2.2 Explain the main elements of one recognised ethical framework for counselling and psychotherapy
The three main elements of the BACP Ethical Framework are; Values of Counselling and Psychotherapy, Ethical Principles of Counselling and Psychotherapy and Personal Moral Qualities.
The Values of counselling and psychotherapy as listed in the BACP ethical framework are the foundation on which principles are informed. Counsellors working under the BACP framework commit to holding the following values in their professional work:
“Respecting human rights and dignity
Protecting the safety of clients
Ensuring the integrity of practitioner-client relationships
Enhancing the quality of professional knowledge and its application
Alleviating personal distress and suffering
Fostering a sense of self that is meaningful to the person(s) concerned
Increasing personal effectiveness
Enhancing the quality of relationships between people
Appreciating the variety of human experience and culture
Striving for the fair and adequate provision of counselling and psychotherapy services” (BACP Ethical Framework for Good Practice in Counselling & Psychotherapy, 2010, P2)
In holding these fundamental Values which are all geared towards the wellbeing and safety of the client and ethical mindfulness and personal responsibility of the counsellor, ethical principles are informed.
Ethical Principles are actions which are born out of the fundamental Values listed above. When making an ethical decision the BACP framework asks us to consider these principles;
“Ethical decisions which are strongly supported by one or more of these principles without any contradiction from others may be regarded as reasonably well founded. However, practitioners will encounter circumstances in which it is impossible to reconcile all the applicable principles and choosing between principles may be required” (BACP Ethical Framework for Good Practice in Counselling & Psychotherapy, 2010, P3)
It is clear that this is where the autonomy of the Counsellor comes in, the principles should be considered when making a decision however the decision does not automatically become unethical should it contradict one of the principles. The counsellor needs to be able to trust in their decision whilst using the values and principles of the framework as a guide.
The BACP (2010) lists the Ethical Principles of Counselling and Psychotherapy as follows:
Being Trustworthy
Autonomy
Beneficence
Non-maleficence
Justice
Self-respect
The third main element of the framework looks at Personal Moral Qualities. The framework asks not that a counsellor possess all of these qualities but should certainly be aiming towards integrating these qualities in to their being; doing all that they can to grow in to these qualities.
The BACP (2010) lists Personal Moral Qualities to strive for as follows:
Empathy
Sincerity
Integrity
Resilience
Respect
Humility
Competence
Fairness
Wisdom
Courage
Should a client feel as though they have been mistreated by their counsellor there is a section of the framework which deals with ‘professional conduct procedures’. There are guidelines for the client regarding how to make a complaint and how the complaint will be dealt with and also information for the practitioner detailing the procedures which are in place. This highlights the fact that there are consequences to the choices that counsellors make, counsellors are accountable and there are sanctions in place should their choices be deemed as damaging to a client.
2.3 Analyse the similarities and differences between their chosen ethical framework and the requirements of at least one other professional body or employing organization
Professional Ethical Frameworks exist in many caring professions; The Nursing and Midwifery Council have their own ethical code “Standards of conduct, performance and ethics for nurses and midwives”.
Like the BACP ethical framework the NMC code of practice exists to safeguard the wellbeing of the public. They are similar in that they both have the wellbeing and safety of the public at the heart of their publications. Both agree that respect for human rights, dignity and confidentiality are essential to the role of the practitioner. Both publications require their members to adopt a non-judgmental attitude, offer respect to the client/patient and promote self care in the individual. There is also a section in each publication on complaints and sanctions, making it clear to the public that nurses, midwives and counsellors are accountable for there actions if in breach of the code/framework.
The NMC publication is a ‘code’, it reads as a list of ‘musts’; a set of rules which must be adhered to “You must act as an advocate for those in your care, helping them to access relevant health and social care, information and support (NMC, 2008)”. The BACP publication is different in its approach altogether in that it is a ‘framework’, there are no musts only guidelines on how to work ethically, preserving the autonomy and trust in the Counsellor’s right feelings on each individual situation. The very nature of each profession is very different; a nurse/midwife’s role is one of advocacy, the professional giving advice and providing care with a view to an outcome of fixing the patient; making them well. A counsellor’s role however is to allow the client adequate space to grow in to themselves and to know what is right for them, in this case the client is the expert and ultimately holds the key to their own answers and progress. This is reflected in the publications; the BACP framework gives far greater attention to the subject of ethics, breaking it down in to sections to illuminate the importance of the counsellors’ own way of being in the world.
What feels right to me about the way the BACP framework treats its members is that it is in the same way and with the same respect that it asks counsellors to treat clients.
2.4 Using examples, analyse potential conflicts between the requirements of organisational and other codes of professional practice and their chosen ethical framework for counselling and psychotherapy
When working as a counsellor within an organisation, there may be occasions where the requirements of the organisation do not fit with the ethical guidelines outlined in the BACP framework. One organisational requirement within a prison is that if an incident occurs that means all of the prisoners have to go to their cells, known as a ‘lock down’ then any counselling session being conducted at that time would have to finish at that point and the client would be taken to his cell. In terms of counselling ethics and the BACP framework this causes a conflict. This organisational requirement does not respect the autonomy, human rights and dignity of the client and also does not fit with the basic humanistic philosophy of trusting that humans are basically good.
Another example drawn from my own experience of working on placement within a drug and alcohol service refers to physical environment. Within this particular organisation there was little space and so when not in session with a client, counsellors were required to sit in an area where they were exposed to all service users. As a student on my first placement I did not feel comfortable in being approached on occasion by my clients who would begin to chat with me about what was going on for them. This did not feel appropriate to me and as I was still forming my own personal boundaries as a student, I felt uncomfortable and exposed. This conflicts with the BACP framework as it does not respect beneficence; I was not working within the limits of my competence as a student as the result of an organisational requirement.
2.5 Summarise how these conflicts could be resolved
In the first example although nothing can be done regarding the organisational requirement; all inmates must be taken to their cells in the case of a lockdown, a resolution may come in the form of communication. When the counsellor next sees the client they could talk about their own feelings surrounding being forced to end a session so abruptly. Maybe they felt anger, loss, sadness and frustration. Then encourage the client to explore how that experience was for them and whether it has affected the relationship between counsellor and client. The counsellor would also take those feelings of anger, loss, sadness and frustration to supervision which will help in reaching an emotional resolution.
In the second example communication could also be the key. An option would be to discuss your feelings with the managerial supervisor to see whether the requirement to sit in an exposed area could be resolved. Again taking the issue to counselling supervision to help gain some person clarity surrounding the boundary issue would go some way to resolving the conflict.
3.1 Using examples analyse the key issues surrounding the following in relation to possible actions by clients:
Professional conduct
Professional Conduct means to maintain appropriate actions and behaviours relevant to all areas of your profession. The BACP framework (2010) states, Good standards of practice and care require professional competence; good relationships with clients and colleagues; and commitment to and observance of professional ethics. A client may perceive a breach in this area should their counsellor become overly familiar and tactile when they are in a state of great distress. This could be seen as an attempt by the counsellor to abuse their position of trust for their own sexual amusement which would undoubtedly damage the working relationship and have an adverse effect on the well-being of the client.
Ethical issues
It is inevitable that when working with distressed and vulnerable people in a counselling capacity that ethical issues will arise, we all have our own ingrained views and beliefs of what is right and wrong. It would be clearly un-ethical for a counsellor to borrow money from a client or accept a large monetary gift in any circumstance. The counsellor would be using their position of trust for their own financial gain which goes against the basic ethical values and principles of the counselling profession.
Confidentiality
Trust is a fundamental element in any counselling relationship, it is therefore essential for a counsellor to make it clear at the contracting stage of the relationship what information will be kept confidential and where exceptions to this confidentiality rule apply. A counsellor is required by law to disclose any information regarding drug trafficking, terrorism or money laundering, disclosing any other information to a third party without a client’s consent would be breaching the confidentiality agreement. If for example a client’s spouse called the counsellor out of concern for their partner and asked what was being discussed during sessions and the counsellor divulged some information regarding material being explored during sessions; the counsellor would be breaching confidentiality and the implications of this could be extremely damaging to all parties concerned.
Boundaries
Setting boundaries within a contract means to ensure that a client has a good understanding of what will happen during sessions, what to expect from therapy and what is expected of them. It is very important that once the boundaries of the relationship are set they are adhered to, this is part of creating a safe environment for both counsellor and client and contributes toward distinguishing the therapeutic relationship from other relationships that a client may have. Boundaries set will include what type of therapy is on offer, the cost of sessions, length of sessions, how contact will be made if necessary in between sessions and confidentially agreements including the limitations. If a counsellor were to enter in to a social relationship with a client outside of the therapeutic relationship this would be breaching a boundary. Boundaries preserve the therapeutic relationship; once these are breached therapy can no longer be effective.
Legal responsibility
Legal responsibilities are any factors which a counsellor is required by law to pay attention to. Legal responsibilities in a counselling capacity include; keeping all client records and personal information in a secure and private location in line with the data protection act and legal obligations regarding the limitations of confidentiality. If a counsellor were to misplace a client’s file containing personal information then they would be in breach of their legal responsibility to protect a client’s identity under the data protection act.
Negligence
Negligence can be defined as a person being in breach of a duty of care in the course of their professional activity. Should a counsellor neglect to attend to any factors that could result in the damage of their client then they would be being negligent. If for a example a counsellor did not attend required regular supervision in order to look after themselves and ensure continual growth and competence as a practitioner this could be potentially damaging to clients.
Possible actions by clients
In any of the instances above a client may make a formal complaint through the BACPs professional conduct procedure, this could result in the counsellor being deemed unfit to practise under the registration of the professional body altogether or being suspended for a period of time. If a counsellor is working for an organisation then a formal complaint may also be made through the organisation’s disciplinary procedure. In some cases particularly those which are in breach of the legal requirements of the country, a client may take legal action against the counsellor.
3.2 Using examples, evaluate an appropriate working environment and contract which attends to the physical, emotional and mental safety needs of both the client and counsellor
An appropriate working environment for a counselling session to take place in should attend to the needs of both the counsellor and the client. A room which is in a quiet and private location should be neutral in its decoration and free from unnecessary clutter to avoid distraction. There will need to be two comfortable chairs in the room placed at an appropriate angle and at a comfortable distance away from each other. Room temperature should be at a comfortable level and a table with drinking water and tissues should be within reaching distance of the client for their comfort. To contribute towards the physical safety of the counsellor a panic button or alarm may be considered; “If you are worried about your physical safety, you will be spending energy on worry that could be better used toward your helping” (Frankland and Sanders, 1995, p.167)
To attend to the mental and emotional safety of both counsellor and client a contract outlining clear boundaries needs to be discussed, understood and adhered to by both parties before counselling takes place. Contracting should include what type of therapy will be offer, time allocated to each session, cost of sessions, contact arrangements and confidentiality including limitations. Boundaries are important in establishing and preserving the therapeutic relationship and helping to distinguish it from other relationships in a client’s life. The counsellor should advise their client at the contracting stage that they are a member of a professional body such as the BACP and will be working within a framework of ethics which includes undertaking regular supervision. This may help to instill a sense of safety for the client. By being a member of such an organisation and by undertaking regular supervision the counsellor is attending to their own safety and wellbeing as well as their clients.
3.3 Using examples, analyse the importance of multiprofessional working and co-operation
Multiprofessional working and co-operation means to work together with other organisations and professionals to provide the best possible care for a client; working holistically and taking care of needs that cannot be met through counselling alone. In some cases a group of different professions may meet on occasion to help in monitoring the progress of an individual. Should it be necessary or helpful to share information within a co-operation of workers a counsellor would always gain the consent of the client first.
An example of this would be if you were working as a counsellor for an organisation which deals with substance misuse in individuals. The client may need support in many different areas, there may be a substance misuse support worker dealing with issues relating to addiction, a nurse and/or a doctor dealing with medication and healthcare and a counsellor helping to explore underlying issues and giving the client space to talk.
Another example where a person may need support in many areas could be a young person living in care who is having difficulties at school. As well as the support and benefits of the counselling relationship the client may also need pastoral support from the school, input and guidance from a social services and an education welfare officer all working together using different knowledge and skills to help the client.
4.1 Explain why both casework and managerial supervision are important for a trainee and a qualified counsellor
Casework and managerial supervision are both essential activities for trainee counsellors and qualified practicing counsellors. Casework supervision is where a counsellor will meet with a more experienced practitioner to explore the work that they are doing with clients. The supervisor should be skilled in helping the counsellor to identify issues that may be occurring in the counsellor’s work, any unhealthy attachments that may be forming in counselling relationships, areas of personal growth for the counsellor and whether the counsellor is fit to practice safely and responsibly. This is an important relationship as it gives the counsellor the opportunity to discuss any subject matter that they may have found difficult in sessions and a chance to explore these difficulties without breaching confidentiality. It helps to identify blind spots, gives another perspective on the work being done and encourages growth and self-awareness as a practitioner. This contributes to the element of safety for a client whose welfare is at the heart of the sessions. It is essential that the counsellor feels able to be genuine and trusts in their supervisor so that effective supervision can take place. “It seems that whatever approach or method is used, in the end it is the quality of the relationship that determines whether supervision is effective or not…there needs to be a degree of warmth, trust, genuineness and respect between them in order to create a safe enough environment for supervision to take place” (Hunt, 1986, p20, cited in: Dryden and Thorne, 2004, p87)
Managerial supervision refers to the supervision carried out within an organisation that a counsellor is working for. This is performed by a senior member of staff within the organisation and may include appraisals, issues in relation to the day to day running of the organisation such as time keeping, ensuring that organisational policies are being adhered to and that targets and workload are being met. This is important to ensure that the organisation is running efficiently so that service users are getting what they need and a chance for both counsellor and supervisor to communicate and ensure that the work they are doing is appropriate to the requirements of the organisation.
4.2 Using examples, evaluate the possible impact of effective and less effective casework supervision on the
*service provided for users
If a counsellor is experiencing effective casework supervision then the work that they will be doing with their clients should be appropriate, safe, be meeting the client’s needs and be rich in potential for growth and change in the client. Any personal issues that the counsellor is unable to resolve in their work with a client will have been identified and discussed in supervision and may be addressed by a referral to another counsellor if necessary.
If supervision is less effective the counsellor may be colluding with the client in ways which would hamper growth and change and the client may remain stuck in a difficult place. Personal difficulties for the counsellor being triggered by the work may not be being identified and so the client would not be being given the appropriate space to explore these issues.
*professional development of a counsellor
If the supervisory relationship is effective then the counsellor will feel open and able to honestly explore any concerns and observations coming out of sessions with their clients. The supervisor should be experienced enough to detect when something is wrong and challenge the counsellor whilst still holding the core conditions to enable exploration to develop in a safe environment. The less experience the client has the greater experience the supervisor should have as particularly when training a counsellor may be in early stages of developing their awareness of self and going through changes in their own life experience. There is much learning to be gained from an effective supervisory relationship and the counsellor will be being given the right conditions to grow in to their own counselling style as well as learning from the supervisor’s experience.
Less effective supervision may result in a counsellor feeling unable to be honest in the relationship, the counsellor may not disclose certain feelings and information that when explored would be valuable to their growth as a practitioner.
4.3 Using examples, evaluate the possible impact of effective and less effective managerial supervision on the
*service provided for users
Effective managerial supervision within an organisation will mean that members of staff will have a clear understanding of organisational policies, there will be enough staff to ensure that all service users are able to access the support that they need and communication between managers and staff will be supportive and clear. This in turn will filter down to service users, there will be not be confusion regarding what is on offer to them and they will have access to the support that they need.
If managerial supervision is not effective then there may not be adequate communication or resources within the organisation. A counsellor’s workload may be unrealistic resulting in them being less able to be present during counselling sessions which will impact the therapeutic relationship and the counselling service will be less effective for the service users.
*professional development of a counsellor
If a counsellor is being well supported in terms of managerial supervision then they will be having regular meetings to discuss any changes in organisational policy, having their training needs assessed and the manager will be ensuring that they are feeling competent in their role. The counsellor will be able to access any relevant training that they need as it will have been identified and will therefore be developing and growing professionally.
If a counsellor is not being supported well with effective managerial supervision then communication between counsellor and supervisor may be poor. The counsellor may be feeling pressured in to working beyond their capabilities and may not be feeling well supported. This could result in the counsellor feeling confused and incompetent in their role and therefore hindering professional development.
5.1 Explain the importance of good casework management
A counsellor is required to have a good knowledge of the different aspects of how to manage their casework effectively. To have an awareness of their limitations when it comes to the number of clients that they are able to see whilst still being able to look after themselves is essential to the wellbeing of both counsellor and client. To know when it is appropriate to refer a client to another agency or counsellor will ensure that the client is receiving support appropriate to their needs. To keep organised client notes and records safely in line with data protection laws is important in terms of confidentiality and respecting and protecting the client’s personal information.
5.2 Using examples, analyse the importance of the following aspects of casework management
*referral procedures
A referral may be necessary during a counselling relationship for a variety of reasons. The counsellor may be relocating, the client may request another therapist, the client’s issues may not be of a counselling nature, the client might need extra support beyond the counselling relationship or perhaps the client presents with issues that the counsellor does not feel equipped to deal with. To work responsibly in these circumstances a counsellor needs to know the correct methods of referral and have adequate resources to cover a variety of circumstances.
*keeping case records
Keeping case records containing adequate personal information about a client such as name, address and telephone number is important in ensuring that you have the means to contact your client should you need to. Case records may also hold important information about the route of a client through a service, assessment needs to ensure the client has enough support and perhaps notes regarding individual sessions. A counsellor must be careful not to disclose anything that may breach confidentiality of sessions if others have access to the case records. Clients should be aware of and in agreement with any information that is being kept about them.
*reports and letters
A counsellor may sometimes be required to write a report or a letter to assist their client with something outside of the counselling relationship. It is important that a good level of written communication is established for this purpose. A letter or report may be needed in the case of referral, to help a client with housing or possibly requested as a means to establish a fitness to work. Clients should always be aware if a counsellor is sending any information to another party and it would always be done as a means of support.
*legal rights of clients to access records
Clients should be made aware of any personal information, notes regarding sessions and any other information concerning them that is being kept by the counsellor or organisation. It should be made clear to the client the reasons for keeping records, where they will be kept, who will have access to them and they should know that as part of the Freedom of Information Act (2000) they have a legal right to access these records at any time.
5.3 Explain the importance of the need for casework evaluation for the ongoing professional development of the reflective practitioner
A responsible, reflective counselling practitioner should evaluate their casework regularly. This will assist the counsellor in being able to identify what is working for them as practitioner and what is not. It will help in identifying their own patterns of avoidance in their work with clients, what triggers discomfort for them in their work and will therefore enable them to see where their areas of growth lie. These things will then be able to be explored in supervision enabling growth and development in the counsellor and ultimately benefitting clients and the therapeutic process.
Bibliography
BACP Ethical Framework for Good Practice in Counselling and Psychotherapy (2010)
Dryden, W and Thorne, B. (2004) Training and Supervision for Counselling in Action. London: Sage Publications Ltd.
Frankland, A and Sanders, P. (1995) Next Steps in Counselling. Hertfordshire: PCCS Books Ltd.
NMC: The code: Standards of conduct, performance and ethics for nurses and midwives (2008)
Sanders, P. (1994) First Steps in Counselling. Hertfordshire: Ross-on-Wye: PCCS Books Ltd.
Assessor Comments:
Assessor Comments:
Assessor Comments:
Assessor Comments:
Assessor Comments:
by
annavarty (student)
