Main elements covered in the BACP Ethical Framework for Counselling and Psychotherapy are as follows:
- Ethics
- Values
- Principles
- Personal Moral Qualities
- Guidance of Good Practice
- Standards of Practice and Care
- Professional Conduct Procedure
Criteria 3
Comparison of BACP Framework to other Codes and Organisational Requirements
Many other organisations have Professional Codes and organisational requirements. These organisations generally fall into three categories:
- Healthcare
- Professional Services
- Caring Services
Healthcare covers the Medical Profession; Doctors, Nurses etc.
Non Healthcare covers Professional Services such as those in the Legal Profession, Police, Armed Forces and Security Services
Caring Services covers Voluntary Agencies, such as the Samaritans, Social Services, the Teaching Profession and Care Workers.
Conflict in interests may occur when someone acting in a Counselling role within an organisation hears something from a client which is in direct conflict with the organisations own requirements or regulations or is a threat to the organisation.
The following examples highlight such an issue:
A Doctor who is aware that a patient, who is terminally ill, is over medicating themselves with morphine in order to commit suicide; the dilemma being that this is contrary to the Medical Code of Ethics in which the aim is to preserve life.
A Police Counsellor dealing with a client (a Police Constable) who admits that they are taking bribes, as a result of their own financial problems but want to stop and find a different way of dealing with their debts; the dilemma being that the PC is clearly breaking the law and is preventing others coming to justice.
A Teacher, who acts as the school’s counsellor finds out from a student in a counselling session that she is sleeping with her boyfriend, they are both thirteen; the dilemma being that both students are under the Age of Consent.
The key dilemma in all these situations is when you break confidentiality in order to maintain organisational and legal responsibilities.
A Counsellor could, if bound by the BACP ethical framework only, decide not to declare these issues by referring to the ethical principles outlines in the framework e.g. Fidelity, Autonomy, Beneficence and Justice. As with all ethical dilemmas however the Counsellor needs to be able to talk through their own feelings in order to come to an appropriate and fair decision this is where Supervision is key.
Criteria 4
Key Issues
The issues which are key to the ethical framework are as follows:
The framework states that ‘all clients are entitled to good standards of practice and care’* and that this requires practitioners to maintain ‘professional competence; good relationships with clients and colleagues; and commitment to and observance of professional ethics*’. Counsellors specifically are required to:
- Attend Supervision
- Keep the Clients trust
- Keep up to date with training and workshops
- Be compliant to any new or existing legislation
A selection of ethical principles has been devised in order for guidance in ethical issues; Counsellors can refer to these principles in making ethical decisions and as long as the decision is ‘strongly supported by one or more of these principles’* without contradiction, it is regarded as reasonably well founded. Principles are described as:
- Fidelity
- Autonomy
- Beneficence
- Non-maleficence
- Justice
- Self Respect
Trust is the most vital element in a successful relationship between a client and counsellor therefore it is important that clients be informed at the contracting stage of the relationship of any circumstances where confidentiality may be breached. It is also important to note with the client that should such a breach be required that their consent would wherever possible still be sought.
Boundaries are in put into place to outline the relationship between the client and the counsellor, in order for both parties to be aware of what is expected of them. Boundaries covered in the contract are:
- Time, frequency and duration of sessions
- Communication
- Cancellation
- Fees
- Confidentiality
- Process and outcomes
- Questions
Boundaries not covered in the contract are outlined in the BACP Ethical Framework and cover:
- Sexual Relations
- Abuse of Trust
- Prejudice
- Relationships with former clients
The freedom of Information Act 2005 allows clients to have access to their written notes or information held about them on a PC; in criminal cases a Solicitor or Court may also request this information as use in evidence, so it is vitally important that if notes are to be kept this is to be taken into consideration before doing so. Individuals also have a legal responsibility under English Law to:
- Disclose information relating to terrorism
- Provide information on drug trafficking
- Notify relevant authorities in order to protect a person from harming themselves or others.
Negligence is covered in the BACP Ethical Framework under the heading of ‘Professional Malpractice’ and is defined as ‘the services for which the practitioner is responsible have fallen below the standards that would reasonably be expected of a practitioner exercising reasonable care and skill’* It is important that the Counsellor maintains adherence to BACP guidelines and the Ethical Framework failure to do so may result in a negligence case. It is also worth noting that Counsellors may be subject to ‘suing’ in Civil Court proceedings should a client believe that they have been harmed by the counsellors negligence, this may result in substantial compensation being awarded to client should they be successful in their case. All counsellors should therefore ensure that they hold Public Liability Insurance to protect them from any legal action which may be pursued.
Criteria 5
Safety
It is necessary to ensure that the environment you are working from is both safe and secure for your client and yourself. You, as an individual have a responsibility under Health and Safety Legislation to ensure that you do nothing to endanger yourself or another and should you do so you may be liable for prosecution or pursued for civil damages.
In any area of work there are health and safety concerns and requirements; these are especially relevant to lone workers and people who work with the public. As an individual Counsellor working for one’s self it is important that you have carried out a Risk Assessment of the premises you intend to work from; this should include reviewing escape routes, fire evacuation procedures, layout of the room, furniture, fixtures and fittings and potential hiding spots both within the building (if its open to the public) or in car park areas. The Risk Assessment also must address issues such potential threats and outcomes of a violent attack and what can be done to minimise this from occurring and should it occur what methods there are of alerting others for help. Additional personal training in conflict management and anger management may be required; this would benefit not only the Counsellor but the Client as well. Also as an individual it is important to ensure you have obtained the correct insurance cover; Public Liability etc.
Working with an organisation it is important to have read and understood any risk assessments pertaining to your activity and ensure that you are familiar with protocols and procedures to deal with incidents. Making sure you are aware of location, layout, alarm points and escape routes is also good practice.
Clients require a safe environment to be in when they are talking about feelings as sometimes these may pour out as extreme anger, which is not premeditated, and can sometimes leads to violent behaviour. Having minimised potential hazards in the room and organised procedures for dealing with such behaviour limits risk to both parties. It is important to note though that overt measures such as using a desk as a physical barrier between you and the client will have an opposite reaction; leaving the client feeling vulnerable and not trusted; so measures taken need to address this factor.
For Emotional and mental safety of both the client and the counsellor it is important that:
- The counsellor regularly attends Supervision
- Abides by the BACP Ethical Framework
- Make appropriate referrals
- Is clear in the contracting stage about expectations and what is on offer
Criteria 6
Importance of Casework and Managerial Supervision
Casework/Supervision
Casework or Supervision is a ‘formal arrangement for counsellors to discuss their work regularly with someone who is experienced in counselling and supervision’ (2). The Supervision process allows Counsellors to discuss there own feelings towards clients dilemmas and allow the Supervisor to confront, discuss in detail and monitor issues surrounding the relationship between counsellor and client. The monitoring of the relationship ensures that it remains effective and ensures adherence to ethical standards.
Managerial Supervision
The managerial supervisor’s priorities lay with the organisation needs, specifically they are concerned with:
- Staffing Levels
- Client Numbers
- Client Turnover
- Fees and Budgets
- Statistics
They may also carry out a client assessment to see whether a client meets the criteria of the service provisions given.
Managerial supervision effectively removes some of the tasks required by an organisation from Counsellors and allows them to concentrate their activity purely on their service to clients.
Bibliography
1) First Steps in Counselling, Pete Sanders, PCCS Books 2002
2) BACP Information Sheet S2 - What is Supervision?
*BACP Ethical Framework For Good Practice In Counselling and Psychotherapy