Counseling Ethics for the 21st Century

A Case-Based Guide to Virtuous Practice

Elliot D. Cohen, Gale S. Cohen

• Publisher: SAGE Publications, Inc
• Year: 2018
• ISBN:
  9781506345499
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

Counseling Ethics for the 21st Century prepares students to address ethical issues arising in contemporary counseling practice. Drawing on their own clinical and practical experiences, authors Elliot D. Cohen and Gale Spieler Cohen present detailed, realistic, and engaging clinical case studies along with a comprehensive five-step model that can be used to manage the complex ethical problems raised throughout the book. Each chapter focuses on particular virtues in the context of examining a particular counseling issue, including online counseling, digital record keeping, and social media. Students will be empowered to define problems, identify relevant facts, conduct ethical analyses, and make the best decisions for their clients.

Part I Becoming a Virtuous Therapist

1 Building Character: Virtues of Excellent Practitioners

As discussed in the introduction, it is one thing to practice within the limits of law and another to be an excellent therapist. The former is a necessary condition for the latter, but not a sufficient condition. Here, aspiring to excellence in counseling and psychotherapy requires commitment to cultivating the moral character that is emblematic of virtuous practice. Accordingly, this first chapter starts with the basics of virtue ethics, which stresses the cultivation of moral character. In particular, it defines what it means to be virtuous, and then develops accounts of 14 interconnected counselor virtues that guide virtuous practice.

What Being Virtuous Means

Virtue ethics received its most elaborate articulation in ancient Greek philosophy, especially in the writings of Aristotle. A key note of this approach is that virtuous practice is akin to skill building. According to Aristotle (2015), becoming virtuous is like becoming good at an art or craft. For example, if one wants to become a good musician, one needs to practice. There are no shortcuts. It takes time, patience, and perseverance. Difficult musical passages are executed (e.g., playing a classical guitar piece) by repeatedly executing the difficult passages. The more one practices, the more one can become adept at executing them. It is similar with respect to becoming virtuous. This is because virtues are habits. For example, consider the character trait of truthfulness. What does it mean to be truthful?

One becomes truthful by telling the truth. The more one tells the truth, the more one gets used to it. On the other hand, the more one tells falsehoods with the attempt to deceive or mislead others, the more one gets used to being duplicitous. Indeed, one truth does not make one truthful; for it takes a truthful character to be truthful. This means being in the habit of telling the truth.

Such a habit of truthfulness involves the intrinsic desire to tell the truth, not merely truth-telling. So an untruthful person can be forced at gun point to repeatedly speak the truth; but that does not make this person truthful. The truthful person desires to tell the truth for informational purposes. Moreover, a truthful person will also have requisite emotions regarding the truth. For example, a truthful person may feel guilty or uncomfortable about not having been forthright enough in presenting the facts. In contrast, an untruthful person may lie without batting an eyelash. So possessing the virtue of truthfulness means that one is in a habit of acting, thinking, and feeling in truthful ways. This is why virtuous practice is so challenging. It is a matter of character, not just right conduct.

Virtues also involve moderation, that is, the avoidance of extremes. Thus, Aristotle (2015) informs us that

virtue must have the quality of aiming at the intermediate. I mean moral virtue; for it is this that is concerned with passions and actions, and in these there is excess, defect, and the intermediate. For instance, both fear and confidence and appetite and anger and pity and in general pleasure and pain may be felt both too much and too little, and in both cases not well; but to feel them at the right times, with reference to the right objects, towards the right people, with the right motive, and in the right way, is what is both intermediate and best, and this is characteristic of virtue. (Bk. 2, Ch. 6)

So (moral) virtue involves controlling ones passions (anger, fear, desire, pity, etc.) in a manner that avoids the extremes of excess and efficiency. This, in turn, requires having the ability to adjust one’s response to the context or situation. So the intermediate with regard to controlling one’s fears will invariably depend on such factors as the object of fear, the nature of the impending danger, and what you are trying to accomplish. For example, one may act appropriately in subduing a wild boar that was poised to attack you by shooting it. However, it would be overreacting if you attempted to subdue a yapping Chihuahua in the same way. Indeed, what is extreme and what is intermediate will vary with the nature of the situation. The virtuous person will be able to assess the situation and act accordingly. As Aristotle (2015), admonished, such judgment is not something one can learn entirely from reading a book; rather, it requires time and experience so that we should better trust “the opinions of experienced and older people … for because experience has given them an eye they see aright” (2015, Bk. 6, Ch. 11).

In the context of counseling, assessing danger appropriately requires judgment tempered by experience. So, as we build up our client databases, we can draw analogical inferences from our experiences. “I recall that a former client expressed a desire to kill his wife after he found out she was cheating on him. I was able to help him get through it. And the profile of my current client is very similar.” Of course, we also learn from trial and error, and failure to take adequate precautions can, in retrospect, help us avoid the same mistake in the future. On the other hand, it would be going to extremes to have one’s clients involuntarily detained every time they expressed a desire to kill someone; for this would surely alienate clients and thwart their progress. Experience can indeed light the pathway to virtuous practice, but it provides no algorithm. As you will see, being a virtuous practitioner involves a sort of artful practical knowhow that depends largely on one’s ability to hone in on the welfare and interests of clients and other relevant third parties, and to see these factors through the magnifying lenses of experience and professional training. Such ability requires cultivation of a set of mutually supportive habits or counselor virtues involving dispositions of thought, feeling, and action.

The Counselor Virtues

The following descriptions provide snapshots of what such a set of mutually supportive virtues looks like.

Benevolence/Nonmalevolence

As helping professionals, who are privy to the most intimate and personal aspects of their clients’ lives, virtuous counselors are benevolent, which means that they are deeply committed to advancing the welfare of their clients. Benevolent counselors seek to eliminate pain and suffering of clients as well as advance their positive welfare (Cohen & Cohen, 1999). For example, helping a client overcome a major depression eliminates serious client suffering; whereas helping a client gain greater confidence in social contexts helps promote positive change.

Benevolent counselors’ deep commitment to their clients is reflected not only in the provision of competent services that advance client welfare, but also in the expression of caring sentiments and thoughts. Indeed, to be benevolent means to feel joy at client progress and sadness or regret at setbacks. Benevolent counselors also have intrinsic regard for the well-being of their clients (Cohen, 1985); that is, they see client progress as good in itself, not merely as an instrumental value (such as a means of making money, advancing professional reputation, or receiving praise).

Such practitioners do not stand on ceremony when it comes to client welfare. They are flexibly adaptive, and do not ordinarily “fire” their clients when they refuse to follow their counsel. They view resistance as an inevitable part of the counseling process, and make reasonable efforts to work with resistant clients to overcome barriers to progress. Of course, being benevolent also means avoiding going to extremes to accommodate clients, such as when counseling becomes unhelpful or counterproductive. Benevolent counselors terminate counseling or make a suitable referral when it becomes evident that continuing the counseling relationship is not serving the best interest of the client (American Counseling Association [ACA], 2014, A.11.c).

A condition of benevolence is nonmalevolence (Cohen & Cohen, 1999). This means that the benevolent counselor avoids inflicting harm on the client and seeks to prevent harm. In accord with the premier medical ethic, “First, do no harm” (Latin: Primum non nocere), the nonmaleficent counselor perceives infliction of harm on a client as deplorable. Indeed, better to leave the client without improvement than to leave her worse off! Nonmaleficent counselors are therefore strongly inclined toward referring clients when it’s evident that counseling them poses a serious risk of inflicting harm. For instance, such a basis for referral may arise when the counselor lacks adequate knowledge and experience in treating a particular type of mental disorder (ACA, 2014, A.11.a).

Nonmalevolent counselors also seek to prevent future harm to clients as well as third parties (Cohen & Cohen, 1999). For example, nonmalevolent counselors will take reasonable precautions in safeguarding a suicidal client from attempting suicide. Such a counselor will also act responsibly to prevent harm to endangered third parties—for example, as when a client makes a credible threat to kill or seriously injure another person.

Empathy

Benevolent counselors are also empathetic persons. This is because one cannot begin to help others if one does not have a clue about what will, in fact, conduce to their well-being. Being empathetic permits a counselor to key into the welfare and interests of clients so that they can, in turn, assist them in making constructive life changes.

The virtue of empathy involves the settled ability to resonate with the plights of others, to sense the subjective meanings of their personal and interpersonal challenges, and to be there for them in helping facilitate constructive change (Cohen, 2015). This state of resonance involves a balance of cognitive, affective, sensitive, and behavioral factors. As Carl Rogers (1961) expressed it, in empathizing, it is “as if” one is in the subjective world of another, but “without losing the ‘as if’ quality,” that is, without losing one’s objectivity as an observer (p. 284). The latter “as if” is especially important for counselors because loss of objectivity would prevent the counselor from helping the client engage in self-exploration. Suppose your client has just lost her husband of 20 years in a car accident. A drunk driver ran a stop sign, ending his life instantly. Whether or not you have, yourself, suffered such a tragic loss, you can still empathize; for you can know what it would be like to lose someone so close to you—you can imagine the harsh reality of not ever being able to see, confide in, or experience the love and support of someone who has played such a major role in your life for so many years; and the way it happened, so unexpectedly and tragically (Cohen, 2007). To empathize here is to grasp the subjective meaning and import of these facts, which includes feeling (viscerally) the client’s devastation—the hollowness is in your gut, too, and the lump is in your throat. You are there with the client, sensing what she is going through: the incredulity (“How can this be!”); the forlornness (“I have nothing left!”); the futility (“How could this have happened!”); the anxiety (“What’s going to happen to me now!?”); the sense of powerlessness (“ Nothing will ever bring him back!”). From this point of subjective reference, you are able to reflect back these emotionally charged meanings in a way that conveys insight and understanding, which, in turn, encourages further client disclosure:

“So you are feeling that there’s nothing you could ever do to fill the void?”

“Yes, I could never look at another man. That would be disloyal.”

Relevant self-disclosure can sometimes add to this resonance:

“I recall when my dad died suddenly of a heart attack, how lost I felt …”

“Yes, that’s exactly it. I feel so lost!”

Here, as in all virtues, there is an intermediate point attained where there is the right balance of cognitive, emotive, behavioral, and sensitive factors. In empathizing with your client, you do not plunge so deeply into her subjective world that you too are lost. Neither too close, nor too distant—close enough to grasp and sense the client’s subjective meanings, but not so close that you become so emotionally involved that the client’s desperation becomes your own and you lose the ability to help.

Clearly, the ability to attain this Aristotelian “golden mean” (state of intermediate, harmonic balance between your subjective world and that of your client) is no mere counseling technique. It requires a settled character (habit) of being an empathetic person (Aristotle, 2015; Cohen, 2003). One does not become empathetic when one enters the counseling room. One enters as an empathetic person, and leaves as one. As such, empathizing occasionally no more makes one empathetic than does telling the truth on occasion make one truthful. This does not mean that empathetic people must always feel empathy for the plights of others any more than truthful people must always tell the truth. However, when lack of empathetic regard becomes more the rule than the exception, then it is clear that the person in question is not habitually disposed toward being empa...