Abstract Counseling is a highly sensitive profession that depends on maintaining boundaries and solidifying trust. The establishment of clear ethical codes helps counselors to understand their roles and responsibilities to clients and to their colleagues. Laws at the state and federal level may provide additional protection to both clients and counselors and determine penalties for ethical violations. However, counselors inevitably encounter ethical dilemmas. Ethical dilemmas can arise when there is a conflict between two or more moral standards, or between the law and an ethical standard. Likewise, a counselor’s personal moral code could sometimes conflict with the law or the ethical code guiding their professional practice. This paper outlines some of the most common ethical and legal dilemmas counselors are likely to face, and how counselors can rightfully and safely resolve those conflicts. 

Introduction

The counseling profession is governed by a set of ethical standards similar to those used in the healthcare profession in general. For example, the foremost ethical principles guiding the American Counseling Association (ACA, 2014) Code of Ethics include autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity. Autonomy refers to the empowerment of the client: protecting the client’s rights to self-determination. Yet counselors may inevitably encounter dilemmas related to the client’s right to self-determination. A client who is a minor, for example, has fewer rights than an adult client. An adult client, on the other hand, may also experience lapses in judgment that would require the counselor to make informed decisions affecting treatment options. 

Many of the situations counselors face in their work can be resolved simply and in a straightforward manner by simply referring to the ethical codes of prevailing professional organizations like the American Counseling Association or the American Psychological Association. Unfortunately, though, many situations are ambiguous. Counselors can consult with trusted colleagues, mentors, and advisors, or even with a legal team when dilemmas prove particularly problematic. To avoid lawsuits, to prevent errors in judgment that might impact one’s license or certification, and particularly to avoid harming clients and other stakeholders, counselors need to be aware of the best ways of resolving common conflicts in their profession.

Confidentiality

One of the most important ethical principles in counseling is confidentiality. Clients—including children—are entitled to confidentiality. The law generally protects the client’s right to confidentiality, too, which is why counselors always need to keep confidentiality in mind when working with sensitive populations. Clients will have the right to sue counselors who breach confidentiality. Counselors could inadvertently breach confidentiality, such as neglecting to safeguard client records. For this reason, counselors need to protect client data when it is stored digitally as well as in printed formats. 

The reason behind client confidentiality is clear:...

Clients would not open up to or confide in their counselors if they knew that the counselor might divulge that information to a family member, a friend, a colleague, or an employer. The information shared in therapy is often highly sensitive and could seriously compromise the client’s reputation or relationships. 
Ethical and legal dilemmas regarding client confidentiality frequently arise in situations when the client is at risk for self-harm or harming others. For instance, if a client expresses suicidal thoughts and has attempted suicide in the past, the counselor faces a clear dilemma between alerting a third party to protect the client versus protecting the person’s confidentiality. Only if the counselor has concrete reasons to believe the client could or would act on their suicidal ideations would breaking confidentiality be warranted. Even if breaking confidentiality is legally and ethically warranted, the counselor would still be morally obliged to disclose their intent to disclose to the client in order to avoid legal ramifications or censure.

The same would be true if a client expressed intent to cause harm to another person; the counselor must maintain confidentiality unless it was earnestly believed that the client was capable of taking action. Counselors are not omniscient, though. A counselor can never be sure that a client is not serious when expressing rage or aggression towards another person and so ethical and legal dilemmas regarding the maintenance of confidentiality frequently plague counselors. Resolving this ethical dilemma is never easy. The counselor risks liability for failing to alert the authorities if some harm were to befall someone, and also risks litigation if the information were disclosed but the client never took action.

Counselors also need to...…afford the service fees associated with mental health care. In these situations, the counselor faces an unfortunate dilemma. To refuse treatment to an individual who needs it could represent a form of maleficence if the counselor does not offer the client suitable alternatives such as low-cost or free options or even bartering when appropriate (ACA, 2014). 

Dual Relationships

Counselors often work in collaboration with other mental health professionals or healthcare professionals like physicians. For example, some counselors will treat an individual who is simultaneously in marital or family counseling, or will be treating a child who is also seeing a school counselor. In these situations, the counselor must take great care to avoid breaches of confidentiality while still maintaining continuity of care across the healthcare spectrum.

Conclusion

Although counseling remains one of the most rewarding professions, it is also a highly sensitive one. Clients confide in their counselors. The level to which a client trusts a counselor is parallel to the benefit received from treatment. Therefore, counselors need to ensure that clients continue to trust not just individual therapists but also the counseling profession as a whole.