Psychotherapy and counseling involve a specific human interaction that can get pretty complicated and confusing in some cases. Because it involves a certain degree of intimacy, many gray areas can arise in both in-person and online therapy.
New ethical dilemmas in counseling have been emerging since online counseling got more popular. While it can be unethical not to provide online counseling in some cases, working via the internet does put up some confidentiality difficulties.
According to statistics, the most frequent complaints about ethical issues in counseling involve dual relationships, incompetence, practicing without a license or misrepresenting one’s qualifications, sexual relationships with clients, and breach of confidentiality.
The messy nature of emotions can lead to situations in which it may be unclear what the best approach is. If some boundaries were crossed or the client feels harmed in counseling, some guidelines should be in place to set the course of action.
This is why the ethical behaviors of counselors are defined by ethical codes all around the world. They serve as a code of conduct for a healthy counseling relationship and protect both client and therapist from abuse.
Read further to better understand the ethical principles of counseling, find out what are some red flags in the therapeutic relationship, and what is the best way to approach them in counseling.
Ethical Codes in Counseling
Counseling and therapy are independent professions that are regulated differently from state to state or from one country to another. Ethical codes are established worldwide to assure a good practice in counseling and therapy.
While some of the guidelines may differ locally, the majority of ethical codes in counseling follow the same principles:
- Autonomy: The counselor will respect their client's free will, with no intention to manipulate or influence their decisions. For example, the therapist allows their client to not follow their advice and doesn’t force them in any way to do so.
- Beneficence: The counselor acts for their client’s well-being, trying to minimize any losses for their clients in a critical situation. For example, the therapist recommends another form of treatment if their method is not working for a client.
- Non-maleficence: The counselor will not use their knowledge and abilities to harm their client, their family, or any third party. For example, the counselor is not using confidential information for blackmail or manipulation of their clients.
- Fidelity: The counselor will respect their competencies and training in order to provide the best treatment for the actual issue that a client is addressing. For example, if a client comes to talk about setting boundaries with their family that insists they get married, the counselor discusses that and does not redirect their client to talk about why getting married may be a better option for them.
- Justice: The counselor will treat their clients equally, regardless of race, financial status, or gender, and will not discriminate against them based on subjective matters. For example, the counselor keeps the same price and service quality for both LGBTQ+ and heterosexual clients.
- Veracity: The counselor will always tell the truth regarding their client’s situation and will act accordingly. For example, the counselor communicates transparently with their client if their problem requires more complex treatment, even if this may put them in an uncomfortable position.
- Self-respect: The counselor is also entitled to self-care and self-respect and sets optimal boundaries with their clients on that matter. For example, the therapist doesn’t do favors to clients when the situation is not asking for it (such as lowering their price without necessity).
If you see your therapist following these principles with you and others, you can consider yourself in good hands. But if you’ve identified some issues, taking a look at some unethical counseling cases could bring you more clarity.
Examples of Ethical Issues in Counseling
Ethical issues in counseling can occur in various cases and may be overwhelming for both the professional and the client. Here are some of the main areas that can bring up ethical and legal issues in counseling.
At the beginning of your in-person or online counseling, your specialist should be giving you some information about their training, their conditions, and some rules that apply to working with them.
Let’s take this example: You’ve engaged in online counseling with a therapist who is also a trainer and writer. While working with them, you find one of their online courses on your issue, and a recording with you (with your face blurred) is featured in that course.
It’s an ethical issue in counseling because personal data is highly sensitive content and should be protected by your therapist. If you didn’t sign an informed consent for that recording to be used in their course or be recorded to begin with, they should not be able to use it.
One of the most important aspects of both in-person and online therapy is confidentiality. Violating it means breaking the client’s trust and even causing them serious harm.
Let’s take this situation: You work with a therapist for some time, and you’ve confessed in counseling that you’ve cheated on your spouse. You now divorce your spouse, and they’re contacting your therapist to ask for a report. Your therapist tells your still-spouse that you’ve been unfaithful and regret it, hoping this will make things right with you.
This situation violates more ethical principles, but the biggest issue is that it’s not respecting confidentiality. There are some exceptions from the absolute confidentiality rule, but they are regulated differently by professional organizations (for example, for an adolescent’s safety).
Some therapists may engage in multiple relationships with clients, usually with the counseling beginning after another relationship is already in place.
Let’s take this example: A therapist is meeting with a good friend in their free time. The friend talks about their sister’s anxiety struggle and asks the therapist if they can help for a reduced price. The therapist agrees and starts counseling their friend's sister, who they have seen before in other social contexts (parties, informal meetings, and so on). The therapist continues to meet with their friend informally, too.
This is an ethical issue because it disrupts the impartiality and objectivity of the therapist. Being in a close relationship with a client’s relative can result in their client withholding information, feeling uncomfortable, and not trusting the counseling.
Termination of therapy
Starting and ending therapy is usually up to the client’s needs. The therapist can end working with a client only when this is according to the benevolence principle (for example, if they realize the client’s case is out of their competence).
Let’s look at this example: A therapist has worked with a client for two years, and their client has made significant progress. Now, the client faces financial struggles and wants to end therapy. The therapist starts convincing their client that they still aren’t feeling well, and coming to therapy is still essential in their case.
This is an ethical and legal issue because it violates multiple principles. Because of personal interests, the therapist ignored their client's decision.
Cases of Ethical Violations in Counseling
S.J. Knapp, M.C. Gottlieb, and M. M. Handelsmann describe in their book, Ethical Dilemmas in Psychotherapy. Positive Approaches to Decision Making (2015), several possibly unethical counseling cases, and how the therapists approached them.
- “A 14 years old girl comes to counseling and says that she started having unprotected intercourse with her boyfriend. The counselor understands that their sexual relationship will continue and thinks about warning the adolescent’s parents that she might get pregnant.”
If the counselor had gone directly to the girl's parents, it would have been unethical because her state's legal standards granted 14-year-olds the same confidentiality rights as adults. The counselor reached out for juridic counseling and was advised not to break confidentiality, even if their intentions were good.
- “A psychologist was treating a woman who was abused by her alcoholic husband. She said that she was hit, strangled, and threatened. The psychologist observed that her client was not making any real plans to avoid aggression and stay away from her husband, even if the counselor had given her a lot of options throughout their work.”
The first impulse for the counselor was to protect their client somehow, to offer to drive her home or put her in contact with a shelter for abused women. But it would have been unethical because it would not respect the client’s autonomy. The counselor eventually talked openly with her client, and she eventually agreed to start another treatment program that is specially designed for cases of abuse.
Assuring there are no ethical issues in counseling is usually up to the counselor. But knowing how to recognize abuses and sensitive situations can protect you from harm in face-to-face or online counseling.
DoMental therapists follow ethical guidelines and provide high-quality online counseling. Your confidentiality is protected online by anonymity and encrypted systems, so you can access counseling more easily than ever.