What situations present ethical dilemmas in counselling?

In this article, I'd like to talk about some of the situations that we can encounter which present an ethical dilemma as it relates to counselling. First, it's important to remember that ethics are moral principles that become adopted by individuals and groups to provide rules for right conduct within a community, culture, or society. An ethical dilemma occurs when we are confronted with situations that present possible conflicts in decision making for whether to abide by or break these rules of conduct.

There are many varieties of situations in the context of counselling that could be considered an ethical dilemma. In my own experience with counselling, there are some general types of situations that I find myself facing and feeling fearful of in relationship with clients. These have to do with questioning my own self-work and healing, so that I can be empathetic, compassionate, and non-judgmental. For many years during my 20’s and 30’s I closed off my interest in becoming a counsellor because I believed I was too wounded and hadn’t done enough of my own work (even though I began doing my own work in therapy at 15 years of age).

Some situations may be obvious ethical dilemmas because they seem so blatant, such as a client or counsellor's attraction and interest in a romantic or sexual relationship. To me, this is an obvious dilemma with an obvious response. While it may be natural for either a counsellor or client to notice feelings of a sexual or romantic nature, we must be very clear about setting firm limits and boundaries when it comes to acting on this. This is a clear, black and white situation for me. I’ve encountered it with the parent of a client I supported in community mental health (while working in their home and picking them up for sessions in the community). In this case, I responded with empathy, but set firm limits stating it is not professional and cannot happen. I encouraged there to be conversation or dialogue about it for that person with their partner, in a way that is sensitive, caring, and respectful. I reported my observation and experience to my supervisor, so they were aware of the situation. They decided to assign a different counsellor to support the client and their family.

Most ethical dilemmas, however, seem to be presented in shades of grey, without such clear or obvious solutions to reconcile them. For me, this includes recognizing counter transference (feelings that come up in the counsellor, in response to the client) and how it manifests with a client. It includes areas where I feel unresolved fear and a need to protect myself or the client. It includes fears of anger, both in myself and others. It includes needing to please or be approved of and acknowledged by a client. It includes judging or rejecting the client and seeing aspects of myself in the client. At these moments, I may lose my ability to separate from their issues/feelings/needs and my own. It is a familiar situation to find myself working harder than the client and feeling frustrated if they seem less invested in change.

Giving advice is another situation that is seductive in counselling. I feel surprised by how many counsellors and clients believe that the counselling relationship and profession is based on advice giving. It repeatedly surprises me to see and hear this. Yet, I get it. Many of us have learned that when we seek out the service of a counsellor, it is because they are the expert who tells us what to do. It’s seductive to the counsellor because it feels powerful and can place them in a dominant position of superiority. It’s also easy to identity with a client’s feeling of desperation for change to happen quickly and wanting the counsellor to wave a magic wand to make that change happen.

The emergence of a social-like relationship during the warm-up or closure stage of counselling sessions are another dilemma. How much disclosure or sharing is ethical and reasonable for a counsellor when the client is asking them questions and wants to connect on a personal level? This is not always an easy question to answer. There are differing views about the issue of counsellor self-disclosure. Some of this goes back to the role of the expert and professional. It’s not just about the therapeutic relationship and accepting unbalance – the one sidedness in the exchange – a lack of reciprocity. If there is no sharing on both sides to give the client all the room to take up space provided, then how will the client feeling connected to the counsellor and see them as humanely as possible, instead of as the detached expert or professional?

The issue of counsellor self-disclosure is a paradoxical one that harkens back to the days of the detached psychoanalyst. Sometimes, personal disclosure that briefly slips into the realm of appearing as socializing, may emerge in the interest of connecting and demonstrating to the client that the counsellor is human, real, and vulnerable, not an idealized version of the detached professional expert who is fully integrated and without their own personality or lived experience – which has been so well crafted from the cold roots of the18th and 19th century psychiatric and medical models developed in North America.

Another example that presents ethical dilemmas are with issues related to diversity and multiculturalism between a counsellor and client. These also present complex situations that require consideration about our capacity for developing a strong therapeutic relationship. I think these are difficult to navigate, depending on the specifics. How can two people (or more) be a perfect match for engaging in a therapeutic relationship when there are so many identities that exist across the spectrum of culture, religion, spirituality, ethnicity, age, gender, sexuality, education, income, socio-economic levels, and more? Is what we are expecting of human beings in the counselling relationship, a reasonable expectation to have for any two or more people?

Finally, I think at times it may be asking a lot of people to fully accept and embrace this multitude of differences in our experiences, identities, and perspectives. For this reason, I think we ought not try to force ourselves to be a perfect match with every person or every situation. This ethical dilemma is not necessarily about whether the counsellor is the most culturally competent, socially just, sensitive, and safe for supporting the client. Perhaps the issue is more about whether the potential relationship between two people can be a fit for supporting a therapeutic or healing process. I think this is a shared responsibility, with primary responsibility on the counsellor for addressing it and secondary responsibility on the client to explore making a choice about which counsellor to work with is in their own best interest. These situations involve important rights and responsibilities that present ethical dilemmas in counselling.