Professional Identity, Ethics,

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Professional Identity, Ethics, Basic Techniques
of Counseling

• EDC 543
• Theories Techniques of Counseling
• Dr. Jason McGlothlin
• University of Dayton

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ProfessionalIdentity
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5 Recognized Mental Health ProfessionsWhat are
the Differences?

• Psychology
• APA CoA Accreditation
• Social Work
• CSWE Accreditation
• Psychiatric (General or Child Adolescent)
• Acc. Council for Graduate Medical Education
• Psychiatric Nurses
• Nat. League for Nursing Accreditation Commission
• Counselors
• CACREP, CORE, COAMFTE

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Professional Counseling is

• The application of
• Mental health
• Psychological or human developmental principles
• Using such interventions as
• Cognitive, affective, behavioral, systemic
• Using strategies that address
• Personal growth
• Career Development
• Wellness
• Pathology

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Professional Counselors What do we do?

• Promoting Educational Success
• Supporting Career Development
• Improving Mental Emotional Well-Being
• Anxiety, depression, etc.
• Substance abuse, etc.
• Family relationship issues
• Sexual abuse / Domestic violence
• Eating disorders
• Social emotional difficulties in terms of
  disabilities and illness
• Death of loved ones
• Transitions

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Counselor Work Settings

• Schools universities
• Hospitals
• Mental health agencies
• Rehabilitation facilities
• Business Industry
• Correctional Institutions
• Religious Organizations
• Community Centers
• Private Practice
• Police Facilities

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Counselor TX Populations

• Children
• Adolescents
• Young Adults
• Adults

• Older Adults
• Couples
• Families
• Etc.

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American Counseling Association

• Mission Statement
• To promote public confidence and trust in the
  counseling profession.
• Identity Statement
• The American Counseling Association is a
  partnership of associations representing
  professional counselors who enhance human
  development.
• Vision Statement  
• To become recognized as the association for
  professional counselors.

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Chronology of the 17 Specific Divisions of ACA

• Association for Counselor Education Supervision
  1952
• Counseling Association for Humanistic Education
  Development 1952
• National Career Development Association 1952
• American School Counselor Association 1953
• American Rehabilitation Counseling Association
  1958
• National Employment Counseling Association 1966
• Association for Multicultural Counseling
  Development 1972
• International Association of Addiction Offender
  Counselors 1972
• Association for Specialists in Group Work 1973
• Association for Spiritual, Ethical, Religious
  Values in Counseling 1974
• American Mental Health Counselors Association
  1978
• Counselors for Social Justice 1979
• Association for Counselors Educators in
  Government 1984
• Association for Adult Development and Aging
  1986
• Association for Gay, Lesbian, Bisexual Issues
  in Counseling 1988
• International Association of Marriage Family
  Counselors 1989
• American College Counseling Association 1991

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Requirements for Professional Practice

• A masters degree at a minimum
• Licensure / certification
• Usually with extensive supervised clinical
  experience
• Adherence to a Code of Ethics (ACA)

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Council for Accreditation of Counseling Related
Educational ProgramsCACREP

• Formed in 1981
• A form of specialized accreditation
• Representative of ACA its divisions
• Recognized by Council on Postsecondary
  Accreditation (COPA)
• Accreditation in the United States
• Non-governmental or Papal
• Voluntary
• Pursues quality and public accountability
• Self Evaluation

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CACREP (2001)Common Core Curricular Areas

• Professional Identity
• Social and Cultural Diversity
• Human Growth and Development
• Career Development
• Helping Relationships
• Group Work
• Assessment
• Research and Program Evaluation

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Licensed Counselors?

• Over 80,000 professional counselors are licensed
  or certified in 44 states and the District of
  Columbia.
• State licensure typically requires a master's or
  doctoral degree, two to three years of supervised
  clinical experience, and the passage of an
  examination.
• In states without licensure or certification
  laws, professional counselors are certified by
  the National Board for Certified Counselors
  (NBCC).
• Participation in continuing education is often
  required for the renewal of a license or
  certification.

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National Board for Certified Counselors (NBCC)

• Established in 1982
• Initially created by ACA
• Monitoring a National Counselor Certification
  (NCC) system
• Identifies counselors who have voluntarily sought
  to obtain certification while meeting standards
  in training, experience, performance
• National Counselor Examination for Licensure
  Certification (NCE)
• Follows CACREP core curricular standards
• Certifies more than 31,000 counselors

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State of Ohio Counselor Social Worker Board

• Licensed Professional Counselor (LPC)
• A graduate degree in counseling (degrees in other
  disciplines i.e., Psychology, Social Work and
  Marriage and Family Therapy are not considered
  counseling degrees).
• 60 quarter or 40 semester hours of graduate work
• 4500 hours of supervision (1500 may be prior to
  Masterís degree)
• Exam - LPC (Offered only until December 31, 1998)

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State of Ohio Counselor Social Worker Board

• Professional Counselor (PC)
• A graduate degree in counseling (degrees in other
  disciplines are not considered counseling
  degrees).
• 90 quarter or 60 semester hours of graduate work
  with coursework to satisfy the content
  requirements and a minimum of 30 quarter or 20
  semester hours in clinical coursework.
• Exam - Effective January 1, 1999 offered as the
  Professional Counselor Licensure Exam - PCLE) No
  supervision required.

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State of Ohio Counselor Social Worker Board

• Professional Clinical Counselor (PCC)
• Meet requirements for PC
• Exam - Professional Counselor Licensure Exam
  (PCLE)
• 3000 hours (1500 yr. maximum) post PC supervised
  experience registered with the Board
• Clinical Field Evaluation
• No MAT or GRE scores required

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EthicalIssues
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Codes of Ethics can serve as a catalyst for
improving practice

• Hirlihy Corey (1994)

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There are many counseling codes of ethics But
ACA is the Spring Board!!!

• This does create a problem with Unity!

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Reasons for Ethical Codes

• Protect profession from government
• Regulate Itself!!!
• Control internal disagreements / bickering
• Stability in the Profession
• Protect Practitioners from public malpractice

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Unethical Behavior(Levenson, 1986 Pope
Vetter, 1992 Swanson, 1983)

• Violation of confidentiality
• Exceeding ones level of professional competence
• Negligent practice
• Claiming expertise one does not possess
• Imposing ones values on a client
• Creating dependency

• Sexual activity w/ clt
• Certain conflicts of interests dual
  relationships
• Questionable financial arrangements
• Bartering Excessive Fees
• Improper Advertising

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ACA Code of Ethics Standards of Practice

• The Counseling Relationship
• Client Welfare
• Respecting Diversity
• Client Rights
• Client Served by Others
• Personal Needs Values
• Dual Relationships

• The Counseling Relationship (cont.)
• Sexual Intimacies with Clts.
• Multiple Clients
• Group Work
• Fees Bartering
• Termination Referral
• Computer Technology

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ACA Code of Ethics Standards of Practice

• Professional Responsibility
• Standards of Knowledge of Ethics
• Professional Competence
• Advertising Soliciting Clients
• Credentials

• Professional Responsibility (cont.)
• Public Responsibility Nondiscrimination
• Responsibilities to Other Professionals

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ACA Code of Ethics Standards of Practice

• Confidentiality
• Relationship with Other Professionals
• Evaluation, Assessment, Interpretation

• Teaching, Training, Supervision
• Research Publication
• Resolving Ethical Issues

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Model of Ethical Decision Making(Kitchener, 1984)

• Step 1 Develop Ethical Sensitivity
• Awareness is the Key!
• Step 2 Define Dilemma Options
• What exactly is the problem?
• Step 3 Refer to Professional Standards
• What does the profession say?
• Step 4 Search out Ethical Scholarship
• Literature Codes of Ethics saves you in court!!
• Step 5 Apply Ethical Principles to Situation
• Step back and look at the big picture for a
  single course of action.

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Model of Ethical Decision Making(Kitchener, 1984)

• Step 6 Consult with Supervisor Respected
  Colleagues by asking
• What facts of the case seem most important to you
  in determining the ethical alternatives?
• What have I not considered?
• Is my interpretation of the ethics code accurate?
• What other parts of the code are applicable that
  I have not identified?
• What other books articles do you know of that
  are relevant to my decision?
• Does my analysis of the ethical principles appear
  sound?
• Is my evaluation of the most responsible options
  consistent with your judgment?
• How would you resolve this dilemma?
• Why would you make that choice?

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Model of Ethical Decision Making(Kitchener, 1984)

• Step 7 Deliberate Decide
• Absorb the information from Step 6
• Step 8 Inform Supervisor Implement Document
  Actions
• When ready to implement action inform
  supervisor explain rationale
• DOCUMENTATION IS THE KEY TO IT ALL!!!
• Step 9 Reflect on the Experience
• Learn from what you did reflect on how it went.

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BASIC Techniquesin Counseling
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BASIC COUNSELING TECHNIQUES

• Why Bad Counseling
• Pay attention to how you look
• Arms
• Position in Chair
• Face
• Pay attention to how you sound
• Tone of voice
• Rate of speech
• Counselor Matching vs. Opposite Modeling of
  behavior

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BASIC COUNSELING TECHNIQUES

• Empathy is a MUST!!!
• Reflection of Feelings
• Parroting
• Paraphrasing
• Reflecting
• Summarizing
• Clarification

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McGlothlins Stages of Simple Problem Solving

• Build relationship via empathy
• Identification of problem
• Explore feelings of client others
• Explore options past efforts
• Collaborate on a course of action
• Client Counselor summarize what has will
  happen
• Follow-through Follow-up

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Activities Discussion Topics
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Topics for Discussion

• Take a position of the issue Counselors should
  be required to undergo their own personal therapy
  before they should become practitioners. Defend
  your position.
• List some of your personal strengths, values,
  beliefs, past experiences, and so on, that you
  think will work in your favor in establishing a
  meaningful and therapeutic relationship with
  clients. How might these get in your way?

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Topics for Discussion

• If you were looking for a counselor yourself,
  what characteristics would you want?
• Discuss the possible therapeutic value of
  developing a sense of humor. When might humor be
  appropriate inappropriate in a session?
• If you were in a job interview, how would you
  respond to the question What do you consider to
  be the most pressing central ethical issue
  facing counselors?

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Topics for Discussion

• What are some clinical and ethical issues you can
  see that are associated with diagnostic
  procedures. What do you think is the appropriate
  role of diagnosis in counseling?
• What questions do you have regarding the
  counseling profession in general?
• If you had a magic wand, what would you be doing
  (in the counseling arena in 20 years)?

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Intern Jack the difficult client

• Jack, a counselor intern, is working in a
  university counseling center, Mai-Ling, a
  freshman who came to the US from mainland China
  with her parents 8 years ago, has come for her
  first session with Jack and has agreed to let him
  audiotape the session from his supervisor. She
  states that she has come for help in deciding
  whether to continue in her 2-year associate
  degree program or switch to a baccalaureate
  program in computer science. Jack, very much
  aware that his supervisor will be listening for
  reflections of feelings and other attending
  skills, asks Mai-Ling how she feels about being
  confronted with this decision. She responds by
  simply restating her problem. The session
  continues in this fashion, with Jack probing for
  the clients feelings and the client responding
  in a cognitive, content-oriented manner. After
  the session ends, Jack determines to ask his
  supervisor how to build rapport with this
  difficult client.

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Intern Jack the difficult client

• What is the problem in this case?
• Not sensitive to cultural differences
• High vs. Low context cultures
• How can this be avoided in this case?

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Lynn, Elaine, the Divorce

• Lynn has been counseling Elaine, a 30-year-old
  client. During this session, Elaine states that
  she wishes she could just walk away from her
  marriage, but she cant do it because it would
  traumatize her children. Lynn, herself a child of
  divorce whose father abandoned the family,
  further explores Elaines fears for the children.
  At one point she ways, Well, yes, the statistics
  do show that a lot of kids lose touch with their
  fathers after divorce. It would be really hard
  for them if that happened. It could even have
  repercussions well into their adult years.

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Lynn, Elaine, the Divorce

• What is the problem in this case?
• Transference?
• How can this be avoided in this case?

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The Parents will Know Marsha Takes Drugs!

• Marsha, age 15, has been seeing her school
  counselor for several weeks. Although Marshas
  parents her teachers have been concerned about
  her erratic behavior, Marsha has asserted that
  she is just moody. Now, she admits that she has
  been buying using cocaine. After further
  exploration, the counselor believes that Marsha
  has been taking some serious risks, not only by
  using the drug, but also by making her purchases
  from various dealers in an unsafe area of the
  city. The counselor lets Marsha know that ,
  because of the danger her behavior is putting her
  in, her parents will need to be informed. Marsha
  is outraged. Even though the counselor had told
  her that she couldnt uphold confidentiality if
  her behavior posed a danger to herself or others,
  Marsha insists it doesnt apply here. She says,
  I know what Im doing. Ive been buying coke for
  months now and nothing bad has happened to me. I
  trusted you and now youve betrayed me. This is
  sure the last time Ill ever see a counselor!

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The Parents will Know Marsha Takes Drugs!

• What is the problem in this case?
• Not sensitive to cultural differences
• How can this be avoided in this case?

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Joseph, a Navajo Indian Informed Consent

• Joseph, a Navajo Indian who espouses the
  traditions of his culture, is your prospective
  client. During the initial interview, you want to
  secure his informed consent, which would include
  giving him information about the implications of
  diagnosis and the potential risks associated with
  counseling. You might make a statement like,
  Sometimes clients in counseling seem to feel
  worse before they feel better. You might tell
  Joseph that, based on the symptoms he has
  described, he seems to be suffering form
  depression.

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Joseph, a Navajo Indian Informed Consent

• Multicultural issues in ethics informed consent
• Beliefs about wellness
• In traditional Navajo culture, it is believed
  that language has the power to shaper reality and
  control events. Thus, in following your standard
  information consent procedures, you could be
  creating the reality for Joseph that he is
  depressed and will feel worse for a while.

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Soo Jung Post Partum Depression

• Soo Jung is a 22-year-old Korean American who is
  brought to the counseling center by her husband.
  During the intake interview, she tells you that
  she has been having crying spells, has lost her
  appetite, and is not sleeping well. She gave
  birth to her first child two months ago. When you
  suggest to Soo Jung that she may be experiencing
  post-partum depression, she becomes very upset
  and says, Why are you telling me this? You need
  to talk with my husband. Because the counselor
  did not include her husband in this discussion,
  the client may be interpreting the counselors
  action as attempting to undermine her marital
  relationship.

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Soo Jung Post Partum Depression

• Multicultural issues in ethics informed consent
• Not a claim of dominant values
• Korean Americans are significantly more likely
  than European Americans and African Americans to
  hold a family-centered model of decision making
  about health issues.

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The End!!!

• EDC 543
• Theories Techniques of Counseling
• Dr. Jason McGlothlin
• University of Dayton