Ethics and Professional Issues for
edited: Wednesday, January 27, 2010
By Dr. Mirline Lozis-Polynice
Rated "PG13" by the Author.
Posted: Wednesday, January 27, 2010
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Ethics and Professional Issues for
School Counselors and Mental Health Practitioners
Dina is a 43-year-old Caucasian counselor working as a supervisor for a company that offers individual, therapeutic counseling. Her foster parents adopted her at the age of twelve. She is still grieving the loss of her mother and has always talked about the fact that she did not have time to say goodbye to her when she passed away. She is a seasoned and intelligent counselor who is honest with her staff and clients. She is a divorced woman living alone with her 10-year-old son.
In December, Dina started a sexual relationship with a former client of hers. She is 14 years older than her former client. Her professional relationship with her former client began when he was 15 years old. She was 25 years old at the time. She was initially his ongoing social worker and then became a supervisor and managed his case in that capacity. When the client became 18 years old, he refused services from the company and moved to California. When the client became 28 years old, he returned to LA and became reacquainted with his former counselor Dina. Their relationship proceeded into an intense sexual relationship. Engaging in a sexual relationship with current or former clients is an area where counselors must exercise much caution and avoid engaging .
Jane, who formerly managed the clients’ case under Dina’s supervision, continued in the same position and Dina was still her supervisor. Upon learning of her supervisor’s relationship with the client, Jane approached Dina with the issue. Jane informed Dina that her relationship with their former client was unethical and she needed to end it.
Despite Jane having approached her, Dina continued her relationship with the client and took him to all the events that the company had. Jane felt uncomfortable with the situation because she felt that the client was still her client and Dina was taking advantage of the client’s fragility. Jane eventually changed positions and moved to another department within the company as she no longer felt comfortable being supervised by Dina.
The issue was compounded by a call to the company by Dina’s ex-husband who reported that his ex-wife was engaging in a sexual relationship with her former client. According to the ex-husband, Dina had been engaging in a sexual relationship with the same client since he was 15 years old. He further reported that Dina often invited the 15 year old client to spend the weekend at their home. She reportedly cited the client not having a family as a way to justify her wanting him to spend the weekend. Following the ex-husband’s report, Dina’s company placed her on administrative leave without pay until a full investigation was completed. Dina became angry with the company and stated that she was considering suing the company for abuse of discretion.
This case is reflected in the Code of Ethics A.7, Sexual Intimacies With Clients. According to A.7.a., “counselors [should] not have any type of sexual intimacies with clients and [should] not counsel persons with whom they had a sexual relationship.” And section A.7.b also refers to former clients, “where counselor should not engage in sexual intimacies with former clients within a minimum of two years after terminating the counseling relationship.”
Dina felt that she had a right to engage in sexual intimacies with her former client because it had been more than 8 years since their counseling relationship terminated. I believe that her behavior is unethical even though the Code of Ethics states that a counselor should refrain from engaging in sexual intimacies following two years after terminating the counseling relationship. My values would not allow me to engage in any kind of relationship with my former clients; I would always see this client as a child growing up before my eyes.
Dina’s relationship with her former client is further unethical because Dina continues to work for the same company, doing the same job and she also is able to access all the files when she needs or wants to. I believe that Dina continues to be in an exploitative position because she continues to be “the supervisor.” According to the Code of Ethics A.7.b, “counselors who engage in such relationship after two years following the termination, have the responsibility to thoroughly examine and document that such relationship did not have an exploitative nature, based on the factors…”
For Dina‘s company, this situation represents a conflict of interest. The company argues that she still works for the company and is therefore not trustworthy with other children especially since she is a supervisor.
It is also important to note that some responsibility also lies with Jane who formerly managed the young man’s case. Jane failed to take appropriate action. Instead of her changing positions she should have consulted with other counselors who are more knowledgeable about ethics as highlighted in section h.2.b. of the Code of Ethics. When she had reasonable knowledge, she should have attempted to first resolve the issue informally with Dina. According to Section H.2.e., if Dina does not want to resolve the problem, then, “upon reasonable cause, [Jane should] take action such as reporting the suspected ethical violation to state or national ethics committees. Section H.2.f. reports that these codes have been written in this section with the objective to protect the clients, but they aren’t written to injure counselors.
Another Ethical Standard that should not be a source of debate is the fact that counselors must practice confidentiality and demonstrate professional competence. The aforementioned is demonstrated in the case of Martin in the scenario #4 “Ethical Pitfalls In Managed Care”, where Martin was required to get telephone authorizations for a client’s session. The case manager, who Martin only knows by her first name, was able to access Martin’s client computerized file. This situation reflects section B.4.a.b., of the Code of Ethics. According to that section, “the counselor is responsible for securing the safety and confidentiality of any counseling record they create, maintain and transfer etc…” I think that Confidentiality is the most common ethical dilemmas in the counseling field. There will be instances in which family or friends and even other collaterals will call without having prior written authorization of a client. Thus, it is essential that counselors understand and adhere to the principle of confidentiality to protect their clients’ right to privacy. There are instances nonetheless where confidentiality must be weighed, specifically in instances where it poses a case of public danger (homicide or suicide.) Martin should use the DSMIV for diagnosis. The DSMIV is used especially to bill the third party. Thus, there is no need for him to reveal any other information. Martin was able to demonstrate his professional competence by referring his client, who suffered from depression and anorexia, to a psychiatrist. According to the section C2.a.c. “Counselors should practice only within the boundaries of their competencies based on their education, training, supervised experience and also a counselor should accept employment only for positions for which they are qualified etc…” This decision was very ethical, and I think that all counselors should know their limitations.
Mirline Lozis-Polynice, PhD