1. WHEN ARE COUNSELLORS AT RISK OF ETHICAL MISCONDUCT? Dr. Cristelle Audet Dr. Glenn Sheppard Canadian Counselling and Psychotherapy Association Annual Conference May 14-17, 2013 Halifax, Nova Scotia

2. OVERVIEW Ethical practice & fiduciary relationship But…misconduct happens Working outside areas of competencies Unintentional  awareness Identifying ethical vulnerability

3. THE BASIS FOR ETHICAL PRACTICE  Intentionality  Knowledge of ethics, standards, the law, and school board policy  Skill in making ethical decisions  Courage to act on our ethical obligations  Tolerance for ambiguity

4. NATURE OF COUNSELLOR-CLIENT RELATIONSHIP Fiduciary Relationship  Counsellors have a fiduciary duty to their clients.  It is “a relationship in which one person is under duty to act for the benefit of the other on matters within the scope of the relationship.”

5.  A fiduciary is “one who owes to another the duties of good faith, trust, confidence…one who must exercise a high standard of care…” (Blacks Law Dictionary 1999) NATURE OF COUNSELLOR-CLIENT RELATIONSHIP (cont’d.)

6. ETHICAL MISCONDUCT In the US… 6 - 10% counsellors affected Nuekrug et al. (2001) 34 states report 1,018 complaints Inappropriate dual r/s (24%) Sexual r/s with client (7%) Breach of confidentiality (5%) Failure to report abuse (1%)

7. COMPLAINTS Theme Informed Consent & Client Confidentiality Couples counselling Boundaries Working outside areas of competency/expertise Socializing the therapeutic encounter Multiple roles/multiple clients

8. COMPETENCE “Render counselling services to a degree of skill and knowledge commonly applied under all circumstances in the community by the average prudent reputable member of the profession.”

9. BOUNDARIES OF COMPETENCE Counsellors limit their counselling services and practices to those which are within their professional competence by virtue of their education and professional experience, and consistent with any requirements for provincial and national credentials. They refer to other professionals, when the counselling of clients exceed their level of competence. CCPA Code of Ethics, 2007

10. COMPROMISED JUDGEMENT Gap in professional knowledge Personal issues / wounded healer / burnout Unconscious, feeling-based actions not sufficiently accounted for

11. SELF-AWARENESS EXERCISE: Identifying Potential Vulnerability (Brennan, 2009) http://www.counselingoutfitters.com/vistas/vistas09/A rticle_13_Brennan.pdf

12. Conscious good intention Preconscious/ unconscious needs, wants, motivations

13. GOAL: Identifying PAST developmental themes TASK: Apply 2 adjectives/phrases to each period Childhood Adolescence Adulthood to this time

14. GOAL: Identifying PRESENT developmental themes TASK: Apply 2 adjectives/phrases to each period or position of adulthood Professional identity Personal/intimate identity Social identity

15. GOAL: Identifying HOT issues TASK: What events or issues arouse your passion? What kinds of people raise your blood pressure? What kinds of clients make you sad? Based on the above: What kinds of clients or issues are most likely to raise a red flag for you?

16. GOAL: Identifying COLD issues TASK: What events or issues leave you cold, uncaring, without any passion? What kinds of people induce boredom, lethargy, lack of concern or interest? Based on the above: What kinds of clients or issues are most likely to raise a red flag for you?

17. MECHANISMS OF IMPAIRMENT Countertransference Feelings toward client triggered by counsellor’s past Splitting Mental process enabling the co-existence of two separate yet competing desires

18. High Risk Situations = Developmental theme + HOT/COLD issue + countertransference OR Developmental theme + HOT/COLD issue + splitting

19. “PREVENTION” Focus on feelings, fantasies, personal history Analyze occurrences of countertransference Identify areas where ethical violations are most likely to occur Process/consult in individual or group supervision Maintain an ethics notebook/journal Connect with an ethics mentor Move beyond rule-based discussion Be open to feedback

20. RESOURCES http://www.ccpa-accp.ca/en/resources/ CCPA Code of Ethics CCPA Standards of Practice for Counsellors Ethics Casebook Notebook on Ethics FAQ  7. Ethics