2016 will be a year remembered for dramatic exits and entrances, especially in issues related to ethics and equality. The field of professional counseling is no haven from various controversies as the preeminent national organization for professional counselors, the American Counseling Association (ACA), recently made headlines for their responses to legislation passed in Tennessee. On April 27, 2016, Tennessee passed legislation allowing professional counselors to deny professional services to LGBT individuals based on “strongly held principles” and refer the individuals seeking help to a different provider. The ACA reported that this law violates the ACA Code of Ethics. Ironically, the ACA’s 2017 Annual Conference & Expo was scheduled to be held in Nashville, TN; however, in response to the passage of SB 1556/HB 1840 the ACA has announced the decision to change locations for the event out of the state of Tennessee. The ACA’s dramatic exit comes as no shock given the vast number of dramatic transitions in response to equality-based issues from North Carolina to Target stores. What stands out in this particular case is that the intrusion of an-outside-agenda as mandated by this Tennessee legislation essentially undermines the foundation of the helping relationship in psychotherapy: the agenda in counseling ultimately belongs to the client.
BREAKING DOWN THE ISSUE
The ACA Code of Ethics is a 24-page document developed by the American Counseling Association to establish a standard for ethical practice in the helping profession. The Code of Ethics describes numerous aspects of the therapeutic relationship to ensure that the therapist acts as an agent of positive change without allowing for unethical practices that ultimately lead to the detriment of a client or colleague. The items that are inconsistent with the Tennessee law are found within: A.4.b which addresses how counselors ought to respect diversity and be aware of bias, especially of discriminatory nature, and seek supervision or training to overcome these barriers to the helping relationship; A.11.b which addresses that counselors should avoid referral of clients when the basis of referral is a personal value or bias rather arguing for supervision and training to overcome these barriers to the helping relationship; C.5 which addresses how counselors are not to engage in discrimination with any professional colleague or client based on any protected status (ACA, 2014).
“A.4.b. Personal Values Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants 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.” (ACA, 2014)
“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.” (ACA, 2014)
“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.” (ACA, 2014)
Ultimately, the ACA is challenging professionals to develop a consistent, genuine, and ever-developing commitment to the welfare and personal growth of self and others. The ACA Code provides the following overview regarding the therapeutic relationship in counseling:
“Counselors facilitate client growth and development in ways that foster the interest and welfare of clients and promote formation of healthy relationships. Trust is the cornerstone of the counseling relationship, and counselors have the responsibility to respect and safeguard the client’s right to privacy and confidentiality. Counselors actively attempt to understand the diverse cultural backgrounds of the clients they serve. Counselors also explore their own cultural identities and how these affect their values and beliefs about the counseling process. Additionally, counselors are encouraged to contribute to society by devoting a portion of their professional activities for little or no financial return (pro bono publico).” (ACA, 2014)
THE AGENDA-LESS RELATIONSHIP
Clearly, when considering the various excerpts from the ACA Code of Ethics, SB 1556/HB 1840 is a violation (cf A.4.b; A.11.b; C.5.). The next logical question is why should this be an issue for professional counselors? If a professional counselor holds a bias against a certain person, place, event, issue, then wouldn’t it be advantageous of the counselor to refer a client? The ethical answer is yes and no. If a counselor becomes aware of a personal emotional reaction to an issue addressed in therapy, also referred to as countertransference, then it may be appropriate to refer to a different counselor for the well-being of the client; however, the ACA Code advocates that counselors should seek supervision and training to overcome these areas to be effective either presently or in the future. The counselor’s goal is to be an effective part of the change process in the life of client. If a counselor is unable to overcome a bias, prejudice, discriminatory belief, etc., then he/she runs the risk of introducing an agenda into the helping relationship.
One of the greatest benefits of counseling in the life of a client is that counseling provides an “agenda-less” relationship whereas other relationships in life require some form of expectation or sacrifice. The counselor ought to see the client’s goals, welfare, and values/identity as the means to establish agenda. If a counselor were to promote an exception to this agenda-less relationship, such as a “strongly held belief” in “any-random-fill-in-the-blank-issue” then the safety and client-centered agenda is potentially shattered, especially considering the pressure, guilt, shame or other emotional impacts associated with dismissal and referral from therapy based on “any-random-fill-in-the-blank-issue”. Logically this is the answer to the question of why SB 1556/HB 1840 should be an issue for professional counselors: To do harm to a client is contrary to the purpose of therapy and without further self-discovery and training these issue-areas will not change in the life of the counselor.
Regardless, some counselors will persist that their strongly held beliefs or values should be imposed on a client population for their benefit. This is a dangerous presupposition and one that diverts from the mission and purpose of the professional counselor as outlined in the ACA Code of Ethics. Fortunately, there are career options in business, religion, etc., where an individual can practice this type of influence over others without compromising the ethics and integrity of their field.
FINAL THOUGHTS ON COUNSELING ETHICS
As a licensed professional counselor, I have enjoyed the benefit of working with all sorts of clientele from the impoverished to celebrities, homosexual and heterosexual, various religions, couples, families, children, and adults. My own personal values, beliefs, counseling approach, and practice have been developed through education, experience, and gradual supervision/training to address my own issues that I may bring into the counseling office. Such is the duty of all ethical licensed professional counselors. If you are seeking professional counseling services, I urge you to seek out a therapist who respects you, your values, and the uniqueness that you bring to life. It is a privilege for a therapist to share in your journey towards personal change and that privilege should not be taken lightly. Make today count.
Trey Harrison, MA, LPC, CT www.lpctrey.com
American Counseling Assocaition (2014). 2014 ACA code of ethics. Retrieved from http://www.counseling.org/Resources/aca-code-of-ethics.pdf