Ethics in Counseling Essay

This paper analyses social, respectable and legal issues at heart a complaint initiated by the NSW Health Care Complaints Commission (HCCC) against a psychologist, Steven Kreft (HCCC v Kreft, 2011). The HCCC investigated a complaint by a node of Kreft of soulfulness-to-personised and intimate disclosures, as well as un master copy preaching in the solicitation of a photograph of the node in which the client was garbed in infrawear. Krefts actions are assessed in light of headmaster and estimable standards as well as potential breaches of the law. Steven Kreft, was an commenced psychologist specializely specialising in the treatment of men with anxiety conditions apply cognitive- doingsal therapy (HCCC v Kreft, 2011). The client, a 19-year-old married woman, was referred to Kreft because of anxiety and possibly timidity attacks, unaccompanied during the initial stages of counselling, she raised birth problems, her appearance and sexual ask and practices with him and these became the focus of their sessions.Kreft conveyed to the client that he was not watchd or learninged in the treatment of kin problems or sexual disorders, however, the client stated that she wished to continue stooling with him and he did not insist on referring her elsewhere. The client ultimately accused Kreft of failing to strike proper master key boundaries and engaging in in book discussions of a individualised nature in which he Complimented her on her appearance referring to her petite size, pathetic height and thin build, and samened her to his miss Commented on her wearing Bonds underwear like his girlfriend wore Asked the client to comment on his corporeal appearance reveal details of his in the flesh(predicate) life including the number of sexual partners he had had, that his girlfriend would share a bed with other girlfriends when they slept over, that he had been in turn in legion(predicate) times, and that he had thought intimately homosexualit y during his youth (HCCC v Kreft, 2011). In addition, Kreft was accused of failing to follow or observe appropriate remedial practice and/or failing to observe proper professional boundaries when he asked the client for photographs for a study in which other plurality would rate the clients appearance. One of these photographs pictured the client dress in underwear. Kreft copied these photographs onto his deliver computer for later presentation to unnamed others.This model was not recorded in the clients clinical notes (HCCC v Kreft, 2011). The HCCC investigated the clients complaints and took disciplinary action against him. There are numerous social, ethical and legal issues in this case. Although Kreft was in fact a psychologist, for the determination of this paper, his put up go forth be assessed against the Australian hash out Associations statute of ethics and Practice (2012). This paper will explore the source dissymmetry mingled with Kreft and his client, the e ffect of his behaviour on the therapeutic consanguinity and whether Krefts behaviour might soak up breached sexual anguish laws. respectable and legal guidelines exist to offer protection to citizenry who may experience injury as a result of the actions of some other person. According to Welfel (2013, p.3), professional ethics in counselling encompasses five dimensions of behaviour including having sufficient knowledge, skill and judgement respecting the clients human dignity and freedom using a counsellors inherent force play responsibly and, performing to promote public confidence in the counselling profession.This provides a utile framework for assessing Krefts conduct in this case. Beginning with Krefts expertise, Kreft unremarkably used a strict cognitive-behavioural protocol for the management of anxiety and panic disorders. Kreft is described by his own treating psychiatrist as a delicate practiti peerlessr in a narrow plain stitch, having been trained to think ra tion tout ensembley and logically. Krefts practice involved administering protocols, carrying out logic-based interventions and requires his patients to occupy a lookout where they share a common objective and commitment to the treatment and its proposed resultant role (HCCC v Kreft, 2011 at 227).Although referred to Kreft because of his relevant expertise, the treatment interaction became sexualised when the client began talk nearly her sexual experiences and practices. There was push exploration of her concerns about her face-to-face appearance, low self-esteem, need for validation by men via her sexual activities and descriptions of her peculiar(prenominal) sexual behaviour. Here, Kreft was out of his professional depth. Specifically on this matter, the Australian counselor-at-law Associations (ACA) Code of Ethics and Practice states that counsellors must go-ahead to strive suitable referral where competent service rout outnot be provided (p.3) and undertake unbroken supervision and debriefing to develop skills, monitor performance and sustain professional accountability (p.3).Although Kreft blotd thatthe clients relationship and sexual issues were beyond his expertise and conveyed as much to the client, he could have insisted on referral, patronage the clients preference for continued sessions with him. The ACA further states that competence includes existence able to recognise when it is appropriate to refer a client elsewhere (p.12). The rationale for this professional expectation is that counsellors are required to take all reasonable steps to ascertain that the client does not suffer physical, aroused or psychological harm during counselling sessions (p.4). Sexualisation of the therapeutic relationship can be harmful to clients, and in this case, it is difficult to see how it served the client. According to the ACA Code of Ethics and Practice, the helping relationship constitutes the effective and appropriate use of accessorys skills t hat are for the benefit and safety of the client in his or her circumstances (2012, p.3), and counsellors must take all reasonable steps to ensure that the client does not suffer physical, emotional or psychological harm during counselling sessions (2012, p.4).In relation to the disclosures, for whose benefit where they? It is unclear what led Kreft to make sexualised self-disclosures and what purpose he thought they served. Perhaps it was a response to the clients exploration of her relationships and sexual activities. Such client self-disclosure can sexualise the therapeutic relationship (Gurtheil & Brodsky, 2011, p. 183). Counsellor disclosures are inevitable and sometimes efficacious, but self-disclosure can become burdensome to the client and therefore detrimental. Gurtheil and Brodsky (2011) state that in cases of sexual misconduct, a key turning point often occurs when the relationship shifts from a therapeutic exchange to one of sharing personal confidences and feelings (p. 114). They further state that even therapists whose practice deliberately includes open self-disclosure, it is rarely useful and usually burdensome for clients to hear details of the therapists emotional, sexual, personal or family life. Such disclosures, especially when they involve sexual feelings, are tight always considered boundary violations (p.115).It seems that Kreft may have been meeting some personal need by making the disclosures. Without having observed the interaction, it is difficult to judge, however, perhaps in an attempt to normalise the clients experience or cover her engaged, Kreft seems to also be almost boasting of his own sexual prowess. This amounts to an development of the client forhis own needs. The APA states that, counsellors must not exploit their clients financially, sexually, emotionally or in whatever other way (pp.4-5). If poorly handled, the power imbalance inherent in the therapeutic relationship can lead to evolution of clients (Barnett, Laz arus, Vasquez, Moorehead-Slaughter & Johnson, 2007, p.402). A young fe manlike client, is less likely to challenge the justness of such comments. In addition to the sexualised disclosures, Kreft devised an coiffe based on his narrow focus on CBT, which he believed would help the client. He requested and obtained a photo of his client wearing a bra and underpants for the purpose of an exercise aimed at challenging the clients maladaptive or prejudicious beliefs about her appearance.The photo was to be shown to a number of unnamed people in order for them to rate her appearance. Kreft claimed in his testimony that he created the exercise based on his expertise and training. He did not state that he researched current effective practice or discussed the clients needs in supervision. It would seem prudent to educate oneself about an unfamiliar field of practice or client. In fact, the ACAs ethical expectations include counsellors committing to ongoing personal and professional devel opment, as well as undertake repair supervision and debriefing (p.3). A cursory investigation of recognised treatments for consistency image problems Butters and Cash (1987) research into effective cognitive-behavioural treatment of women with body-image dissatisfaction found that a combination of methods produced improved affective body image, reduced maladaptive body-image cognitions and intensify social self-esteem about fitness and sexuality. The methods included providing clients with information about body-image dissatisfaction, having clients construct a personalised hierarchy of body areas, desensitisation to self-acting thoughts and developing counterarguments for irrational thoughts.Butters and Cash (1987) did use observer ratings of client physical attractiveness as part of the series of exercises, but there is no suggestion that clients were to be barely dressed in the photographs used. Kreft seemed to exercise poor judgment in his selection of a photograph in which t he client was so scantily clothed. Kreft seemed unaware of his power in the relationship. Power inwardly the therapeutic relationship can take numerous forms. Proctor (2002, p.8) states that one basic form is societal power which is expressed in the imbalances between the genders and between the old and young. In thiscase, Kreft was an older male with a teenaged female client. According to testimony in his case, Kreft was accustomed to working with male clients, so he may have been unaccustomed to working with a young female. He may have been unaware of the subconscious power he held in the relationship simply by virtue of his stronger go under in society. Pope and Vasquez (2007, pp41-42) describe other forms of power that therapists have in relation to clients. These include the power of expectationclients expects that the therapists interventions will be able to induce beneficial change.Related to this is the power to favor the approach to therapy. Kreft chose to make personal disclosures and chose the therapeutic exercise involving the clients photograph. She complied with the activity, although she stated in her complaint that she was very uncomfortable about it. Kreft failed to recognise this in her delayed provision of the photo, but also failed to recognise that any young woman might be uncomfortable with such an exercise, insofar reluctant to refuse. He did not make this psychologically safe for her. chthonian the Victorian suitable prospect Act 2010, both the disclosures and the request for photographs could be deemed sexual harassment and therefore unlawful. A person sexually harasses another person if he or she engages in unwished-for conduct of a sexual nature in relation to another person in circumstances in which a reasonable person, having regard to all the circumstances, would have anticipated that the other person would be offended, humiliated or terrifyd. pick out of a sexual nature includes making orally, any remark or statement w ith sexual connotations to a person or about a person in his or her mien, and, making any comment of a sexual nature in a persons presence (Victorian Equal Opportunity and Human Rights Commission, 2013a, p.79).There are therefore triple characteristics of behaviour that would have it constitute sexual harassment being unwished being conduct of a sexual nature and being conduct that a reasonable person would consider likely to offend, humiliate or intimidate in the circumstances. There seems little doubt that Krefts disclosures about his sexual activities fit this definition of conduct of a sexual nature. In relation to whether the comments were unwelcome to the client, it certainly appears so, as she has complained of as much. For conduct to be unwelcome, it must be unsolicited or uninvited by the client, and regarded as undesirable or offensive by the client. Kreft does not suggest that theclient invited the comments. Even if a client does not speak up or complain at the time, t he conduct might still be considered unwelcome (Victorian Equal Opportunity and Human Rights Commission, 2013b, p.6).The clients age is a factor recognised as causing someone to tolerate behaviour even if unwelcome. Numerous sexual harassment cases have recognised how a power imbalance between the parties can contribute to a person remaining silent about how unwelcome the behaviour is (VEOHRC, 2013a, p.85). The final component in sexual harassment is whether the conduct occurred in circumstances in which it could reasonably have been expected that the conduct would offend, humiliate or intimidate the person. Again, given the clients age in relation to Kreft, and the exceedingly sexual nature of the disclosures, within a relationship that should be center on the clients concerns, it seems that this third criterion of sexual harassment would be met. In conclusion, it seems that Steven Krefts behaviour in this case strike down far short of recognised ethical, legal and social expec tations. He took on a client with issues outside his narrow expertise and attempted to work with her in relation to the highly sexualised disclosures she made about her relationships with men. Krefts own highly sexualised personal disclosures were unethical according to professional guidelines and potentially unlawful, under sexual harassment laws.Krefts attempts to help the client change her detrimental beliefs about her body were devised without reference to existing knowledge in the treatment of such problems and again became sexualised when Kreft chose a photo of the client dressed only in underwear. Ultimately, Kreft was required to update his training, engage in regular supervision, and change a suspension of practice for six months. Krefts case provides a number of warnings for other practitioners about the dangers of a narrow knowledge and experience base, as well as the importance of understanding the various dimensions of therapeutic relationships. Counsellors would do w ell to have a sound understanding of ethical boundaries and how they might appropriately respond to a clients disclosures of sexual behaviour. Having regular supervision is crucial for assisting counsellors in all of these areas.ReferencesAustralian Counselling Association. (2012). Code of ethics and practice. QLD Author.Barnett, J., Lazarus, A., Vasquez, M., Moorehead-Slaughter, O., & Johnson, W. (2007). Boundary issues and multiple relationships Fantasy and reality. Professional psychology Research and Practice, 38(4), 401410. Butters, J. W. & Cash, T. F. (1987) Cognitive-behavioral treatment of womens body-image dissatisfaction. Journal of Consulting and Clinical Psychology, 55, 6. Gurtheil, T. G. & Brodsky, A. (2011). Preventing boundary violations in clinical practice. London Guilford Press. HCCC v Kreft (No. 1) (2011) NSWPST 2.HCCC v Kreft (No. 2) (2012) NSWPST 1.Pope, K. S. & Vasquez, M. J. (2011). Ethics in psychotherapy and counselling A practical guide. New Jersey John Wi ley and Sons. Proctor, G. (2002). The kinetics of power in counseling and psychotherapy ethics, politics and practice. 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