In this section, you will learn to:
- Consider various obstacles and challenges that may arise in the decision-making process with your clients
- Consider the legal and ethical requirements when working with clients during the decision-making process
Supplementary materials relevant to this section:
- Reading D: Crises and Goal-Setting
In the previous section of the module, you learned about alternative models that may be used to support client decision-making – models that particularly lend themselves to certain client situations or issues. In this section, you will learn about potential obstacles and challenges that may arise throughout the decision-making process. You will also learn to apply ethical principles to the decision-making process.
Engaging in a decision-making/problem-solving process requires clients to move from the relatively ‘safe’ area of exploring problem situations to identifying ways of addressing the problem situation and actioning these. This process generally involves significant uncertainty and change and may be uncomfortable for both the client and counsellor (Egan, 2014). The problem-solving/decision-making process, therefore, throws up many challenges and obstacles for both client and counsellor. These include:
The myth of the ‘right’ choice
Clients often become stuck as they buy into the unrealistic idea that there is a ‘right decision’. This may result in backtracking or ‘decision paralysis.’ In reality, “the only right decision is the one that fits for the client.” (Geldard & Geldard, 2012, p. 218). You can help clients move from decision paralysis by encouraging them to think in terms of costs and benefits rather than right and wrong.
Perfectionism
Perfectionism (the need to do things ‘perfectly’) can also be crippling in the process of making a clear decision. Individuals who have perfectionist tendencies may find it hard to be satisfied with anything that is not an ‘ideal’ solution (McLeod & McLeod, 2011).
Unhelpful or unrealistic beliefs
Clients may often frame option decisions as ‘I should do this’ or ‘I must do that’ which generally indicates they are being driven by self-destructive beliefs often formed in childhood. For example, clients driven by beliefs such as “I must never make mistakes” or “I should always put other people before myself” may set unrealistic goals for themselves that are likely to fail or make decisions they resent. As the counsellor, you should gently challenge goals or decisions based on unhelpful or unrealistic beliefs.
Client ambivalence
You will almost always encounter client ambivalence in the decision-making/problem-solving process. On the one hand, clients want to be free of a problem, yet they may resist fully accepting responsibility for change. Change may mean giving up the pay-offs of previous behaviour (for example, being the victim and being able to blame someone else for the problem or substance abuse). Ambivalence may become apparent through observing client's body language. For example, a client may verbally commit and agree to stated goals. However, his or her body language may tell a different story. You can help clients manage ambivalence by acknowledging costs and benefits and helping them be prepared for difficulties and setbacks along the way.
Client resistance
Client resistance may occur if the client feels that the counsellor is either overtly or covertly attempting to push them in a certain direction. Unless clients determine personal goals for counselling, the probability of change is minimal. You can avoid activating client resistance in the goal-setting process by actively involving clients in setting goals and being aware of your own values and agenda throughout the process.
Conflict with a client's core sense of self or values
Setting goals that require actions that conflict with a client’s core sense of self or values are highly unlikely to succeed. Arriving at a decision is not merely a matter of logically working through the practical implications of what is the best thing to do right now – decisions or solution options should align with client beliefs and values. Read the following extract to see why this is important.
An example of problem-solving gone wrong
“Steve is a community housing support worker who has spent a lot of time working with Gareth, a retired single man who persistently reports trouble with neighbours who are noisy and inconsiderate. Typically, Gareth tries to ignore the insensitive behaviour of his neighbours or, at best, writes them a polite note (which they ignore).
In their conversations, Steve encouraged Gareth to express his anger and annoyance at his neighbours as a means of letting them know how he really felt. Gareth could see that this strategy made sense and agreed with Steve that he would try it but never carried it through. When asked why, he replied, “I know that letting myself get angry with them would be a much better way to get the message across. Every time I talk to Steve, I know that I end up deciding to do this. But I just can’t do it. I was always taught that emotions are a waste of time or even destructive".
What happened with Gareth could be understood as a long-term tension within his sense of who he is, between a current intention to feel and express emotion and an injunction to be ‘good’ and not cause trouble. The problem with his neighbours is so hard for Gareth because their actions have created a situation in which he has been led to choose to act in a way that challenges his core sense of self.
This example is a reminder that arriving at a decision is not merely a matter of logically working through the practical implications of what is the best thing to do right now. Sometimes, making a decision can require revisiting one’s position on core life issues. In a relationship where counselling sits alongside other professional tasks and roles, there may not be enough time and space to work on these deeper issues. Steve and Gareth came to an understanding that directly expressing his frustration to his neighbours was not a realistic option for Gareth, so they moved on to consider other potential solutions.”
Adapted from McLeod & McLeod, 2011, p. 229
Upset or distressed
Clients may be too upset or distressed during the first session to focus on goals. In this situation, the counsellor should attend to the process goals of establishing that the client is safe and has been connected to appropriate formal and informal support/resources. The counsellor can return to this goal-setting issue in the next session.
Counsellors may not be skilful
Counsellors may not be skilful or committed enough to set goals with the client. One of the main reasons that counsellors do not help clients develop realistic life-enhancing goals is that they are not trained to do so (Egan, 2014).
Read
Reading D – Crises and Goal Setting explores important considerations in supporting clients in goal-setting, including crises, multicultural issues, and resistance.
Counsellors should not continue working with clients without a clear idea of where they are going and what they will achieve. Clients need to have a clear idea of what they aim to achieve in counselling and should be guided by appropriate goals, even if it means starting with achieving a small change. If the client refuses to agree with goal-setting, the counsellor should consult a supervisor and follow organisational guidelines.
Now that you know some obstacles you and your client may encounter, let’s explore ethical considerations.
Check your understanding of the content so far!
The task of helping a client navigate the decision-making process is a particularly risky process regarding ethical practice. When a client struggles with a decision, stepping in and offering solutions and advice is very tempting. Similarly, it is difficult to avoid persuading or directing a client when they are engaging in harmful or risky behaviour or making what you perceive as poor decisions. However, being too directive or telling the client what to do is not ethically appropriate for a counsellor.
You have learned about the importance of ethical practice throughout your learning. As a reminder, the following table reviews some key terms related to ethical practice and how they apply when working with clients during the decision-making/problem-solving process.
| Codes of conduct/practice | These are guidelines that define ethical practice. These will vary slightly according to different counselling bodies or organisations but support the core features of ethical counselling practice. An example is the Code of Ethics and Practice set out by the Australian Counselling Association. These codes typically highlight the importance of client autonomy and non-directive practice. Counsellors need to remember these principles when working with clients during the decision-making/problem-solving process. |
| Human rights and discrimination | Every individual has basic human rights that must be respected. In counselling, counsellors should respect a client’s human rights, such as the right to individuality, their own values and beliefs, and freedom of choice. Discrimination occurs when an individual is treated differently, in a way that is not helpful, based on a characteristic about them (e.g., gender, disability, race, age or sexual preferences). When working with clients during the decision-making/problem-solving process, the counsellor must respect each client’s diversity and right to make their own decisions. In many cases, the client may make decisions that the counsellor may not personally agree with. However, counsellors must respect the client’s right to make their own decisions. |
| Duty of care | This term refers to a counsellor’s responsibility to protect the well-being of clients and others who may be impacted severely by a client’s actions. While, as a general rule, counsellors should respect the client’s decision and work with them to achieve it, if the client’s decision would cause harm to the client or another person (e.g., suicidal intention or intention to harm another person seriously), then the counsellor has a duty of care to intervene. |
| Practitioner/client boundaries | Counsellors are responsible for maintaining appropriate boundaries with a client (i.e., limiting the client-counsellor relationship to a professional contract/agreement only). Counsellors need to maintain boundaries and not become inappropriately involved in the client’s life. For example, the counsellor cannot ‘step in’ and do things for the client or control the client’s decision-making process. |
| Privacy, confidentiality, disclosure, and records management | Clients have a right to privacy. Counsellors should take appropriate actions to protect client privacy (e.g., ensuring sessions are not overheard, recorded or observed without the client's consent and protecting the client’s personal information and session notes). Counsellors must also keep what clients tell them during sessions secret and private (except in cases where duty of care and other limitations apply). Counsellors should not disclose client information to other parties except in these specific situations. When working with clients in the decision-making process, counsellors will keep records and documentation. They must ensure that they follow their organisation’s policies and procedures at all times, that they ensure clients are aware of the limits of confidentiality and how records will be stored, and that they appropriately protect the privacy/confidentiality of the client. |
| Rights and responsibilities of workers, employers and clients | Clients and employers have their own responsibilities and rights. As a counsellor, you need to be aware of the organisational responsibilities that may apply in your workplace. When working with clients during the decision-making/problem-solving process, the counsellor must engage in appropriate contracting and ensure that clients know their rights and responsibilities. Counsellors must also comply with their own responsibilities by following all organisational policies/procedures and legal and ethical requirements. |
| Work role boundaries | The counsellor’s role has specific boundaries. Counsellors cannot be ‘everything to everyone’. Counsellors should acknowledge the limitations of the counsellor role and not act outside their role boundaries (this includes making appropriate referrals to a more specialised service if appropriate). When working with clients during the decision-making/problem-solving process, the counsellor must not exceed their boundaries and should make appropriate referrals when relevant. |
| Work Health and Safety (WHS) | Counsellors are responsible for ensuring the work environment is safe for themselves, other workers, and clients. This may include ensuring that the counselling environment is safe and that there are no hazards that have a high likelihood of causing harm (e.g., faulty chairs, cords that can be tripped over, poor lighting/ventilation, etc.). |
In addition to the considerations explored in the table, counsellors should be guided by the core ethical principles of counselling when facilitating the decision-making process. These include:
Respect for the client’s individuality, values and beliefs
As a counsellor, it is important for you always to be aware that you are viewing your client’s issue through the filter of your own experience, values, and worldview. Even if you have had a similar experience, you will still not have as much information about the problem as the client. This is why it is important not to offer your client advice or make decisions for them – any solution you might advise will be grounded in what is best for you, not necessarily the client. Remember, clients are the experts on their own lives.
Case Study
Allan’s client is considering divorcing her husband as he has been engaging in an extramarital affair. Allan has strong beliefs about fidelity in marriage, and he divorced his wife two years ago when he found she was cheating on him. Allan finds himself advising his client to leave her husband.
This is an example of inappropriate counsellor behaviour.
Culture plays an important role in goal setting. As Wosket (2006, as cited in Egan, 2014) points out, goal setting has cultural implications that counsellors may overlook. For example, while Western culture focuses on the importance of individual goals, in other cultures, collective or communal considerations may be paramount and should be considered central in any decision-making/problem-solving process.
Objections are sometimes legitimately raised about the endorsement of the pursuit of individual over collective goals that is explicit or implicit in more Eurocentric or Westernised approaches to counselling. So here, the counsellor has to be careful not to contaminate the client’s process with his own conscious or unconscious bias toward reinforcement of predominant cultural norms attached to goal setting. The process of goal setting can still be usefully applied to communal or collective contexts, for instance, where the client’s allegiance to family or cultural expectations prevails over individual preferences or objectives. Committing to a course of action that honours a sense of duty is a legitimate goal. For instance, the goal of keeping the family together may be a high priority for an Irish Catholic woman and one that, if accomplished, might give her more of a sense of achievement and fulfilment than pursuing the individual goal of leaving an unsatisfying relationship.”
Adapted from Egan, 2014, pp. 340-341
You should therefore be aware of your clients' cultural contexts and consider this as you support them through the decision-making process. Client goals need to fit in with a client’s cultural values. It is important, however, to recognise that cultural background is only one aspect of your client. Making global assumptions about clients based on their ethnicity or cultural background (i.e., stereotyping) means you are not respecting your client’s individuality. Treating a client differently (unhelpfully) based on characteristics such as age, gender, sexual orientation, or ethnicity constitutes discrimination.
Respect for the client’s autonomy and freedom of choice
Remaining neutral and non-judgemental is particularly difficult when you see a client making what is potentially a poor decision. However, it is explicitly stated in the Code of Ethics and Practice that “counsellors do not normally give advice.” (ACA, p. 5). If you don’t help clients develop the skills to solve their own issues, then you are fostering dependency. Remember that choosing a particular course of action is always up to the client. However, you can ensure they consider all aspects and potential implications of a decision by facilitating the cost/benefit process discussed in the previous section of this module. You should take care to maintain appropriate client/counsellor boundaries (i.e., limiting the client-counsellor relationship to a professional contract/agreement only) throughout the decision-making process. Counsellors should not generally be speaking for/or advocating for clients in contexts outside of the counselling relationship.
It is crucial that the decision-making process is facilitated and not directed by the counsellor in order to respect the client’s rights. However, as always, remember that if there is a risk or harm to a client or someone else, you may need to be more directive and consider duty of care requirements.
Safeguarding your client’s well-being
This should be within the boundaries of the counselling relationship. Although you should respect your client’s autonomy and free choice when it comes to choosing particular courses of action, you are still bound by your duty of care to protect clients and others when necessary. This means that when clients make a decision or propose solutions that will result in either harm to themselves or to others, you may need to engage in your own decision-making process in regard to the appropriate action to take.
You should explain the organisation’s policy of confidentiality and disclosure as well as record-keeping to clients before commencing with the counselling process. An example of what you might say to clients follows:
“Everything you share with me in the course of our work together will be treated as highly confidential. However, there are a few circumstances in which I may be required to break confidentiality. These include:
- if I consider you to be at risk of seriously harming yourself or someone else
- if your counselling records have been requested by a court of law
- if another party or agency has requested your information, and you have agreed and provided your written consent to this.
I will take notes during or after each session to help me keep track of our progress together. These notes will be stored in a private and secure location and may be viewed by you if you wish. The service will keep your counselling records for a period of seven years from the date of your last contact with the service.”
Ensuring that you are a competent counsellor
Ensuring that you are a competent counsellor by a continual process of self-reflection and self-development. You can monitor your effectiveness as a counsellor throughout the decision-making process via self-reflection and supervision. Areas of focus should include ensuring that you provide a non-judgemental, non-directive service and that your values are not impacting your client’s decision-making process.
Acknowledging the limits of your competency
Acknowledging the limits of your competency and referring your client to someone more suitable in these situations. Once clients have identified their aims and goals for counselling, you need to make your own decision as to whether you and the organisation you are working for can help them achieve these. Different organisations offer different models of counselling and intervention and may be more appropriate in helping clients achieve certain goals. If client needs and requirements cannot be met, you should make referrals to alternative sources of guidance and support according to organisation guidelines.
Case Study
Rafiel’s client books an initial counselling session as she is finally ready to address her dependence on prescription drugs. Rafiel has little experience in the field of addiction and she is aware that withdrawal from prescription drugs may require medical support. She decides to refer the client to an addictions counsellor for assessment.
Being guided by the core ethical principles described in the case study should help ensure that you are not inadvertently influencing or advising your client as you support them through the decision-making/problem-solving process.
Limits of competency
The following video outlines why it is important to stay in the limits of your competency as a Counsellor.
watch
In this section of the module, you learned about some of the obstacles and challenges that may occur when working with clients during the decision-making/problem-solving process. You also learned how following critical legal and ethical requirements can help ensure effective practice. It is important to keep these considerations in mind throughout all of your counselling interactions.
- Australian Counselling Association (2013). Code of ethics and practice of the association for counsellors of Australia. Retrieved from: http://www.theaca.net.au/documents/ACA%20Code%20of%20Ethics%20and%20Practice%20Ver%2010.pdf
- Egan, G. (2014). The skilled helper. A problem-management and opportunity-development approach to helping. (10th ed.). Belmont, CA: Brooks/Cole, Cengage Learning.
- Geldard, K. and Geldard, D. (2012). Personal counseling skills: An integrative approach. (1st ed.). Springfield, IL: Charles C. Thomas Publisher.
- McLeod, J. & McLeod, J. (2011). Counselling skills: A practical guide for counsellors and helping professionals. (2nd ed.). Berkshire, UK: Open University Press.
