty University Online, Counseling 501 – Ethical Decision Making Paper Scenarios, 2016)

Identify the Problem

In the aforementioned scenario, John is a drug and alcohol counseling intern in an outpatient facility. He co-leads many groups at this facility; therefore, he has not only had the opportunity to familiarize himself with many of the clients, but they also have gotten to know him fairly well. One of John’s clients sent him a “friend request” on his private Facebook account. The client, named Ben, seems to be a pretty decent guy and John has enjoyed his time with Ben during group. John accepts Ben’s request. At this moment, John just entered into a dual relationship with Ben. This is just one of the potential problems because another client, Jeanne, whom John is not so fond of, sent him a “friend request” as well. Consequently, John denied Jeanne’s request informing her that he does not befriend females. This is another potential problem for John.

As I look over the ACA Code of Ethics Preamble and compare John’s actions to the core professional values and ethical principles, I see some conflicts that could arise from John’s actions. First, John did not really safeguard the integrity of the counselor-client relationship by accepting Ben’s “friend request” and then denying Jeanne’s. At this point, John’s professional relationship with Jeanne could become strained because she may feel rejected by John’s actions; thus, reducing John’s ability to properly counsel her during group. The second problem that could be created from John’s actions is that Ben might be hurt from what he sees on John’s personal Facebook account. Maybe John is not the person that Ben thought he was when he just knew him as his counselor. This could also affect the integrity of John’s counseling relationship with Ben. John’s actions are also found to conflict with the ethical principles of nonmaleficence (doing possible harm to both Ben and Jeanne) and justice (treating Jeanne differently because she

is a woman), even though the real reason John refused Jeanne’s request was based on her argumentative behavior during group.

When John entered into a dual relationship with Ben, he did not stop and conduct a self-evaluation as to why he should accept Ben’s “friend request”. He accepted it based solely on the fact that he enjoyed his interactions with Ben, and not on what the ACA Code of Ethics suggests concerning dual relationships. John is facing the ethical problem of dual relationships which is mainly related to self, but could possibly relate to the institution for which he works if he violated the outpatient facility’s professional code of conduct by befriending a current client on social media.

Applying the ACA Code of Ethics

As a professional counselor or even in John’s case, which is a counseling intern, the client’s welfare is always of the utmost importance. It is the duty of the counselor to make sure that the client’s welfare is cared for in order to promote the client’s growth and development as an individual (ACA Code of Ethics, 2014). According to the ACA Code of Ethics (2014), counselors are to make decisions that would avoid bringing harm to their clients, trainees, and research participants and “to minimize or remedy unavoidable or unanticipated harm” (§A.4.a.). According to this standard, it would have been in the best interest of the client if John had not accepted his client’s “friend request”, but since he did accept it, John should try to rectify this issue bringing as little harm as possible to the client. Another ACA Code of Ethics (2014) that could be applied to this situation is standard §A.5.e., which states that counselors are to abstain from entering into a personal virtual relationship with persons who are currently involved in a client-counselor relationship. However, the ACA Code of Ethics (2014), standard §A.6.b., does

allow for boundary extensions but only to very limited exceptions: attending a client’s formal ceremony, visiting a client’s ill family member, purchasing a product from the client, etc. Once again, it is the responsibility of the counselor to take appropriate actions to ensure that no harm is brought to the client if a limited dual relationship does develop. Standard §H.6.a. can apply to this situation in that a counselor may continue with the use of social media, but the counselor is required to maintain a professional site that is separate from his personal site, clearly distinguishing between the two profiles (ACA Code of Ethics, 2014). Standard H.6.b. goes further in explaining that clients must be made aware of the counselor’s use of social media by detailing to the client the benefits, limitations, and boundaries of the use of social media as part of the informed consent process (ACA Code of Ethics, 2014). The state of Indiana rules and regulations for mental health counselors does not specifically address the social media dilemma between counselors and clients, but it does support the ACA Code of Ethics by charging the mental health counselor to be aware of any action that might interfere with the effectiveness of treatment, which could lead to harm, whether it be to the counselor or to the client (Indiana Administrative Code, 2014, §25-23.6-2-8).

Determine the Nature/Dimensions of the Dilemma

There are five ethical principles which are considered foundational to professional counselors because when reviewed properly, these principles can help to bring clarity to an issued-filled situation (Forester-Miller & Davis, 1996). These five moral principles are: autonomy, nonmaleficence, beneficence, justice, and fidelity. They are all equal in absolute truth, but when applied to certain situations, it is the responsibility of the counselor to prioritize them in order to resolve an ethical dilemma (Forester-Miller & Davis, 1996).

In Johns’ situation, it would have been best had he put more weight on the moral principle of nonmaleficence. I believe that by considering this moral principle as a priority in this situation, John would have made a better decision concerning the “friend requests” from both Ben and Jeanne. Nonmaleficence is simply stated as “above all do no harm” (Forester-Miller & David, 1996); unfortunately, John not only ignored the ACA Code of Ethics regarding the prohibition of befriending clients on social media, but he also engaged in an action that could bring harm to his clients. Another moral principle that would need to be considered in this situation is that of beneficence, which means it is the responsibility of the counselor to promote the client’s welfare by doing good and preventing harm when possible (Forester-Miller & Davis, 1996). The third moral principle that takes priority in this case is justice. Forester-Miller and Davis (1996) explain that this is not treating all equally, but rather it is “treating equals equally and unequals unequally but in proportion to their relevant differences” (p. 2). Counselors must offer an explanation which clarifies the necessity and appropriateness of their decision if a client is to be treated differently (1996). In John’s case, there was not an explanation given that fits either requirement of justice concerning his decision to not accept Jeanne’s request.

In reviewing the situation that John was faced with, I believe that he should have never accepted Ben’s request. For me this is fairly straight forward because the ACA Code of Ethics strictly prohibits virtual relationships with current clients; however, after doing some research, I did find some conflicting research between professionals. Remley and Herlihy (2016) suggest that in order for a counselor to remain objective, it is important that he/she adhere to the ACA Code of Ethics standard §A.5.e., which prohibits counselors from having a virtual relationship with their current clients. Zur and Walker (2015) have determined that it is not clearly established if engaging in social networking with clients is detrimental to the client; however,

they do encourage a cautious and questionable approach for the counselor when deciding to befriend a client on a social media site. Some of the cautions and questions that Zur and Walker (2015) encourage counselors to carefully examine include: making sure that the privacy controls are put in place in order to control what a client is allowed to see, to fully understand what kind of client is sending you a request (high-functioning fellow professional or a disturbed person), could there possibly be a hidden meaning to the friend request, how will this benefit the client, and could this affect the treatment of the client and the therapeutic relationship. However, Zur and Walker (2015) did suggest that the best answer would be for the counselor to set up a professional social media page that follows the guidelines of the ACA Code of Ethics.

If the decision was still not clear to John, then it would have been best practice for him to consult with his supervisor at the facility. The supervisor could not only have diverted an issue by giving John solid advice, but he/she could have possibly redirected John to the facility’s code of conduct for their employees regarding such a matter. Also, John could have sought out help from fellow colleagues who may have been faced with similar situations. Another course of action in order to find a solution to this problem would have been to contact the Behavioral Health and Human Services Licensing Board for the state of Indiana, the Indiana Counseling Association, and the National Association for Alcoholism and Drug Abuse Counselors (NAADAC).

Potential Courses of Action

If John could go back before receiving any social media friend request, then one course of action would be to address this issue as part of the informed consent process. If social media was not a part of the facility’s informed consent policy, then John could have brought this up to

his supervisor and hopefully, it would have been addressed. Even if the facility did not change its informed consent policy, then John could have still addressed this issue during the initial meeting of group therapy, making it very clear that he does not accept any friend requests from his clients. This would not only have prevented the ethical dilemma with Ben, but it would probably have kept Jeanne from being hurt (if she was in fact hurt). However, since the scenario included John accepting Ben’s friend request, then one possible course of action would be for John to inform Ben of his mistake. Another course of action could be that John closes down his personal social media page and opens up a professional page adhering to the ACA Code of Ethics, and providing that the facility allowed this. One final course of action could be that John shuts off his personal page for the period of time that he is in a counseling relationship with Ben.

Consequences of Determined Course of Action

Once again, if the issue of social media was addressed as part of the informed consent process, then there would likely be no consequences unless John completely ignored the rules. In which case, he should at the very least be reprimanded. However, since John did accept Ben’s friend request, then by going to Ben and recanting his acceptance, John will be taking a chance of hurting Ben; thus, bringing potential harm to him and to the client-counselor relationship. If John shut down his personal social media page and opened a professional social media page with the approval of the facility, then he could accept friend requests from his clients, even from those who were argumentative.

Faced with these options, I would have to combine telling Ben that I was ethically wrong by accepting his friend request on my personal social media page, but that I would enjoy having him as my “friend” on my professional social media page. I understand that this could still be

harmful; but hopefully by admitting to my mistake and by rectifying it through the provision of another option I could continue the client-counseling relationship with little to no damage. If the facility did not allow for a social media page, then I would have no choice but to be honest about my mistake with Ben. This would not be an easy decision.

Evaluate the Selected Course of Action

The selected course of action could possibly bring harm to Ben, which unfortunately breaks the moral principle of nonmaleficence. However, I do believe in honesty. As for does this course of action test for justice, I believe that it does. I feel that I would have no choice but to treat all clients the same in this situation because it is mandated by the ethical guideline that I should not enter into a virtual relationship with any current clients. I also believe that it passes the test of publicity at least for this particular scenario. As for the test of universality, I would probably advise that honesty in this situation is probably best.

Implement the Course of Action

I would first implement this course of action by talking to my supervisor about what happened. I would request a meeting with my client in private, but not necessarily excluding my supervisor. I would inform the client about the ACA Code of Ethics and what it says about entering into a virtual relationship with a current client. I would express to him/her that this kind of relationship could negatively affect the treatment. If a professional social media page is an option, then I would provide him/her with the information so that he/she could get connected to that virtual community. I would give the client a chance to ask any questions or to express any concerns or feelings. I would hope to be as transparent as possible concerning this issue and lastly, I would offer an apology.

References

American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved May 10, 2016from http://www.counseling.org

Behavioral Health and Human Services Licensing Board. (2014). 2014 Indiana AdministrativeCode. Retrieved May, 10, 2016 from http://www.in.gov

Forester-Miller, H. & Davis, T. (1996). A practitioner’s guide to ethical decision making.American Counseling Association. Retrieved May 10, 2016 fromhttp://www.counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2

Liberty University Online. (2016) Counseling 501 – Ethical decision making paper scenarios.Retrieved May 9, 2016 from http://www.liberty.edu/

Remley, T.P. and Herlihy, B.P. (2016). Ethical, legal, and professional issues in counseling.New York, New York: Pearson Education, Inc.

Zur, O. & Walker, A. (2015). To accept or not to accept? How to respond when clients send“friend request” to their psychotherapists or counselors on social networking sites.Retrieved May 10, 2016 from http://www.zurinstitute.com/socialnetworking.html




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