Professional Orientation and Ethics: Ethical Self Reflection: Self-Evaluation Paper, Part 1 & 2

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Creating Your Professional Path

My initial inspiration in entering counseling stemmed from the idea of creating meaningful change through lived experience and advocacy, as well as values that resonated with the therapeutic relationship. My history around mental health, substance use, and eating disorders provided me with both the awareness of the suffering and the strengths that can come with these experiences. It's this awareness that fuels my desire to help people, not as though I'm a Christopher Columbus sailing a one-person ship, but as an individual exercising genuine compassion. I'm also motivated by a need for funding and more accessible, ethical, evidence-based care, especially for young people who may not have the financial or familial means for necessary treatment. I'm currently in the process of starting a nonprofit organization that'll provide access to opioid medication-assisted treatment (MAT), specifically Vivitrol. Additionally, honesty, authenticity, compassion, and autonomy align naturally with the counseling profession, allowing me to articulate my intention to provide a safe, empowering, and healing environment.

I'm motivated to work with young adults in substance use treatment, in particular young adults who are entering recovery for the first time without support. Whether through research or personal experience, we understand that access to MAT, coupled with emotional and structural support, equals better chances for young people to achieve long-term success in recovery. Understanding the number of young adults who are denied treatment due to systemic and financial inequities has reminded me of the importance of advocating for this population. The values I incorporate into my counseling practice are authenticity, compassion, and autonomy. To me, authenticity is simply being honest and showing up as my authentic self so that clients can do the same. When a space is genuine and free from theater and pretension, I believe change can occur. Compassion is when I show up with respect and empathy for my clients, even though I may not fully understand their lived experiences. Autonomy means walking alongside my clients as they examine their values and goals, even if it's more than I'm able to stretch or expect.

My experiences in treatment centers have influenced my ethical compass. I've seen just how frequently client autonomy is compromised, often in the name of crisis, and I've witnessed how miscommunication and judgment can lead to distrust. These experiences continue to challenge me to maintain transparency, remain culturally humble, and provide trauma-informed care. I see that our therapeutic alliance must be built upon respect for our shared humanity rather than control. Over the next one to two years, I'll focus on developing my clinical competence related to addiction treatment. I'm pursuing a CACREP-accredited program to complete a graduate degree in Clinical Mental Health Counseling. I'll complete my practicum/internship hours in co-occurring disorders and substance use. From that point, I'll pursue licensure as an LPC Associate in Texas where I'll spend my hours in both outpatient and private practice. In a longer timeline, I envision myself accomplishing both: private practice focused on addiction and co-occurring disorders, but also supporting the nonprofit organization that I hope to develop that'll fund early-stage access to Vivitrol for disadvantaged young adults. I imagine providing a compassionate and trauma-informed model of care that's clinically-integrated. At the same time, I'd advocate for systemic change to address dismantling barriers for accessing and utilizing recovery-based resources. I'd build missions for both the nonprofit and the practice to serve young adults seeking recovery in the absence of resources. I want to work with clients who've been walked on or disregarded by the systems that have been tasked to protect and support them, but also provide a space for clients to exist freely—as themselves with respect and possibility in their future. I want to create a bridge from inpatient treatment to long-term recovery supports in the healthcare system where there currently isn't one.

If future clients or colleagues were to describe the work I practice, I hope that they'd say, "She meets you where you are, with authenticity, compassion, and hope in your potential." That's what I want to bring to the counseling relationship: to be present without judgment, be honest without harm, and have an authentic and grounded belief in people, and their capacity for healing. My hope in ten years is to be in a position to say that I advocated for ethical, compassionate care for people who are often overlooked or misunderstood. I want to be able to say that I advocated for access to recovery regardless of who you are or where you reside. And I hope to end it knowing I helped people find their voice, and autonomy, one client at a time. The change I set out to bring about in the field is ambitious but needed. I want to aggregate funds to help decrease the access gap to MAT by starting a nonprofit organization in my community to provide underserved young adults financial support with Vivitrol. I'm hoping to reduce stigma and reach high-achieving populations that often go unnoticed because they don't fit the "typical" mold of addiction. I want to help create a new standard of practice that's ethical, trauma-informed, and centered in the client, where recovery as expected is normalized, and dignity, respect, and support are present for all individuals accessing recovery supports.

This work isn't merely a job for me; it's a calling. It's my hope to build these spaces that I wish existed to help others heal, and that healing is a real and possible option for those who are told it isn't. Corey (2024) mentioned that in order to develop a meaningful career informed by competency and character, vision and intention are required, and I hold that in high regard. For me, my entry to the field has less to do with a 9-5 job and punching the clock for in-and-out times, and more about building a life, which is anchored in supervision, collaboration, and vibrancy. This isn't a linear trajectory; it's an evolving process built upon what I continue to learn with each client. And if I can have the opportunity to see and hear someone, and provide permission for change, or just freedom from the burden that brought them to me, then everything I've done to get to this moment is worthwhile.

Countertransference

The type of client interaction I expect to be most emotionally challenging is working with clients who are resistant to help and are suffering, often reminding me of people I've cared about in the past. I'd also expect to struggle with witnessing self-destructive behaviors resulting from such deep pain, especially if clients didn't yet believe they had the right or the capacity to heal. I'd assume that I'd have this reaction, as I tend to feel a great deal of empathy for people in pain when they don't believe in their worth or potential.

Since I've witnessed the transformative impact therapy and recovery can have, it's tough to witness someone pushing away support that could help them. Occasionally, these feelings spark a strong inclination to fix or rescue someone. I understand that this inclination can permeate and compound the work I do with clients, particularly since I have lived experience with mental health and substance use challenges and understand there's a risk I'll over-identify with specific clients who possess a similar revelation of the pain to which I can relate. I'd recognize countertransference through several warning signs: strong emotional responses that feel disproportionate to the client's words or actions—like frustration, urgency, or protectiveness; thinking about the client outside of sessions in an emotionally charged manner; or even physical behavioral signs where I might want to over-help, or rescue, or avoid specific topics altogether.

To maintain an ethical response to countertransference, I'd immediately bring these reactions forward in supervision to gain an external perspective and ensure I'm safely within the confines of ethical practice. I'd also engage in self-reflection and journaling to identify what personal experiences may be getting activated, so I can better determine when I've moved away from the client's therapeutic needs and into my own. Mindfulness and grounding techniques can help manage countertransference and keep me engaged in the present moment with the client, allowing me to respond from clinical judgment rather than emotion.

If countertransference isn't managed, it could manifest as prioritizing my own needs over the client's best interest and well-being, which could cause me to discount important topics, push clients too quickly, or lead me to make biased decisions that aren't grounded in the client's goals. More seriously, it can compromise the therapeutic relationship and derail the client's progress by creating confusion, mistrust, or emotional risk for the client who may become aware that my emotional response is somehow affecting our work together. Working through countertransference demands continued vigilance and humility. I can utilize my self-awareness to acknowledge my inclination towards over-identification and put in place measures of protection. These measures include utilizing supervisory opportunities, engaging in self-reflection, and practicing mindfulness, which enable me to transform potential countertransference into more profound empathy. This approach allows me to establish and maintain a therapeutic framework that facilitates practical work.

Self-Care

As a future counselor, caring for myself isn't an extra or an add-on, but rather an ethical responsibility that impacts my ability to care for clients. I know that balanced self-care doesn't happen by accident; it's something I have to be intentional about, and it needs to be part of my routine, at least as part of how I navigate my week, to prevent exhaustion and stay effective. I healthily address my stress through daily grounding practices such as movement (exercise), writing in a journal, and resting. I use other outlets for creativity as needed, like painting, to decompress. I engage with and connect to a number of people in ways that encourage me to maintain healthy boundaries in both my daily and professional life. These practices help me connect and recharge, while also maintaining emotional regulation. I get the sense of being burned out early, illustrated by cues of emotional numbness, feeling irritable, fatigue that doesn't go away with rest, or withdrawal because all of the responsibilities and options feel overwhelming. When that happens, I need to take a literal (or metaphorical) step back and examine my routine before I lose my clinical presence.

Boundaries are essential to my well-being. I have to be careful about my emotional availability and avoid over-identifying with clients, while still protecting myself and keeping work out of my personal space. This'll require maintaining a manageable caseload, limiting after-hours communication, and being assertive when I need to ask for support. I prefer to think of self-care as an ethical requirement rather than a corrective action. I plan to practice self-care regularly and access therapy, supervision, movement, rest, and creative output as consistent, active, and preventive care. I'll also incorporate these practices as a way to regularly check in with mentors and colleagues, allowing me to continue reflecting and assessing before I reach the point of burnout.

When I notice feeling depleted, I'll access supervision, peer consultation, trusted friends, and routines that remind me of my intention. These types of support help me reconnect and ground myself back in the work while avoiding ethical misfires, and may help me return to the work with clarity and compassion. Respecting my boundaries will ensure a sustainable career and enable me to offer my clients the steady, ethically appropriate care that I believe they deserve.

Dealing with Value Conflict

One particular value that I might try to advocate or champion is the value of personal accountability and self-awareness as important pieces of healing. This fundamental value may not only cause conflict with clients who consistently externalize blame, but also with clients from cultures whose values, at times, emphasize collective responsibility rather than individual accountability.

This value could both facilitate and inhibit effectiveness in counseling. Research suggests that clients who have more self-awareness tend to have more positive treatment outcomes (Prochaska & DiClemente, 2005), and my value of accountability may allow clients ready for self-study and growth to benefit. I could be inhibited in effectiveness if I sensed frustration in clients who aren't yet involved in self-examination, or clients who have different cultural frameworks. Sue and Sue (2019) note that imposing Western values of individualism on a client from a collectivistic culture may not only put trust in the therapeutic alliance at risk, but also perpetuate cultural bias. To minimize the chance of forcing my values, I'd practice cultural humility as well as consider their perspectives, using supervision and motivational interviewing ideas to acknowledge autonomy (Miller & Rollnick, 2013). I'd present with unconditional positive regard and ask open-ended questions about the client's values around responsibility that the client believed to be valuable, rather than trying to impose my own values onto the work. When I noticed internal frustration, I'd look at this as clinical information about my own triggers rather than as evidence of client resistance.

To manage value conflicts while aiming to use referral as a last resort, I'd consult with supervision to gain perspective on whether or not my values were getting in the way of the treatment being effective (Corey et al., 2019). I'd consider more professional development in cultural competency and would honestly assess my own ability to provide unbiased treatment that could be replicated. If I identified that I could practice with therapeutic neutrality with the help of more supervision, it could be helpful to continue. On the other hand, if I was constantly frustrated and not practicing unconditional positive regard, these are red flags that the conflict is interfering with the treatment. Referral would only be considered if I felt that continuing the work could cause harm to the clients or significantly limit their progress, and only after considering other options, including peer consultation and if we'd considered alternate therapeutic approaches. Any referral would be made in the least obstructive way possible, not only in terms of the work, but also making sure that the client understands that it was my limitations (and not their value as a person) that prompted the referral.

Ethics in Multicultural Practice

One significant ethical dilemma I've grappled with is how to balance cultural respect with my clinical responsibility when a client's cultural beliefs or practices seem to contradict evidence-based treatment practices. It's been challenging to know when to respect and validate cultural norms versus when to gently investigate those beliefs that might contribute to harm or distress while being mindful of not imposing my own cultural frame of reference or discarding cultural practices that have meaning to clients. I've learned to step into these moments with curiosity, humility and collaboration, rather than presuming a fixed clinical response that privileges western therapeutic models over indigenous knowledge.

This dilemma is so important to me because I've seen how easily clients can feel poorly understood and judged when their cultural values aren't acknowledged in the therapeutic context. I care about engendering genuine trust where clients feel able to be themselves without my assumptions and cultural bias interfering with our work together. I want to ethically provide appropriate care professionally for all of my clients, while recognizing that care is relevant and inclusive, accessible, and culturally congruent to facilitate effective treatment with healing outcomes. Sue and Sue (2019) warn us that imposing western cultural values on clients and looking through a western lens does damage to the therapeutic alliance, as well as perpetuating harmful cultural bias. My cultural identities, privileges, and biases will always influence my clinical work both in visible and invisible ways. My lived experience and cultural background inform my understanding of behavior, risk assessment, and family dynamics, and I must be continuously mindful of how my cultural lens is different from my clients'. I understand that I'm privileged in certain areas—such as access to education and proximity to the dominant therapeutic modes, and I make active efforts to not make assumptions or center my own norm during sessions. I remain committed to continual self-reflection, education, and supervision in order to identify blind spots and address my accountability to culturally-competent care, recognizing that cultural bias often exists outside conscious awareness.

In order to continue to approach clients in a way that's respectful, culturally responsive, and inclusive, I'll approach every client with curiosity and not assumptions, allowing them to determine what's meaningful and relevant within their cultural context. I'll continue to ask for feedback about how my language, interventions, and presence land with each client, and be open to any necessary corrections. I'll incorporate culturally relevant ways of working into my practices as appropriate, while also allowing each client's values, traditions, and identity to inform our therapeutic relationship. This approach aligns with the ACA Code of Ethics (2014), which states that counselors must incorporate culturally relevant information about the effect of culture on care and adapt their practices accordingly.

The ongoing practical steps I'll take to develop multicultural competency and avoid ethical violations include pursuing continuing education, workshops, and training on cultural humility and intersectionality, to help expand my knowledge of different worldviews. In addition, I'll actively seek supervision and consultation when I'm not sure how cultural dynamics are influencing the clinical relationship or I encounter a situation that makes me aware that I don't fully understand. I'll engage in regular self-reflection, and remain open to being challenged, while recognizing that cultural competency is an ongoing journey and not a destination that requires commitment and humility as I walk with my clients.

Informed Consent

To present and explain informed consent at the very beginning of a session with a client, I'd take a collaborative and conversational approach, guiding the client through each section of the document and inviting the client to ask questions throughout the process. Rather than handing them a form and asking them to sign it, I'd frame informed consent as the beginning of the relationship and trust-building collaboration, highlighting that the client will play an active role in counseling from the very beginning. I'd also alter my language and speaking speed to match the developmental level of the client or fit their communication style as needed. I'd check in and ask questions to clarify their understanding, to ensure that informed consent doesn't remain solely a procedural formality, but is an actual conversation.

There are several key points that are necessary for clients to understand during the process of informed consent. I'd ensure that the client understands the nature and purpose of counseling including the potential goals, risks, and benefits of any therapeutic intervention.

I'd also describe the limits of confidentiality, including mandatory reporting laws related to child abuse, elder abuse, and imminent threat of serious bodily harm to self or others and any other scenarios where disclosure is required either legally or ethically. Most importantly, I'd make clear the client's rights including their right to ask questions, their right to refuse specific interventions, and their right to terminate counseling at any time without any consequence. These conversations are important as they reinforce the collaborative nature of the therapeutic relationship and make sure your clients are as informed as possible about what they're consenting to.

Tailoring the informed consent process for different populations and circumstances requires cultural sensitivity and awareness of developmental differences. For example, when tailoring the informed consent for minors, I'd ensure that both the legal guardian and the minor understood the counseling process, using age-appropriate language and concepts, while negotiating parental control and the minor's emerging autonomy. If I was working with clients who have limited capacity, I'd address informed consent slowly and make sure I was using simple language and making use of visuals or multiple check-ins to confirm their understanding and meaningful participation in the decision-making regarding their care. With clients from diverse populations, I'd be sensitive to norms regarding authority, family involvement, and help-seeking, and consider utilizing an interpreter or cultural liaison to ensure genuine understanding and cultural responsiveness.

I'd review and amend informed consent throughout the counseling relationship when there's been a significant change in the therapeutic process. This could include implementing new interventions, changing a treatment plan, changes in the session flow or actions, or changes in the therapeutic goals based on the client's presenting information and changes. I'd also revisit informed consent when confidentiality is compromised by most situations (if the client is in crisis OR if there's a legal purpose OR if I'm mandated to report), and I'd want to confirm that the client understood these limits in the therapeutic agreement. I generally view informed consent as a living, unfolding dialogue, and I'm always inclined to check in periodically to ensure the client still understands their rights and the boundaries of our services.

Finally, I don't see informed consent (or agreement) as a one-time event, but rather an ongoing ethical obligation, because the counseling relationship, therapeutic goals and interventions, all evolve over time when working with clients who are changing and growing. Clients have a right to know and agree to any significant changes to their care, and sustaining that agreement requires continuous communication and collaboration throughout treatment. An ongoing informed consent process helps maintain full transparency for clients, builds trust, and fosters client participation in their treatment as empowered participants throughout the therapeutic process, honoring their right to autonomy as they go through their own healing process in the respective stages.

Malpractice

To protect myself from a malpractice suit, I'll maintain proper professional boundaries and stay within my area of competence, knowing that practicing outside the bounds of my training or competence creates a massive liability (Corey et al., 2019). I'll also access regular supervision and consultation when necessary (especially regarding ethical dilemmas or questionable decisions about treatment), understanding that when I work in isolation, I exponentially increase my risk. I'll keep client welfare more foremost than all other interests by providing detailed informed consent, being culturally humble, and providing evidence-based care and treatment within the above-stated ethical standards and best practices. These proactive measures will create an ethical practice that in and of itself protects me and my clients while preserving service quality.

My approach to documentation will be thorough and legally defensible using the fact that clinical records often are the most important evidence in malpractice cases (Bennett et al., 2006). I'll document all clinical choices with the necessary speed, objectivity and accuracy; I'll make clear rationales for treatment choice obvious in written form including clear, extensive progress notes at each contact and thorough written documentation for all significant incidents or safety concerns. I'll choose professional language that references the observable facts in the clinical progress notes and tests and assessments, not my opinion or speculation that could be misinterpreted. To keep records in an ethical and legal context, I'll adhere to all relevant state laws and professional standards regarding client confidentiality, the storage of records in a secure manner, and record retention periods that are appropriate. The ACA Code of Ethics offers a comprehensive mix of guidance for ethical practice and legal protection if taken seriously (American Counseling Association, 2014).

The Code advises that counselors practice in areas of competence, maintain appropriate professional boundaries, and obtain informed consent at all phases of the process—not just at intake. Cultural responsiveness, protecting client autonomy, and clear/accurate clinical documentation of all clinical interactions and decisions are given an emphasis that demands attention. Following these guidelines while paying attention to ethical code updates throughout my career and participating in continuing education to stay current will give me an ethical underpinning to carry out the best possible client care and legal protection.

Supervision and consultation will be a key safety net for navigating ethical or legal risk throughout my career (Falender & Shafranske, 2017). Supervision and consultation are vital professional relationships that give me space to consider how to reflect on complex cases, identify my blind spots, and learn how to apply ethical principles in real-time clinical and case situations. Supervision is a space I can process emotional responses to the difficult cases and prevent impulsive or biased decisions that may have significant ethical or legal repercussions later. If I value and honor supervision through consistent use and seek consultation and additional supervision when I'm unsure, I'll have professional accountability and legal protection when forced to negotiate high-risk clinical situations.

Self-awareness and professional humility are critical in the fight against malpractice, as both allow me to recognize and confront my limitations before they become liabilities (Pope & Vasquez, 2016). Self-awareness helps identify my own emotional triggers, knowledge gaps, and areas where I may have insufficient experience to be practicing independently. As I remain conscious of my own reactions, it helps me avoid acting on personal biases, professional burnout, or unchallenged expectations that may result in harm to clients. Professional humility helps me remember that I'm never done learning, and that seeking advice, engaging in continuing education, and acknowledging when I need help or more knowledge, is a professional strength—not a character flaw—that ultimately protects both my clients and my practice from harm and legal liability.

Confidentiality

A particular concern I have about confidentiality in counseling is how to approach situations when a client discloses information that doesn't meet the legal threshold of breaking confidentiality, but that still raises ethical issues based on risk of harm to self or others. These gray-area situations require clinical judgment, and involve multiple ethical challenges - and the way forward isn't always clear (Corey et al., 2019). A few examples of this may look like a client describing ill-defined suicidal ideation without imminent plan or intent, describing concerning parenting behaviors but not a clear case of abuse, or discussing a specific risky behavior that could include the possibility of risk to others but isn't an immediate threat.

This question both intrigues and challenges me because it inhabits the gray area of counseling ethics, where there's no clear answer and the stakes can be extraordinarily high for everyone involved. It forces me to grapple with my dual role as both a protector of clients' autonomy, but also as a responsible steward for clients' safety and the safety of the community as a whole. Situations like these bring to light the emotional burden of clinical decision-making and also underline the importance of utilizing a mindful, informed ethical decision-making process and exercising clinical judgment, rather than simply responding from fear, anxiety, or my own personal biases in ways that may jeopardize client welfare and my professional judgment (Pope & Vasquez, 2016). The ACA Code of Ethics is beneficial as it contains language that gives guidance to these complex confidentiality issues (American Counseling Association, 2014). It emphasizes that confidentiality is a professional responsibility and a fundamental component of the therapeutic relationship. While confidentiality is important, the Code does state specific exceptions where disclosure is warranted to prevent an imminent risk of serious harm to the client or others. The Code further encourages counselors to use clinical judgment, obtain supervision and/or consult with colleagues, and document thoroughly when faced with these ethical dilemmas. These guidelines help make it clear to me that confidentiality doesn't involve a dogmatic approach to following the rules, but instead involves a contemplation of the decision that involves transparency and professionalism, while always putting the client first.

To protect confidentiality while still protecting the client, and others when warranted, I'd implement a few practices throughout my clinical practice. I'd consider the risk factors and safety factors regularly, and use structured assessment tools when appropriate to assess risk (Granello & Granello, 2007). I'd maintain an ongoing discussion with the client to address their wellbeing. When uncertain of what to do regarding confidentiality, I'd consult with my supervisor, colleagues, or ethics committee to gain some perspective. I'd follow the legal and ethical obligations for mandated reporting requirements, and document precisely what my legal and ethical obligations entailed, why there were concerns regarding safety or harm, the decisions I made, how I came to that conclusion, and my clinical rationale. I'd also document what I told the client about all of this, if they were informed of the reporting, and any other related concerns. If I had to disclose to anyone, I'd always try to get a hold of the client first, if possible, and explain why I had to disclose, what my obligations were in relation to that disclosure, and provide emotional validation and support throughout the experience so we maintain the client's trust and to minimize damage to the therapeutic alliance.

From the first session, I'd carefully explain confidentiality and the limits of confidentiality, in language that was understandable and free of clinical jargon, and encourage the client to ask questions to demonstrate they genuinely understood. I'd explain the legal limits of confidentiality including: threats to self or others, child or elder abuse, and being ordered to disclose in court or for insurance reasons, providing as many concrete examples as the client required for full understanding (Welfel, 2016). I'd always state that confidentiality is what builds the counseling relationship, and is intended to create safety and trust, and I'd remind the client that the only exception is if I need to prioritize safety or wellbeing. It's designed to be an ongoing conversation, providing informed consent, building trust, and establishing the therapeutic alliance based on honesty, understanding, and freer communication about safety and wellbeing.

Case Analysis

In this hypothetical scenario, a client in college reveals in session that they have been compulsively monitoring social media of their ex-partner and that they recently purchased a firearm to "resolve" the matter in person. The patient shows explicit anger while stating, "I can't take it anymore - they need to feel what they did to me." The client identifies their ex-partner, describes where they live, and explains that they intend to go to their ex-partner's home sometime within the next week. This scenario is reminiscent of the influential Tarasoff v. Regents of the University of California case, which involved Prosenjit Poddar informing his therapist that he intended to kill fellow student Tatiana Tarasoff, and the therapist did not warn the victim, resulting in her murder, and established that there is a legal duty to protect an identifiable victim of serious threat (Corey et al., 2019).

In this instance, the central ethical dilemma posed is balancing the client's right to confidentiality, a fundamental aspect of our practice, and my legal and ethical duty to protect an identifiable third party from harm. While confidentiality is the base of our therapeutic relationship, the client clearly made a viable threat and stated they'd harm their ex-partner, which would invoke my ethical duty to warn and duty to protect third parties from serious threats in accordance with ethical codes and case law. The ethical dilemma is determining an appropriate course of action that's as ethically and legally sound as possible, to protect victims, but to preserve the trust and transparency with the client as much as possible.

Along with the challenge of assessing the central ethical issue are several prominent challenges that need careful assessment. Ethically, I need to evaluate when the threat rises to the point where I'll need to breach confidentiality under the duty to warn and protect standards. Clinically, I want to determine the severity and immediacy of the threat, level of intent and access to means by the client, and the client's overall mental status and level of impulse control (Granello & Granello, 2007). Legally, I need to decide if the threat conveys specificity, imminency, and a person who's identifiable, which may trigger mandatory reporting laws and signify liability if I don't intervene. There's also an inherent risk of damaging the therapeutic alliance and trusting relationship I have with the client, because if the breach of confidentiality isn't handled properly and transparently there'll be a great chance the client will disengage, deteriorate into a crisis, and could even escalate to an unsafe situation.

Guidance is provided in the ACA Code of Ethics (Counselor as Professional) for working in such situations in Section B.2.a when they clearly state: "When there's clear and imminent danger to a client or to others, and disclosures are required to protect the life of a client or to protect others from harm, counselors are required to break confidentiality" ("ACA Code of Ethics," 2014). Section B.2.e goes on to say counselors need to disclose information, only to the degree required, and to make appropriate efforts to inform the client if possible. The significance and legal impact of the Tarasoff case is that it established that mental health professionals have a duty to protect identifiable individuals from clients who communicate serious threats, and that duty has expanded into a broader duty to protect in many states (Welfel, 2016). This broader duty may include the duty to warn a potential victim, notify law enforcement, or seek hospitalization.

Before taking any action, I would immediately reach out to my clinical supervisor to discuss the severity of the threat, my potential options, and how to take steps in full concert with ethical practice and agency policy. I would also consult with our organization's legal counsel or risk management department to clarify my legal responsibilities under state law. I would want to clarify whether the incident meets the legal threshold for duty to warn or protect, the particular procedures I would need to take in my jurisdiction, and how to document everything demonstrating sound clinical and ethical reasoning.

There are a number of possible actions I could take in this situation. I could notify law enforcement, especially given the specific threat that is imminent in nature and the access to weapons. Another option could be to facilitate an emergency psychiatric evaluation or hospitalization if deemed a danger to others and unable to control the behavior. I could also notify the identified possible victim if state law requires it, and continue to work with the client, following a high risk safety plan and closely monitoring the client given the new information. Each possible option would come with some significant consequences. Filing a report with law enforcement could result in protecting the possible victim, fulfilling my legal obligations or duty to protect, and deepening the breach of trust that leaves the client feeling betrayed and ending treatment with me; hospitalization may lessen the immediate risk, but could increase the client's distress and feeling of loss of control; and continuing with therapy without notification denies a duty to protect the victim, which can lead to legal liability for failing to protect the therapeutic rapport and breach of ethical duty (Pope & Vasquez, 2016).

Due to the client's present specific threat, the weapon possession, and expressed intent to harm, I'd have to file a report with law enforcement and consult with law enforcement about next steps - e.g. if they'd warn the possible victim directly. This choice follows the ACA Code of Ethics, state laws, and Tarasoff case law, while maintaining some level of support for the client by continuing to offer therapy for the future, and being transparent and explicit in explaining my actions. I'd demonstrate ethical and legal responsibility by documenting thoroughly, starting with the exact words the client used in their direct statement to me that demonstrated the seriousness of the threat. I'd document my clinical risk assessment, the consultation process with my supervisors and legal advisors, and my rationale for each decision I took in response to the threat that was communicated to me.

When reconnecting in subsequent sessions with the client to repair the breach, I would put myself in a mindset that involves being open and honest in our sessions, as well as making them as safe as possible, and explaining my legal and ethical reasons for my actions. I might expect and normalize the emotional response to the breach and acknowledge the emotional states of fear, anger, or mistrust that might arise from the breach. We often spend time and part of our relationship re-establishing a foundation of safety, where we can work collaboratively and my role will be specific and consistent; supporting the client and processing what occurred, along with the pre-existing concerns we had been addressing. When a therapist takes ethical action, we should expect some degree of ethical discomfort that momentarily alters the relationship, but preserves the therapeutic relationship.

Self-Evaluation

I'd describe my learning and development during this course as both enlightening and instrumental to how I think about myself as an ethical counselor-in-training. The course has supported my understanding of several key ethical concepts (informed consent, confidentiality, duty to protect, etc.) while revealing the complexity and specificity of ethical decision making. Additionally, I no longer see ethics as a list of rules to follow in my practice, but rather, I've learned how to engage in critical thinking when faced with a complicated situation, when to consult my supervisor and colleagues if I'm unsure, and I recognize epistemically that ethics is a relational and ongoing responsibility that I have as a practitioner, but not a responsibility that I complete as a requirement during my training.

My current strengths include robust self-awareness, a genuine passion for cultural humility, and an authentic devotion to the well-being of clients that informs all clinical thinking. I engage in reflective practice to identify how I chose to act, how those components inform my relationships, seek supervision and/or ask for feedback on my practices from instructors and peers, and embrace empathy and a clinical intentionality in every ethical dilemma. I approach this work with a great deal of enthusiasm and intellectual curiosity which motivates me to keep learning, challenge assumptions, and ensure that I remain firmly rooted in an ethical, client-centered approach. These strengths support my ability to be fully engaged in the learning process and reflect on how the theoretical concepts become applicable in my future iterations as a practitioner. Nonetheless, I see a few areas for improvement and further development in my ethical foundation work. I want to find greater confidence and clarity about managing moral ambiguity for which there is no clear right answer and learning to trust in my clinical reasoning while also calling in appropriate consultation. Further, I want to work on strengthening my ability to manage countertransference in the moment, especially during situations of heightened risk or emotional intensity where my personal expressions might not support my professional responsibilities; that is, ethical practice. Finally, I want to better understand how culture impacts ethical/safeguarding practices in order to respond with greater awareness and sensitivity when working with diverse clients in ways that meet standards of ethical care, whereby ethical practice is necessarily culturally responsive to be effective.

I'm putting a lot of effort, time, and emotional energy into this course because I recognize that ethics aren't only fundamental to my competency, functioning, and identity as a future counselor, but I also understand the absolute importance of ethical practice within counseling. More than simply completing assignments, I've spent lots of time thinking critically about how the items we studied, for example client safety, related to clinical experiences I may be dealing with as a counselor, and to bring together theory of ethical practice with practical ethical application. I've also been emotionally engaged with the course content, especially during class discussions around client safety, cultural competence, and recognizing the weight of ethical responsibility that's part of the job. I was expressive about my engagement because my efforts related back to a sense of belonging to a community of learning and practice, and I take my ethical obligations to clients seriously, beyond the idea of tendency to eliminate potential harm.

I'd say my participation in class discussions and activities in-class have always been consistent, engaged, and thoughtful throughout the semester. I'm such that I bring myself to class in a way to be present, engaged, and thoughtful (reflective) at all times. I'm careful to contribute thoughtfully to class discussions, including not stealing the spotlight, as well as responding to my peers with respect and genuine inquiry. Even when I'm not directly engaging in conversation I stay mentally and emotionally engaged, reflecting on how the discussion relates to my own development as a professional and how I want to develop my clinical practices. I've appreciated the nature of collaborative learning and have intentionally sought to honor my peers in their learning, while simultaneously challenging my own reasoning and perspectives.

I'd give myself a 98% right now for participation because I've been present, engaged, and reflective in all aspects of the class discussions and activities. I've contributed thoughtfully, have respected my peers and shown genuine curiosity when responding to their contributions, and have tried to connect both what I've learned to my own insights, as well as the broader clinical relevance of the material. I've been deliberate in engaging with the learning process, by having prepared for class with relevant reading and by engaging with the emotionally difficult content and was able to remain professional in discussions of ethically challenging or unsafe practices. I wouldn't give myself a perfect score because although there's always very slim room for improvement with respect to speaking up more in discussions or challenging myself to go further outside my comfort zone when discussing vulnerable and personal examples of my own biases or limitations.

References

American Counseling Association. (2014). ACA code of ethics.

https://www.counseling.org/resources/aca-code-of-ethics.pdf

Bennett, B. E., Bricklin, P. M., Harris, E., Knapp, S., VandeCreek, L., & Younggren, J. N.

(2006). Assessing and managing risk in psychological practice: An individualized

approach. Professional Resource Press.

Corey, G., Corey, M. S., Corey, C., & Callanan, P. (2019). Issues and ethics in the helping professions (10th ed.). Cengage Learning.

Falender, C. A., & Shafranske, E. P. (2017). Supervision essentials for the practice of

competency-based supervision. American Psychological Association.

Gone, J. P., & Kirmayer, L. J. (2010). On the wisdom of considering culture and context in psychopathology. In T. Millon, R. F. Krueger, & E. Simonsen (Eds.), Contemporary

directions in psychopathology: Scientific foundations of the DSM-V and ICD-11 (pp. 72-

96). Guilford Press.

Granello, D. H., & Granello, P. F. (2007). Suicide: An essential guide for helping professionals and educators. Allyn & Bacon.

Hook, J. N., Davis, D. E., Owen, J., Worthington Jr, E. L., & Utsey, S. O. (2013). Cultural

humility: Measuring openness to culturally diverse clients. Journal of Counseling

Psychology, 60(3), 353-366.Ethical Self Reflection – Part One 31

Hwang, W. C. (2006). The psychotherapy adaptation and modification framework: Application to Asian Americans. American Psychologist, 61(7), 702-715.

La Roche, M. J., & Bloom, J. B. (2018). TPR as a culturally responsive intervention. Practice Innovations, 3(4), 236-248.

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.

Pope, K. S., & Vasquez, M. J. T. (2016). Ethics in psychotherapy and counseling: A practical guide (5th ed.). Wiley.

Prochaska, J. O., & DiClemente, C. C. (2005). The transtheoretical approach. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (2nd ed., pp. 147-171). Oxford University Press.

Sue, D. W., & Sue, D. (2019). Counseling the culturally diverse: Theory and practice (8th ed.). Wiley.

Welfel, E. R. (2016). Ethics in counseling and psychotherapy: Standards, research, and

emerging issues (6th ed.). Cengage Learning.

Ethical Self Reflection – Part Two

Alexandra Arpey

Chadron State College

Counseling Ethics and Professional Identity – COUN 533

Dr. Kathleen Woods

August 6, 2025

1. Friendship

If a client were to come to me about forming a social relationship after the end of therapy, it would require an intricate examination of ethical and clinical issues, and the decision must be a thoughtful, deliberate process. Although a social relationship may contain an element of flattery, there are many hurdles to cross in this situation, and the exploration must be based on the client’s needs. One reason to discourage accepting friends as clients or becoming socially involved with clients is that counselors may need to be liked, in which case there’s a danger of being less challenging in the counseling process for fear of jeopardizing the relationship (Corey et al., 2024, p. 282).

I’d first consider the clinical implications of the request. I’d need to determine if my former client simply wants companionship to avoid processing difficult feelings related to our termination, or if they’re continuing to seek out therapeutic engagement through a friendship. Questions about transference may also play an important role; is the client engaging with me because they genuinely want an interpersonal relationship, or because we had a connection with the feelings of intimacy we developed in our therapeutic relationship? I’d have to consider the degree to which the power differential of the therapeutic relationship has lessened. Corey et al. (2024) note, “former clients may need you more as a therapist in future than as a friend” (p. 283), which must be considered in terms of their potential long-term therapeutic need.

Ethically, while I’m not in formal care of the former client, there still exists a potential for both of us to engage in exploitation based on the therapeutic understanding we had together. Professional codes demonstrate that post-therapeutic relationships are discouraged and/or prohibited, as a consideration for any future possibility of exploitative practices with former clients. As Corey et al. (2024) document, “counselors are at an increased risk for exploitation of clients because of an imbalance of power understood in the therapeutic relationship” (p. 282). I’d have to consider whether I could maintain therapeutic conditions if the client returned to access therapeutic services. The primary issue that requires explicit consideration is boundary confusion: how will we create an equivalent, reciprocal relationship in a subsequent friendship?

Initially, I’d professionally consider the former client’s request without a vehement, forceful rejection. That is, I’d take their request into consideration and emphatically express my appreciation for their positive reference to our therapeutic alliance. In the exploration process, I’d start by exploring what intrigued them about wanting to have a friendship with me, examining the timing and their feelings surrounding the termination of our relationship, investigating their dependency and what other relationships they may have that support them, and ultimately facilitating a consideration of what characteristics or qualities they valued about me that they might seek in other friendships.

As stated by Corey et al. (2024), it’s important to explore whether “counselors’ own needs may be so enmeshed with their clients’ needs that objectivity is lost” (p. 282). My decision framework would first involve suggesting they wait six months to two years before any social contact; seeking supervision or peer consultation on the specific circumstances; thoroughly documenting their request and the decision-making rationale; and articulating clear boundaries if the friendship were ever to proceed.

However, because I do identify and would generally acknowledge the ex-client’s positive feelings surrounding our therapeutic relationship, I’d most likely decline the friendship while allowing them to process or explore termination feelings, supporting them in developing other reciprocal relationships, and leaving the door open for potential future therapeutic services. The rationale for my intention aligns with Corey et al.’s (2024) suggestion that “therapists may not challenge clients they have a social relationship with because of their need to be approved and liked by the client” (p. 282). In general, exploitative risks and boundary confusion, as well as compromised future therapy options, are more concerning than the potential benefits of friendship, even with caring, well-meaning clients. As a result, I’d want to focus on the ex-client’s long-term well-being and therapeutic goals, while also preserving the integrity of the therapeutic process and adhering to principles of professionalism and ethical behavior, given that professional boundaries exist to protect both parties.

2. Competence

Being a competent professional counselor conveys much more than your ability to follow the rules; it means a fuller commitment to the ethics of practice, professional development, and client welfare. To me, being a competent professional means showing up with integrity, self-awareness, and commitment to always serving others ethically. It means acknowledging the limitations of my knowledge and skills and only practicing in areas where I’ve received adequate education, training, and supervision. As Corey et al. (2024) note, “competence at one point in one’s career doesn’t guarantee competence at a later time—we must take active steps to maintain our skills” (p. 307). This view makes clear that competence is more than something you achieve; it requires that you take ongoing responsibility for your own competence by continuing to learn and paying attention to and developing yourself.

Competent professionalism conveys many aspects that work in concert to provide effective client care. It means being willing to seek consultation and supervision as the years progress for situations which compromise your competence or may challenge your ethical judgment. It always means a lifelong commitment to learning through continuing education, clinical experience, and keeping up to date on research and evolving best practices. Being competent also implies the ability to understand and respond to cultural differences with humility, openness, and respect, while also reflecting on my values and how my values are influencing my work, especially in ethically or clinically difficult situations.

The American Counseling Association (2014) states that counselors must only “engage in practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience” (Standard C.2.a). Competence also includes attending to my own mental and emotional wellness so I can be fully present and effective with clients.

The process of assessing competence is complex and involves a combination of self-reflection, outside feedback, and measuring assessments. I’ll assess competence by regularly reflecting on my clinical work. After engaging in the work, I’ll use self-reflection to identify the aspects of my work that I feel competent with and those I don’t feel competent or effective. I’ll seek to be in supervision ongoing and request direct feedback that’s timely and as honest as possible regarding my strengths, blind spots in work, and professional development areas to work on from multiple sources. I’ll use formal assessments in the form of supervision assessments, client outcomes, and formal assessments that speak to my development over time.

As noted by Pope and Vasquez (2016), “competence entails self-assessment, and the ability to honestly recognize limitations” (p. 89). I’ll listen to my clients and monitor their responses to me. I’ll also consider the therapeutic relationship and assess for ruptures, misunderstandings, and lack of progress when making determinations about my competence in working with clients. In relation to competence, I’ll pursue training opportunities for continuing education in areas where I’m lacking experience and feel unprepared to engage in clinical work. I’ll remain aware of relevant research and updated practices in psychotherapy and counseling. I’ll be honest with myself and vigilant concerning whether or not I can support the client with their needs when the case exceeds my competence, further necessitating referrals to alternative resources.

Staying and remaining competent requires that care be implemented as per professional guidelines, with a commitment to practice lifelong learning consistent with ethical codes of conduct in all disciplines. I’ll remain competent to practice only within the boundaries of my education, training, supervised experience, professional credentials, and appropriate professional experience, as imposed by the ACA Code of Ethics (American Counseling Association, 2014). I’ll continue in increasingly engaged professional development opportunities, attending workshops and continuing education courses, remaining current with emerging areas of research in the field, while regularly consulting with colleagues, supervisors, and mentors to uphold the clinical work I practice. The National Association of Social Workers (2021) also asserts that social workers must “strive to become and remain proficient in professional practice and the performance of professional functions” (Standard 4.01.b). I’ll monitor my own physical and emotional wellness, as advised by the American School Counselor Association (2016), remaining grounded to maximize my engagement with clients. According to the Canadian Counselling and Psychotherapy Association (2020), “counsellors discontinue or refer to other professionals in cases in which the counselling needs of the clients exceed their level of competence” (Standard B.4). So, if I acknowledge a knowledge gap or skill area, I’ll ensure there’s a check with my own training, knowledge development is initiated, or I’ll refer the client to an appropriate service. I’ll also continue to maintain cultural competence to broaden my awareness, becoming ever sensitive and responsive to the identities and experiences of those I engage with in my professional development. I’ll view competence as an ethical professional obligation, which is consistent with lifelong learning, ongoing self-reflection, and interaction with the counseling profession.

3. Supervision

As a graduate student who’s being supervised, I expect to experience a number of important ethical dilemmas requiring thoughtful navigation and professional development. These ethical dilemmas will provide me with important learning opportunities to help me develop as an ethical practitioner while keeping client welfare at the forefront of my clinical work with clients.

Some of the major ethical dilemmas I may discover as a student would include feeling uncertain about a clinical decision while working with a client, but being afraid to bring it up in supervision because I might look incompetent. This type of danger creates a dynamic where my ego and insecurity could undermine client care. In thinking through how to deal with this type of concern, I’d remind myself that supervision is a “protected space” for growth, and ultimately not addressing my concerns could jeopardize client welfare as well as my professional growth as a counselor. As Corey et al. (2024) point out, supervisees have the obligation to initiate asking for what’s needed during supervision. I’d practice being honest with my supervisor, even if it was uncomfortable, and view it as part of learning instead of weakness. I’d be following ethical principles in that I should always prioritize client welfare over my own discomforts or insecurities as a professional.

I might also experience another ethical dilemma related to managing my own emotional experience. Specifically, countertransference can cause issues if my client shares a life story that triggers something for me personally. Rather than ignoring that emotional response and trying to cope with my feelings, I can openly discuss my feelings and how to ethically manage my reactions in supervision. Corey et al. (2024) indicate that a significant part of supervision should include discussion of the supervisee’s countertransference responses when working with a client. If I felt too emotionally invested with a client or was recognizing too much slippage of my boundary, that’d be, in my view, a yellow light on my radar and I’d seek consultation with my supervisor soon after a session. I want to make sure I don’t allow my personal issues, intentional or unintentional, to interfere with my professional obligations.

I could also fall victim to taking on more than I’m competent to handle, especially if I want to prove something or not disappoint others when I shouldn’t be taking that on. In that case, I could remind myself that it’s unethical for me to practice outside of my competence, and it’s more responsible to admit to myself that I’m not competent enough for something and seek help or provide a referral. The American Counseling Association (2014) gives clarity on this point in Standard C.2.a, stating that counselors should practice “only within the boundaries of their competence.” Similarly, if I observed concerning dynamics in the clinical work of another student such as boundary violation or risk of a client’s harm, I’d have to give careful consideration as to how to respond. Again, I’d discuss with my supervisor or possibly with a faculty member while putting priority on client welfare, while also being cognizant of due process and confidentiality guidelines. As Corey et al. (2024) indicate, supervisees have the responsibility to appropriately and consistently create boundaries in their work, which means not just their relationships with clients but with issues concerned with other students when needed.

As a student, I’d be expected to rely on supervision, the ACA Code of Ethics, and communication to navigate ethical considerations or dilemmas in a way that meets client care and learning about being a counselor. I understand that ethical decisions aren’t a barrier to overcome but a part of learning and will ultimately make me a more competent and ethical practitioner.

4. Diagnosis

I see diagnosis as a tool—not a label—and I want my clients to be aware of this distinction from the very beginning. A diagnosis can help us to recognize patterns, understand your symptoms, and select an effective treatment option, based on what we know works for what you are experiencing. A diagnosis also determines who has access to care, as many insurance companies require a diagnosis to justify treatment. Diagnosis is intended to “indicate appropriate treatment strategies for specific disorders” and provide a framework for research of different treatment options (Corey et al., 2024). That said, you are not a diagnosis. You are a whole complex person—not a disorder—and I will always see you as such.

I also understand that diagnoses can be influenced by cultural bias or a narrow perspective; therefore, I try to take into consideration your culture, lived experience, and the context you are in when making any clinical decision. The authors summarize that “cultural sensitivity is necessary for making a proper diagnosis,” and that “what may be deemed ‘healthy’ or ‘normal’ in one culture may not be the same in another” (Corey et al., 2024). If we fail to take note of cultural characteristics, we can make a misdiagnosis that continues a stereotype or does harm to our client. So if I ever provide any diagnosis, I would do so in a transparent discussion with you about why it is relevant and how it can inform our work together. You have a right to know and understand your diagnosis, and I want us to be in a position of shared responsibility and collaborative effort, based on openness, mutual respect, and with your aspirations in mind.

What I hope to say to my clients regarding my views on diagnosis is that this is something we can approach together, with openness and attentiveness, rather than my imposing a diagnosis on you without explanation. A diagnosis can be useful—it can inform the treatment you receive, it can enable us to use language to describe your lived experience, it can provide a framework for making sense of psychological phenomena—but it doesn’t tell the full story. We need to remember that a diagnosis is a clinical tool and doesn’t define who you are, and doesn’t take account of your strengths, your resilience, or your whole humanity. As importantly noted in specific literature, “diagnosis may help to normalize a client’s situation,” and aid with treatment planning, but also remember that “the individual with the least power is often the target of the diagnostic label, and this serves to further disempower already oppressed clients and communities” (Corey et al., 2024).

If diagnosis is part of your treatment plan, I will ensure you understand the diagnosis, have space for questions, and feel supported in deciding what the diagnosis means for you. I follow what Corey et al. (2024) describe as a “diversity-sensitive diagnosis,” where the client is actively engaged in the diagnosis and case formulation so as to foster the client’s psychological liberation. More than anything, I want you to feel as if you are seen and heard, not just a category in a book. I’m committed to thinking of diagnosis as one of many tools we can use to help support your healing journey, while respecting your autonomy, cultural identity, and inherent value as a human being.

5. Ethics in Group Work

In my role as a counselor in an agency setting designing and facilitating a group, my most notable ethical concern would be truly informed consent. It’s important that I assure every possible group member has a full understanding of the intention of the group, the structure of the group, expectations for participation, limits of confidentiality, and the possible risks and benefits. According to Corey (2024), “members must be provided with as much information as possible about benefits and risks” before proceeding with engaging in group work. This process is complicated by the fact that group members need to understand not only the therapeutic process but also the intricacies and challenges of participating in a group.

Screening and selection would also be a substantial concern because not every client is suited for every group; placing someone into group work that they’re not ready for can create harm for the client. I’ll need to assess the client’s current goals, emotional stability, and readiness for group work if I’m to create a safe and productive environment for all clients. The authors highlight that “not everyone will benefit from a therapeutic group experience, and some people may be psychologically harmed by certain group experiences” (Corey et al., 2024).

Confidentiality would be another major ethical issue, as I can’t assure that group members will not breach one another’s boundaries. As Corey et al. (2024) wrote, “You cannot guarantee confidentiality in a group; however, group leaders must educate members about unintentional breaches of confidentiality.” I’d have to stress the importance of confidentiality throughout the group, remind them constantly, and if breaches occurred, I’d address them openly and decisively.

Cultural sensitivity would also be particularly important, especially in a group with diverse representation where assumptions or microaggressions could be harmful to any participant. I’d want this to be a space where we’ve established group norms that keep togetherness while respecting diverging identities and perspectives; I’d also internally reflect on my own bias and cultural lens. The text emphasizes that group counselors “have to establish norms that accept, value, and respect cultural differences” in a group and “become aware of the myths, stereotypes, and assumptions they learned as a result of living within a society that affect their work as they facilitate groups” (Corey et al., 2024).

The techniques of the group would also be a concern, as I’d ensure I don’t use any intervention until it’s appropriate to the group goals and grounded in research or theory, and that I’m properly trained in using it. I’d be mindful of pacing and not to overextend clients emotionally or use extreme methods that could retraumatize participants. As the authors signal, we must have “an invitational style and not be pushy or dictatorial,” and that we “cannot guarantee a risk-free environment but must work to minimize harm” (Corey et al., 2024).

Termination and follow-up would ethically matter as well, as I’d want to make sure to support the clients upon exiting the group and provide resources for continued growth. The text expresses that “the final phase of the life of a group is also critical” and “neglecting the process of termination can easily leave the members with unfinished work” (Corey et al., 2024). I’d seek supervision and consultation as needed throughout, as well as reflect on my own competence regularly, while grounding myself in evidence-based practice and ethical guidelines to ensure safety and foster growth for all members.

6. Advocacy

In rural communities, social justice advocacy may be even more necessary because they typically experience systemic inequities that have serious impacts on their mental health and wellbeing. Compared to urban areas, rural populations experience much lower access to mental health services because of limited numbers of providers and longer travel times to providers (Smalley et al., 2010). The National Rural Health Association (2021) states that rural areas have approximately half the number of mental health providers per capita than urban areas, leading many rural residents to lack services due to access issues. Additionally, rural communities frequently experience higher rates of poverty, fewer employment opportunities, and worse funded schools or health systems, all of which contribute to chronic stress and systemic inequity that ultimately affect their mental health. These factors are what mental health providers must seek to alter through advocacy.

The cultural context of rural areas presents further complications that necessitate social justice advocacy. Stigma around mental health concerns is often heightened in rural settings, which prevents people from seeking help and heightens the need to educate clients and to reach out in culturally appropriate ways (Hauenstein et al., 2007). Rural counselors wear many hats using more of a generalist approach, so they must feel comfortable addressing challenges from many vantage points and needs that rural counseling clients have that are applicable to social economic perils and constraints on their wellbeing. Corey et al. (2024) point out that “practitioners in small towns can minimize risk through informed consent processes, sufficient documentation, boundaries and expectations clarified, and through continued involvement in consultative processes.”

In addition, confidentiality can be difficult to maintain in smaller towns where people likely know one another (i.e., “small-town syndrome”), which can impact willingness to seek services. Unlike in urban centers, rural areas may have greater disconnection from legal, educational, and advocacy resources, making it imperative for counselors to provide services in ways that support clients’ navigation through systemic barriers.

Practicing in rural settings brings ethical and practical challenges. Clients may face transportation barriers, limited crisis or psychiatric services, and high caseloads for counselors (Jameson & Blank, 2007). Counselors must navigate dual or multiple relationships transparently, seek supervision, and practice self-care to prevent burnout (Rosmann, 2012). As Schank and Skovholt (2006) note, “it is ethical to uphold the code of practice by noting each ambiguity within small community settings.” Counselors working rurally should ground their advocacy in cultural humility and pursue ongoing professional development to ethically meet community needs.

7. Critique of “Good Will Hunting”

The film Good Will Hunting (1997) beautifully portrays the story of healing and growth that Will Hunting, an emotionally burdened, gifted young man, has with Dr. Sean Maguire, his court-mandated therapist. There are several instances of healing and support throughout the film, but also many instances of ethical violations and boundary issues that are worth exploring in the context of professional counseling ethics. Using an ethical decision-making approach, this analysis will examine the moral, ethical, clinical violations, and legal infringements in Sean’s therapy with Will while acknowledging both Sean’s motivation for his behavior and how it negatively impacted the therapeutic process.

There are a myriad of blatant ethical rule violations throughout Sean’s treatment of Will that illustrate a clear departure from professional standards. Sean shares personal trauma and suffering that diverts attention away from Will’s needs, involves boundary issues through inappropriate self-disclosure, and violates the limits of the therapeutic frame. In Sean’s first session with Will, he physically grabs him around the neck while threatening him, a clear legal and ethical breach of nonmaleficence and the legal duty of non-harm to every client. There’s no evidence that Sean obtained informed consent regarding confidentiality, intentions of therapy, or court orders. Sean also fails to clarify that he’s both a court-mandated therapist and therapeutic ally, which causes confusion and risk due to dual roles.

Sean demonstrates poor handling of countertransference by being emotionally reactive in their sessions, falling short of ethical standards regarding emotional competence and supervision. He confronts Will too soon and too intensely, without trauma-informed pacing. Their relationship evolves into friendship, crossing professional boundaries and creating a dual relationship that violates ethical standards. Sean doesn’t share his qualifications or treatment framework, failing professional disclosure requirements. Finally, he ends therapy abruptly without formal termination or continuity-of-care planning.

Sean’s behavior violates several ACA (2014) codes: physical aggression breaches Section A.4.b (nonmaleficence); failure of informed consent violates A.2.a; lack of confidentiality clarification breaches B.1.b; excessive self-disclosure violates A.5.d; and dual relationships violate A.5.c. The absence of supervision breaches C.2.e; failure to identify a counseling approach violates A.2.b; and sudden termination violates A.11.c.

While Sean’s empathy and intent to help are evident, his behavior undermines ethical standards and client safety. His self-disclosure lacks therapeutic rationale, his boundaries blur, and his decisions neglect client autonomy and documentation requirements. His abrupt departure may represent abandonment, leaving Will vulnerable.

If I were Will’s counselor, I’d build rapport with authenticity and empathy but clarify roles from the start, ensure informed consent, and maintain clear boundaries. Self-disclosure would be purposeful and clinically relevant. I’d document sessions, develop a treatment plan addressing trauma and attachment, and structure termination to help Will process closure and independence.

If I were Sean’s supervisor, I’d address his lack of informed consent, countertransference management, boundary confusion, and absence of supervision. I’d emphasize session documentation, treatment planning, and ethical use of self-disclosure. Regular supervision would help manage emotional involvement and prevent further violations.

Although Sean’s actions stemmed from compassion, they show how good intentions cannot substitute for ethical practice. As Pope and Vasquez (2016) warn, “the psychotherapeutic relationship is characterized by an inherent power differential that requires ceaseless vigilance to prevent exploitation.”

8. Shifts in Thinking about Ethics

Over the course of this class, I’ve drastically changed my understanding of ethical practice—from focusing on rules to seeing ethics as reflective, intentional, and client-centered. I entered the course wanting to avoid violations; I leave understanding that ethics is about integrity, humility, and protecting clients through thoughtful, culturally responsive choices.

My view of dual relationships evolved: I once thought they were always unethical, but now I understand context matters and boundaries are nuanced. I’ve also learned that self-awareness—recognizing my biases, values, and reactions—is key to ethical decision-making. I now see informed consent as an ongoing dialogue rather than a formality.

I’ve grown more confident using ethical decision-making models and seeking supervision. I’ve learned that ethics is dynamic, not static, requiring lifelong reflection and learning. My focus has shifted from rule compliance to client protection and trust. Ethical counseling, I’ve realized, is living and active—woven into every aspect of practice.

This semester tested me personally. A family member was diagnosed with pancreatic cancer, and I completed much of my coursework early to spend time with them. Despite grief, I remained deeply engaged, reflective, and intentional about my learning.

I confronted biases and discomforts directly, engaging fully in ethical reflection and critical thinking. I maintained strong participation in discussions, sought feedback, and used it constructively. Despite personal challenges, I would give myself a participation grade of 98% based on engagement, preparedness, and contribution.

This reflection process reaffirmed that ethical development never stops. Continuous learning and self-awareness are essential for competent, compassionate care. My professional identity is grounded in ethics, and I intend to uphold those principles as the foundation of my counseling practice.

References

American Counseling Association. (2014). ACA Code of Ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425596

American School Counselor Association. (2016). ASCA Ethical Standards for School Counselors.https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf

Association for Specialists in Group Work. (2007). Best Practice Guidelines.https://www.asgw.org/pdf/training_guidelines.pdf

Canadian Counselling and Psychotherapy Association. (2020). CCPA Code of Ethics. https://www.ccpa-accp.ca/profession/code-of-ethics/

Corey, G., Corey, M. S., & Corey, C. (2024). Issues and Ethics in the Helping Professions (11th ed.). Cengage Learning.

Hauenstein, E. J., Petterson, S., Merwin, E., Rovnyak, V., & Heise, B. (2007). Rurality, gender, and mental health treatment. Family & Community Health, 30(2), 97–108.

Jameson, J. P., & Blank, M. B. (2007). The role of clinical psychology in rural mental health services: Defining problems and developing solutions. Clinical Psychology: Science and Practice, 14(3), 283–298.

National Association of Social Workers. (2021). NASW Code of Ethics.https://www.socialworkers.org/About/Ethics/Code-of-Ethics

National Rural Health Association. (2021). Rural Mental Health. https://www.ruralhealthweb.org

Pope, K. S., & Vasquez, M. J. T. (2016). Ethics in Psychotherapy and Counseling (5th ed.). Jossey-Bass.

Rosmann, M. R. (2012). Behavioral Health in Rural America: Challenges and Opportunities. National Rural Health Association.

Schank, J. A., & Skovholt, T. M. (2006). Ethical Practice in Small Communities: Challenges and Rewards for Psychologists. American Psychological Association.

Smalley, K. B., Yancey, C. T., Warren, J. C., Naufel, K., Ryan, R., & Pugh, J. L. (2010). Rural mental health and psychological treatment: A review. Journal of Clinical Psychology, 66(5), 479–489.

Sue, D. W., & Sue, D. (2019). Counseling the Culturally Diverse: Theory and Practice (8th ed.). Wiley.

Van Sant, G. (Director). (1997). Good Will Hunting [Film]. Be Gentlemen Limited Partnership.