Ethical Principles in Christian Counseling: Staying ... Principles in Christian Counseling: Staying Oriented in Challenging Times David E. Jenkins, Psy.D. ... gender, gender identity,

Ethical Principles in Christian Counseling: Staying Oriented in Challenging Times

David E. Jenkins, Psy.D.

Liberty University, Lynchburg, VA

AACC Counseltalk Webinar

March 17, 2015

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Y-2014 Code of Ethics http://www.aacc.net/about-us/code-of-ethics/

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Changes to the 2014 Code 1. The entire code was restructured and reformatted utilizing eight

Foundational Principles to guide Christian counselors and caregivers.

2. Every section was completely reformatted (including numbering) for easier readability and flow.

3. Other revisions include an increased depth in the cultural competency section, as well as adding an entirely new section devoted to the use of technology in counseling.

4. The Procedural Rules were reoriented to reflect Credential Holders with the International Board of Christian Care (IBCC) (now the Board of Christian Professional and Pastoral Counselors, BCPPC) and their affiliate boards.

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Organization of the Code (p. 10-11)

Core Principles

Ethical

• Compassion

• Competence

• Consent

• Confidentiality

• Cultural Regard

• Case Management

• Collegiality

• Community Presence

Moral/Biblical

• Servanthood

• Excellence

• Integrity

• Trustworthiness

• Dignity

• Soundness

• Relationship

• Humility

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Separate Sections

I. Ethical Standards for All Christian Counselors

II. Use of Technology and Technology-related Applications

III. Additional Ethical Standards for Licensed and Professional Christian Counselors

IV. Additional Ethical Standards for Pastoral and Lay Christian Counselors

V. Standards for Resolving Ethical-Legal Conflicts

VI. Procedural Rules

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ES1-000: A Judeo-Christian Worldview – Practicing through Faith and Values

This Code—and all who follow it—incorporates a Judeo-Christian worldview and meta-ethic, one that is derived from both special revelation (recognizing that Jesus Christ is God-come-in-the-flesh) and general revelation (acknowledging that science and the great arts of humanity also speak a certain measure of truth) as revealed in the 66 books of the Holy Bible. Christian counselors are rooted in this Revelation and consider the Bible to be the final authoritative basis for faith, values and all ethics and interventions.

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1-010: Affirming Human Worth and Dignity

Christian counselors recognize and uphold the inherent, God-given worth and dignity of every human person, from the preborn to those on death’s bed. Human beings are God’s creation and consequently, are due all the rights, respect and ordered logic that this fact of creation entails. Therefore, Christian counselors express appropriate care towards any client, service-inquiring person, or anyone encountered in the course of practice or ministry, without regard to race, ethnicity, gender, sexual behavior or orientation, socioeconomic status, age, disability, marital status, education, occupation, denomination, belief system, values, or political affiliation. God’s love is unconditional and, at this level of concern, so must that be of the Christian counselor.

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1-020: An Orientation of Beneficence

Christian counselors operate first and foremost from a position of beneficence and endeavor to approach the therapeutic alliance in light of the scriptural admonishments found in the following passages: (1) Galatians 6:2 – “Bear one another’s burdens, and thereby fulfill the law of Christ;” (2) Galatians 6:10 – “So then, while we have an opportunity, let us do good to all people, and especially to those in the household of faith;” and (3) Philippians 2:3-5 – “Do nothing from selfishness or empty conceit, but with humility of mind regard one another as more important than yourselves; do not merely look out for your own personal interests, but also for the interests of others. Have this attitude in yourselves which was also in Christ Jesus.”

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ES1-200: Competence in Christian Counseling – A Call to Excellence

In addition to being distinctly Christian, faith-based counselors must also uphold a strong commitment to clinical and professional excellence. Competence makes truthful and realistic statements about the caregiver and the caregiving process, keeps pace with relevant research in the field, demonstrates awareness of limitations, avoids dishonest or exaggerated claims, incorporates accountability when there is awareness of hindering personal issues, and makes needed and appropriate referrals.

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ES1-300: Consent in Christian Counseling – A Call to Integrity

The fundamental right of client self-determination is a foundational pillar for counselors and their clients. Consent allows for the counselor to operate transparently and with integrity, and for the client to make an informed and voluntary decision to engage in the helping process.

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ES1-400: Confidentiality in Christian Counseling – A Call to Trustworthiness

Confidentiality recognizes that every client has a fundamental, moral and legal right to privacy and to have a wide range of personal thoughts, opinions, beliefs and behaviors that are protected from public knowledge. The therapeutic alliance between counselor and client is enhanced whenever there is an environment that offers an appropriate level of confidentiality, privacy and safety. This dynamic helps promote strong and effective trust relationships and is an essential factor in facilitating self-disclosure and the potential for personal, relational, and spiritual growth and wholeness.

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ES1-500: Cultural Regard in Christian Counseling – A Call to Dignity

Cultural, ethnic and racial diversity are important factors for consideration in the delivery of counseling related services. Cultural competency signifies a minimal level of knowledge and awareness that represents such things as the values, norms, and traditions of another that influence perception, thoughts, attitudes, beliefs, identity, communication, relational dynamics, behaviors, life experiences, customs, spirituality and the understanding of the cause, symptomology and remedy of human problems.

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ES1-600: Case Management in Christian Counseling – A Call to Soundness

Comprehensive and thorough case management always considers the whole person—biologically, psychologically, emotionally, cognitively, socially, culturally, relationally and spiritually. It requires a thoughtful and systematic coordination of needed services that are in the best interests of the client, including assessment, diagnosis, treatment planning, care implementation, ongoing therapeutic review, and discharge and aftercare coordination. Soundness for Christian counselors implies the use of empirically validated and evidence-based treatments that also integrate biblical principles.

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ES1-700: Collegiality in Christian Counseling – A Call to Relationship

Christian counselors and counseling leaders recognize the value and benefit of forming and maintaining effective professional and ministry relationships with colleagues across multiple domains. These include, but are not limited to: (1) fellow mental health practitioners; (2) community and ministry leaders; (3) supervisors and supervisees; (4) mentors and mentees; (5) educators and students; (6) researchers; and (7) counseling related referral sources. Collegiality, cooperation and professional respect are encouraged, as are opportunities to work on common ground and for common purposes—to the extent that these activities do not violate one’s conscious or constitute an egregious disregard for Judeo-Christian principles.

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ES1-800: Community Presence in Christian Counseling – A Call to Humility

Christian counselors are aware of the larger role they play in their communities, as well as society in general. Christian counselors further acknowledge they may live in a post-Christian, post-modern and pluralistic culture that no longer shares a common Judeo-Christian value base and therefore, are mindful to present themselves at all times as “Salt and Light” and as “God’s Ambassadors.” In doing so, they conduct themselves with the utmost dignity and humility, avoiding any behaviors and practices that may bring dishonor to themselves as caregivers or to the name of Christ.

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Principles Side-by-Side

AACC Code

• Servanthood

• Excellence

• Integrity

• Trustworthiness

• Dignity

• Soundness

• Relationship

• Humility

ACA Code

• Autonomy

• Nonmaleficence

• Beneficence

• Justice

• Fidelity

• Veracity

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Key ACA (2014) Ethical Statements

A.11.a.—Competence Within Termination and Referral

If counselors lack the competence to be of professional assistance to clients, they avoid entering or continuing counseling relationships. Counselors are knowledgeable about culturally and clinically appropriate referral resources and suggest these alternatives. If clients decline the suggested referrals, counselors discontinue the relationship.

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1-240: Duties to Consult and/or Refer


A.11.b.—Values Within Termination and Referral

Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.

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1-550: Action if Value Differences Interfere with Counseling

1-530: Working with Persons of Different Faiths, Religions, and Values 1-530-a: Not Imposing Values

1-540: Cultural Sensitivity


C.2.a.—Boundaries of Competence

Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population.

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1-220: Duties to Study and Maintain Expertise

ES1-200: Competence in Christian Counseling – A Call to Excellence

1-210: Honoring the Call to Competent Christian Counseling; a.; b.


C.5.—Nondiscrimination

Counselors do not condone or engage in discrimination against prospective or current clients, students, employees, supervisees, or research participants based on age, culture, disability, ethnicity, race, religion/spirituality, gender, gender identity, sexual orientation, marital/partnership status, language preference, socioeconomic status, immigration status, or any basis proscribed by law.

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1-220: Duties to Study and Maintain Expertise

1-010: Affirming Human Worth and Dignity

1-020: An Orientation of Beneficence


F.2.b.—Multicultural Issues/Diversity in Supervision

Counseling supervisors are aware of and address the role of multiculturalism/diversity in the supervisory relationship.

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1-750-d: Overcoming Student Limitations

1-740: Base Standards for Educators and Supervisors

1-750-b: Student and Faculty Diversity


F.6.b.—Gatekeeping and Remediation Through initial and ongoing evaluation, supervisors are aware of supervisee limitations that might impede performance. Supervisors assist supervisees in securing remedial assistance when needed. They recommend dismissal from training programs, applied counseling settings, and state or voluntary professional credentialing processes when those supervisees are unable to demonstrate that they can provide competent professional services to a range of diverse clients. Supervisors seek consultation and document their decisions to dismiss or refer supervisees for assistance. They ensure that supervisees are aware of options available to them to address such decision.

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1-750-d: Overcoming Student Limitations


F.7.c.—Infusing Multicultural Issues/Diversity

Counselor educators infuse material related to multiculturalism/diversity into all courses and workshops for the development of professional counselors.

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Not specifically addressed to counselor educators in AACC Code. However,:

1-750-h: Teaching Law, Ethics, and the Business of Practice

Complex Issues Reflective of Biblically Informed Worldview

1-120: Refusal to Participate in the Harmful Actions of Clients

Christian counselors do not condone, advocate for, or assist the harmful actions of clients, especially those that imperil human life, and agree the protection of human life is always a priority value in any professional or ministerial intervention. Clients who do or intend harm are not to be abandoned and should continue to be served in these troubles, so far as it is humanly possible.

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1-120: Refusal to Participate in the Harmful Actions of Clients—complicated issues including (a) deadly/threatening behavior; (b) substance abuse and other addictive behavior; (c) abortion; (d) separation and divorce; (e) premarital and extramarital sexual behavior; (f) homosexual, bisexual, and transgendered behavior; and (g) euthanasia and assisted suicide.

• Note the AACC heading: “Harm” would be determined in a context.

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We are in a day and world where we must meet the standard of “Can you support/prove it?” And even if you believe you can in a general sense, “…for this particular client?” is more important—and more difficult to answer. Activities (a) and (b) are relatively easy to defend. Activities (c), (d), and (e) are more challenging. Activities (f) and (g) are very difficult issues, in large part because of “context.”

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A Hermeneutics Problem

Process more so than Content

“methodological principles of interpretation”

Worldview affects the nature and trajectory of the interpretive process.

From Herlihy et al. (2014)

“A primary responsibility of counselor educators is to function as gatekeepers to the profession (Gaubatz & Vera, 2002; Remley & Herlihy, 2014). Counselor educators and supervisors have an ultimate duty to protect the public from counseling practitioners who are unable to provide competent services. According to the ACA Code of Ethics, when counselor educators become aware of students’ limitations that might impede performance, they must not endorse these students for completion of the training program (ACA, 2005, Standard F.5.d.), and they are ethically obligated to recommend dismissal from the program when those students are unable to provide competent professional services (Standard F.5.b.).” (p. 150)

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“At this point in time, it is probably accurate to state that counselor educators generally agree that referring a client due to a lack of competence is acceptable. However, if the counselor is likely to encounter similar clients in the future who will require that counselor to have the knowledge and skills to assist them, then the counselor has an ethical obligation to take action to acquire the needed competence. Determining whether it is appropriate to refer a client because of a conflict in values is more difficult. Our professional literature is confusing and somewhat contradictory on the topic (see Kocet & Herlihy, this issue). Additionally, the Ward v. Wilbanks (2010) appellate court’s interpretation of the ACA Code of Ethics (ACA, 2005), with respect to referral policies, seems to be inconsistent with previous rulings. The appeals court interpreted the provision in the ethical standard regarding “inability to be of assistance” to mean that the Code explicitly permits values-based referrals. The issue of values-based referrals is likely to continue to be hotly debated for quite some time.” (p. 152)

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So…in the 2014 update, the ACA redeveloped A.11.a. & b.

(“competence” & “values”)

see Slides 16 & 17


“It seems doubtful that the opposing viewpoints represented in the lawsuits can ever be fully reconciled. The plaintiffs and the defendants rely on different sources of authority to formulate and maintain their views on LGBT relationships: religiously conservative counselors and students rely on their interpretation of Biblical teachings, whereas LGBT-affirmative counselors and counselor educators rely on an accumulated body of social science research indicating that same-sex relationships are healthy expressions of love and intimacy. Perhaps the most fruitful dialogue going forward would convey mutual respect and affirmation of the right to hold differing views on same-sex relationships, while holding true to the fundamental principle that it is the client’s goals and values, not those of the counselor, that are the focus of the counseling relationship.” (p. 152)

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From Bidell (2014)

“LGB-affirmative counselor competency is now uniformly accepted as the ethical standard of care for all LGB and questioning clients (American Psychological Association [APA], 2012; Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling, 2012; IOM, 2011). Yet, some conservative religious beliefs can seemingly contradict these standards.” (p. 170)

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From Whitman & Bidell (2014)

“The purpose of this article is to examine the advancement of affirmative LGB counselor education within the counseling profession, the ethical and professional mandates to do so, and the conflict this can engender among some who hold conservative religious viewpoints about LGB sexual orientations. Specific to counselor educators and supervisors, the intersection of religious views and affirmative LGB counselor education and training are presented with recommendations.” (p. 162)

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From Whitman & Bidell (2014)

“The goal of such educational activities is to help counseling students develop an ability to reconcile their religious beliefs with their professional responsibilities to be able to provide ethical and competent services to LGB clients. When students shift from an “either/or” dichotomous view to one in which they can safely explore their personal and professional values, this reflects an important step toward becoming ethical, culturally competent counselors…The recommendations we offer are not exhaustive, and we encourage other counselor educators to add to these suggestions and conduct much needed research focusing on the issues raised in this article. Indeed, counselor educators must take a leadership role to help students manage conflicts between personal religious beliefs and their professional responsibility to provide LGB-affirmative counseling.” (p. 167)

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From Kocet & Herlihy (2014)

“*Guindon, 2011] suggested that counselors-in-training ask themselves whether their core values fit with the values of the profession. Along similar lines, Remley and Herlihy (2010) opined that ‘if a counselor’s values were so strong that he or she could not counsel clients who held differing beliefs, we would be concerned that the counselor is not well suited for the counseling profession’ (p. 23).” (p. 181)

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“Applying this strategy to the counseling process, ethical bracketing (EB) is defined as the intentional separating of a counselor’s personal values from his or her professional values or the intentional setting aside of the counselor’s personal values in order to provide ethical and appropriate counseling to all clients, especially those whose worldviews, values, belief systems, and decisions differ significantly from those of the counselor.” (p. 182)

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“It is imperative for counselors to note that referral should not be an automatic response or an ongoing professional step. Although a referral may be a temporary option, it should be taken only with the concurrent identification of a remediation plan.” (p. 185)

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On the other hand…

From Hall et al. (2008)

“One interpretation *of the Remley & Herlihy (2010) quote above] is that counselors who hold beliefs that would hinder their ability to work with a specific population are not well-suited with any population, thus they would be ill-suited for the counseling profession as a whole. The danger in making a generalization such as this is that it is likely to scare many counselors from the profession who could otherwise be competent with many populations. This would be unfortunate. Moreover, such an approach raises troubling implications for people of faith, potentially relegating them to the status of outsiders if they are expected to suppress their religious beliefs lest they be accused of being judgmental. While we agree that counselors cannot, and should not, impose their values on clients, neither should they be made to feel that they cannot express their values if they conflict with those of clients.”

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“Hermann and Herlihy ask whether these counselors are well-suited for the profession. A more specific question would be to ask whether counselors with strong values that hinder their ability to be therapeutic with specific populations are well-suited to work with those selected groups. We believe the answer is No. Even so, it is important to remember that these counselors could be competent and highly skilled in working with other populations, so to globalize the issue is to do a disservice to counselors and the clients they help.”

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“With respect to the ACA Code of Ethics, we hope that we have shown that many of the standards are broad and open to interpretation. We believe that the Code’s broadness is a strength that allows for and celebrates differences between and among counselors and their values. However, if, as Hermann and Herlihy (2006) suggest, there is only one interpretation of the Code, then its subjectivity can only be viewed as a limitation to counselors and the clients they serve.”

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Ethical Problem-Solving •Decision Making Model • Examples/Case Studies

The Ethical Decision Making Model at a Glance (Forester-Miller & Davis, 1996)

• Identify the problem.

• Apply the ACA Code of Ethics.

• Determine the nature and dimensions of the dilemma.

• Generate potential courses of action.

• Consider the potential consequences of all options, choose a course of action.

• Evaluate the selected course of action.

• Implement the course of action.

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Examples/Case Studies

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• Start with an Exemplary Case • Move to a Complex Case

See AACC (2014) Section V. Standards for Resolving Ethical-Legal Conflicts

Ethical Security • Develop a principled ethical identity as a counselor (professional, pastoral,

lay) who practices out of a biblically-informed Christian worldview.

• Internalize the moral and/or biblical principles of the AACC and of your profession (e.g., ACA, APA, AAMFT, NASW; “Can you recall them on demand?”).

• Externalize (i.e., “live out”) the ethical principles of the AACC and of your profession.

• Identify ethical principles and apply ethical standards in every client situation, not only the challenging ones.

• Gain mastery of ethical skill through practice, application, and in relational contexts.

• Consider your professional affiliations as means of fulfilling the Great Commission.

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References American Association of Christian Counselors. (2014). Y-2014 Code of Ethics. Retrieved from

http://www.aacc.net/about-us/code-of-ethics/ American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved from

http://www.counseling.org/resources/aca-code-of-ethics.pdf Bidell, M.P. (2014). Personal and professional discord: Examining religious conservatism and lesbian-,

gay-, and bisexual-affirmative counselor competence. Journal of Counseling and Development, 92, 170-179. doi: 10.1002/j.1556-6676.2014.00145.x

Hall, S.E., Flaum, M.E., & Russo, C.J. (2008). Legal and ethical implications for refusing to counsel homosexual clients: A rebuttal. VISTAS Online 2008. Retrieved from http://www.counseling.org/knowledge-center/vistas/vistas-2008

Herlihy, B.J., Hermann, M.A., & Greden, L.R. (2014). Legal and ethical implications of using religious beliefs as the basis for refusing to counsel certain clients. Journal of Counseling and Development, 92, 148-153. doi: 10.1002/j.1556-6676.2014.00142.x

Kocet, M.M., & Herlihy, B.J. (2014). Addressing value-based conflicts within the counseling relationship: A decision-making model. Journal of Counseling and Development, 92, 180-186. doi: 10.1002/j.1556-6676.2014.00146.x

Whitman, J.S., & Bidell, M.P. (2014). Affirmative lesbian, gay, and bisexual counselor education and religious beliefs: How do we bridge the gap? Journal of Counseling and Development, 92, 162-169. doi: 10.1002/j.1556-6676.2014.00144.x

Documents

Ethical Principles in Christian Counseling: Staying ... Principles in Christian Counseling: Staying Oriented in Challenging Times David E. Jenkins, Psy.D. ... gender, gender identity,