Editor’s note: American Counseling Association members received the 2005 ACA Code of Ethics bundled with the December 2005 issue of Counseling Today. Completed over a three-year period, this revision of the ethical code is the first in a decade and includes major updates in areas such as confidentiality, dual relationships, the use of technology in counseling, selecting interventions, record keeping, end-of-life issues and cultural sensitivity.
All ACA members are required to abide by the ACA Code of Ethics, and 21 state licensing boards use it as the basis for adjudicating complaints of ethical violations. As a service to members, Counseling Today is publishing a monthly column focusing on new or updated aspects of the ACA Code of Ethics (the ethics code is also available online at www.counseling.org/ethics). ACA Chief Professional Officer David Kaplan conducted the following interview with Rocco Cottone and Michael Kocet, two members of the ACA Ethical Code Revision Task Force.
David Kaplan: Two months ago we discussed a major change in the recent revision of the ACA Code of Ethics — changing the criterion for breaking confidentiality from “clear and imminent danger” to “serious and foreseeable harm.” This month we will be talking about another critical change in a core area of counseling ethics: allowing a dual relationship when it is beneficial to the client, supervisee, student or research participant (Editor’s note: See Standards A.5.d, F.3.e, F.10.f and G.3.d). It is interesting to note that the new 2005 Code of Ethics does not even mention the term “dual relationship.”
Rocco Cottone: The dual relationship term is really nondescript and does not give good guidance to the profession or to clients who have an ethical concern or complaint.
Michael Kocet: And over time our professional culture had developed the notion that you had to back away from any circumstance that might present a dual relationship, even if there was a potential for benefit to the client.
RC: When you sit down and analyze the concept of dual relationships, you will find that it relates to three different types of relationships: sexual/romantic relationships, nonprofessional relationships and professional role change. The first category, sexual and romantic relationships with current clients, is banned by the code of ethics because we have evidence of the damage that results. The second type of relationship, nonprofessional relationships, encompasses those activities where you might have contact or active involvement with a client outside of the counseling context. The third type of relationship that the old dual relationship term encompassed is a professional role change. An example is when you shift from individual counseling to couples counseling. Moving from one type of counseling to another with one client can be really confusing and ethically compromising.
So, in the end, moving away from the concept of dual relationships was really about the analysis of what the dual relationship term meant and the confusion it caused because of multiple meanings. The new ethics code addresses all three types of roles and relationships with clients.
DK: So instead of banning dual relationships across the board, the recent revision of the ethical code now allows professional counselors to interact with clients outside of a counseling session under certain conditions.
RC: Counselors may now interact with a client in a nonprofessional activity as long as the interaction is potentially beneficial and is not of a romantic or sexual nature. Even if it is a potentially beneficial relationship, counselors must use caution, forethought and proceed with client consent whenever feasible.
MK: Focusing on assessing beneficial versus harmful interactions allows the counselor to really partner with the client to determine whether a potential relationship will help or hurt.
DK: Can you give some examples of potentially beneficial interactions that may now be allowed?
MK: One example is a wedding. Let’s say a long-term client announces that he or she is getting married. The counselor is then asked to the wedding because the client feels that the counseling was instrumental in working through issues that blocked the client from considering new relationships. From the client’s perspective, the counselor’s attendance at the wedding would be very meaningful.
A second example involves a counselor who lives in an extremely rural area, needs to get her car fixed and has a client who is the only mechanic in town. A discussion with the client may lead to the clear conclusion that it is appropriate for the client to service the counselor’s car.
RC: Other examples include attending a graduation ceremony to honor a client’s academic accomplishment or attending a funeral to show respect to a client. It could be as simple as buying cookies from a Girl Scout or as complex as being actively involved in a shared community (e.g., a political party or a disability community) where you are working hand-in-hand with clients, students, supervisees or research participants. Counselors should not feel guilty for engaging in more than one role as long as it is potentially beneficial to the client.
DK: How does bartering fit into this new concept? What if a client would like to do yard work, carpentry, home repair, etc., in return for your services?
RC: Well, the standard we are talking about ( A.5.d, “Potentially Beneficial Interactions”) doesn’t in any way supersede the longstanding standard on bartering (A.10.d).
DK: One of the impressive things about Standard A.5.d, “Potentially Beneficial Interactions,” is that it gives a very nice road map for how to ensure that the focus is on the client’s best interest when the issue of an interaction outside of counseling, supervision, teaching or research arises.
MK: Right. The counselor needs to have a thorough discussion with the client, supervisee, student or research participant about both the potential benefits and the potential harm that could occur. It is then critical that the counselor document this discussion in case records along with the rationale for engaging in the interaction.
DK: As we have pointed out in previous columns, a major theme through the new ACA Code of Ethics is consult, consult, consult! Is the issue of a potentially beneficial interaction with a client, student, supervisee or research participant an area that comes under this theme?
MK: Absolutely. If the counselor has any reservations, it is very useful to consult with a supervisor or colleague, search the literature, etc. There are many ways to consult.
DK: Dr. Cottone, you were the member of the Ethical Code Revision Task Force who spearheaded the change from banning dual relationships to evaluating beneficial versus harmful interactions. Why was this important to you?
RC: From a personal perspective, I have a son who has muscular dystrophy. I am very active in the community here in St. Louis, and at the same time I have a practice that focuses on counseling individuals affected by muscular dystrophy. So the people I counsel are the people in the same community where I am an active volunteer. I sit side by side my clients at the MDA telethons trying to raise money to save people’s lives. I go to parties with my son where my clients are present and we socialize. I began to realize there was nothing wrong with that. In fact, if I hadn’t been involved in that kind of activity, my clients would have looked at me as if I really was not sincerely interested in helping people with their condition.
I want to thank my colleagues on the task force because they were very receptive to the idea of evaluating beneficial versus harmful interactions rather than an across the board ban on dual relationships. The ideas I brought to the ethics task force were significantly different than those in the prior code, so I applaud my colleagues for letting me express my view and improving on some of the ideas I had.
DK: Thanks for giving a very human touch to the new ethical code.
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Next month: New ethical code statements about end-of-life issues.
Letters to the editor: ct@counseling.org