LEARNING FROM THE PAST TO ENHANCE THE FUTURE: ETHICS

ISSUES AND TRAINING NEEDS OF RURAL COUNSELING PRACTITIONERS

Jane WarrenAmanuel Haile Asfaw

Avis GarciaUniversity of Wyoming

Professional Studies Department

Counselor Education Program

Research Team

Jane Warren-University of Wyoming-Department of Professional Studies - Counseling program

Amanuel Haile Asfaw- University of Wyoming-Department of Professional Studies - Counseling program

Carrie Ahls - University of Wyoming-Department of Professional Studies -Counseling program

Johnna Carlene Nunez -University of Wyoming-Department of Social Work program

Jennifer Weatherford -University of Wyoming-Department of Professional Studies-Educational Research program

Noor Syamilah Zakaria - University of Wyoming-Department of Professional Studies - Counseling program

Outline

Ice breaker-Your most difficult ethical challenge this last year

Ethics in counseling Ethics challenges in rural settings Our research Relevance of our research Apply to your own wellness Apply to your ethical challenge Dialogue

The Best of Times-The Worst of Times…

Imagine for a few minutes your most difficult ethical challenge you had this year

What made it difficult? What did you do?

The Best of Times-The Worst of Times…

Share your insights with someone next to you…

Brief discussion…

Ethics in Counseling

Professional—to profess to do (Ponton & Duba, 2009)

Ethics make a profession, a profession…

Ethics in Counseling

Counseling defined (ACA)Counseling is a professional relationship

that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.…..a basic framework and that each

participating organization is welcome to add a statement that fleshes out the particular specialty or area of focus.

Ethics in CounselingEthical Practice

ACA Codes-APGA-1961-Ist codes 5 revisions since 1961 ( every 7-10 years) March 2014 most recent changes

Why???

Ethics in CounselingACA 2014 Code of Ethics: Nine Sections

Section A: The Counseling Relationship Section B: Confidentiality and Privacy Section C: Professional Responsibility Section D: Relationships With Other Professionals Section E: Evaluation, Assessment, and

Interpretation Section F: Supervision, Training, and Teaching Section G: Research and Publication Section H: Distance Counseling, Technology, andSocial Media Section I: Resolving Ethical Issues

Ethics in CounselingSix Functions of 2014 Codes

1. Sets forth the ethical obligations of ACA members and provides guidance intended to inform the ethical practice of professional counselors.

2. Identifies ethical considerations relevant to professional counselors and counselors-in-training.

3. Enables the association to clarify for current and prospective members, and for those served by members, the nature of the ethical responsibilities held in common by its members.

4. Serves as an ethical guide designed to assist members in constructing a course of action that best serves those utilizing counseling services and establishes expectations of conduct with a primary emphasis on the role of the professional counselor.

5. Helps to support the mission of ACA. 6. The standards contained serve as the basis for

processing inquiries and ethics complaints concerning ACA members

Ethics in CounselingProfessional Values-2014 Preamble

Professional values are an important way of living out an ethical commitment. The following are core professional values of the counseling profession: 1. enhancing human development throughout the life

span; 2. honoring diversity and embracing a multicultural

approach in support of the worth, dignity, potential, and

uniqueness of people within their social and cultural contexts;

3. promoting social justice; 4. safeguarding the integrity of the counselor–client

relationship; and 5. practicing in a competent and ethical manner.

Ethics Challenges in Rural Settings

Research has identified: dual relationships, multiple roles, unique community standards, isolation, lack of access to training and supervision, given cases for which they are not prepared, role conflicts, inconsistencies, idiosyncratic choices in such ethical practices as

confidentiality and informed consent, burnout/self-impairment.

Ethics Challenges: Errors Happen

Strom-Gottfried (2003) Social Workers (NASW)--Of 267 adjudicated cases, 107 involved sexual activity, 77 involved dual relationships, 70 involved other boundary violations, 55 involved failure to seek supervision, 41 involved failure to use accepted practice skills, 34 involved fraudulent behavior, and 33 involved premature termination.

Trigg and Robinson (2013) found the most frequent ethical violations were “practicing outside of the scope of one’s training and experience and practicing while impaired due to substance use or mental health matters” (p. 28), violations of professional boundaries (both nonsexual and sexual), and breaches of confidentiality.

The Research Questions

If there are ethical challenges in rural settings and research shows ethical errors occur, what might be the ethical challenges as reported by counseling practitioners in one rural state?

What would counseling practitioners in one rural state want for ethics training?

Let’s ask the practitioners!

Our Research

Through an exploratory survey in 2012 of a representative sample (n=316) of licensed and certified counseling and social work mental health professionals (N=1,324) in Wyoming ethical issues and training needs were identified by the providers. The intended goal was to obtain direct feedback about ethical issues and ethical training needs from practitioners themselves who work in rural settings.

Our Research-The Survey

A brief demographic questionnaire Two questions:

The most difficult professional ethical dilemma or situation I have encountered in the last two years has been:______

Two primary ethical trainings I would find to be most helpful in my practice are: self-care, boundaries, rules and regulations, malpractice, supervision, professional competency, risk management, end of life, suicide, duty to warn, confidentiality, diagnosis, spirituality, multicultural topics, and other.`

Results

316 (27%) responded to the survey—**our distribution results of the survey sample (see Table 1-oour results) closely approximated the (12/29/ 2011 distribution of licensing and certification in the state…) 

CAPA- 23 CAP- 62—3% (3%) PAT- 13 LAT- 134-7% (3%)  CSW- 89 PCSW- 109 LCSW- 493—30% (29%)  PMFT- 16 LMFT- 93—5% (4%)  PPC- 168 LPC- 756—46% (47%)  CMHW- 18—.09%

1974 in total  

Our Research FindingsEthical Issues

Three primary ethical issues: Dual relationships (19%) Confidentiality (19%) Competence (17% ) Two additional findings regarding ethical

dilemmas encountered were professional silence and supervision representing 10% and 9%, respectively.

Our Research FindingsEthical Training Needs

Three primary ethical training needs: Boundaries (12%) State Rules and Regulations

(12%) Supervision (10%)One respondent stated, “I think in our state it is more difficult to maintain professional boundaries because of the closeness of our communities. For instance, in my neighborhood I am surrounded by former clients as neighbors.”

Summary The Two Areas

Ethical issues: Dual relationships (19%) Confidentiality (19%) Competence (17% )Training Boundaries (12%) State Rules and Regulations

(12%) Supervision (10%)

Relevance of Our ResearchFits with the ACA 2014 Ethics Codes

Counseling relationship (A. 5. Prohibited Non Counseling Roles and Relationships-Managing Boundaries )

Virtual relationships Confidentiality Competence Impairment Monitor effectiveness Consult on ethical concerns Continued Education Obtain ethical supervision (online and in

person)

Relevance of Our Researchfor Counseling Ethics Education

Educate about rules and changes in codes

Provide more training for supervisors and supervision

Increase boundary education on all levels Identify the many challenges, choices,

and requirements in confidentiality Understand the ethical issues faced by

rural practitioners may be different than urban—and design programs accordingly.

Relevance of Our ResearchFor Our Profession

Promote dialogue among practitioners about ethical challenges and actions

Encourage compassion for practitioners Promote wellness for all counseling

practitioners

Relevance of Our Research for Existing Ethics Education

Inform Licensing Boards Make Continuing Education Relevant Listen to Practitioners Missing: Multicultural needs (last item

mentioned for training)

Apply to Your Ethical Challenge

What have you learned and what might you do now differently, if anything?

Dialogue

Questions/Discoveries

References

Harrison, R. L., & Westwood, M. J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy Theory, Research, Practice, Training, 46, 203-219. doi: 10.1037/a0016081

Maltzman, S. (2011). An organizational self-care model: Practical suggestions for development and implementation. Counseling Psychologist, 39, 303-319. doi: 10.1177/0011000010381790

.