Challenges in Working with Clients and Personal Values

This essay discusses the challenges faced by counselors when their personal values conflict with their ability to work ethically. It explores the potential ethical risks and implications of such conflicts and provides practical strategies to resolve them. The essay also includes two case studies to illustrate the dilemmas faced by counselors.

Essay

Table of Contents
Title - When working with clients there are times when a counsellor’s personal values create
challenges in their ability to work ethically.....................................................................................4
Introduction......................................................................................................................................4
MAIN BODY...................................................................................................................................4
1) Values and Values Conflict.....................................................................................................4
2) Potential Ethical Risks and Implication...................................................................................7
3) Practical Strategies .................................................................................................................9
REFERENCES..............................................................................................................................11

Title - When working with clients there are times when a counsellor’s
personal values create challenges in their ability to work ethically
Introduction
Counselling values and ethical concerns are considered as one of the cornerstone of
counselling practices. These two main aspects help psychologists to give their support to clients
who face struggle in life. For this purpose, they identify emotional, physical and mental well-
being concerns first before addressing the same (Sanabria and Murray Jr, 2018). For more severe
psychological symptoms, counsellors or psychologists also provide diagnosis, assessment and
treatment procedures to help clients for enhancing their quality of life. But under this
professional practice, a number of cases occurs that arise challenges in terms of handling
conflicts regarding with personal values, because any chancellor cannot impose own personal
values on client (Santa Maria and et. al., 2017). In this regard, based on core conditions of
counselling related to client-centred, some cases have been drawn into present project, by aspects
of behaviour theories, cognitive development and certain of Code of Ethics to provide a
resolution to dilemma experienced by psychologies (or counsellors) due to beliefs conflicts.
Along with this, ethical guidelines of Australian Counselling Association related to case study
are also demonstrated to highlight the significant issues about dilemmas occur while counselling.
Furthermore, key discussion is also made on potential ethical risks and implications, as well as
practical strategies to resolving the same.
Case 1 (Client I): Client is aware they have fertility issues but does not wish to tell their partner
until after they are married as they are afraid their partner will leave them.
Case 2 (Client II): Client tells you they have a Sexually Transmitted Disease (STD) but have
not told their partner and are engaging in unprotected sex.
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MAIN BODY
1) Values and Values Conflict
In counselling profession, main work of professional is to understand problems of clients
and help in resolving the same. But as per ethical norms, imposing personal beliefs and own
values upon clients are restricted, which states that main responsibility of every counsellor is to
accept every client for who they are, including personal concern of them (McMahon and et. al.,
2017). In any case, when values of counsellor are imposed on an individual, then they tend to
react through rejecting those believes that taken without consideration and might be withdrawn
from counselling. While involuntary client are those individuals who are unable to withdraw
physically from counselling, then they might withdraw emotionally, with feeling of distress and
become unmotivated to accept suggestions of counsellors. Therefore, imposing counsellors’
values upon an individual during psychotherapy, arise problems related with indicative of
judgement (Sommers-Flanagan and Sommers-Flanagan, 2018). When therapists paradoxically,
accept the client as they are, regardless of values, then in such case, values of them tend to grow
closer to the own counsellor’s values, that might become role models as well. But a number of
situations arise where chance of personal conflicts arises between a counsellor and client.
In context with first case, it has been evaluated that the person seemed to have infertility
issues but still don’t want to tell its partner, just because of inferiority about refusal of marriage
and leave them (Pelling and Burton, 2019). Knowing their intention and low feelings, may lead
to arise conflict where both of counsellor and the respective client feel angry, upset, even
misunderstood or helpless to take actions. Because when a person is aware about its own
infertility issues then under such conditions, they experience more ‘negative emotional
responses', as compared to one who seemed to have more sense of loss, impatient, stigma and
reduced self-esteem, etc. (Weir, 2020). This could be a painful and high psychological trauma as
well as life-altering phenomenon, which is isolating and stigmatising. Along with this, it is also
not simply a person’s psychological experience but a social one also, which occurs within
context of couple’s or individual’s life. So, under this case, handling such negative state of
emotions arise difficulties for counsellors, because unwillingness of clients to inform their
partner before marriage seems to be unethical (Schirmer, 2019).
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In Australia and New Zealand, infertility counselling started in 1980s, under the name of
Australia and New Zealand Infertility Counselling Association (ANZICA). As per this
association, which serves a crucial role in advancing and advocating counselling or
psychotherapy’s profession, it has been evaluated that it is main role of counsellors to maintain
integrity, dignity and empowerment of client instead of offering them advice or impose own
beliefs. Along with this, while giving a supportive environment they must ensure that feelings of
client should not be hurt and develop counselling relationship within certain boundaries
(Donarelli and et. al., 2019). But in present case, where client is having infertility issues, chance
of conflict in values is higher because of getting high negative respond. In addition to this, main
challenges faced while dealing with emotional reactions of infertile client comprises of issues in
terms of self-disclosure and experienced the ethical dilemmas, especially in offering the
psychological support through all stages of the fertility treatments. Counsellor under present
case, might also experience emotional reactions to infertility crisis of this client, that potentially
affects entire processes and outcome of counselling (Arafa and et. al., 2018).
With respect to second case, a client is on high risk to transfer Sexually Transmitted
Infection (STI) due to intercourse in unprotected sex. As such infection is considered as one of
the chronic diseases which remains for lifelong, therefore, when an infected person intentionally
or unintentionally make sexual relationship with others, without any protection then chance of
transmitting this virus is high (Janssen, 2018). In this case, when counsellors know the entire
case then it becomes almost difficult for them to keep this information safe and not disclosing to
their peers, family ones or life-partner. Because as per Code of Ethics and its principles, it is
foremost duty of psychologists or counsellors to not disclose any personal information of their
client in front of third party, without their consent. But in such case, obeying this ethics, might
put threat for others who are or will be in sexual relationship with infected individuals
(McLennan, Ryan and Randall,2018). It is important however, that counsellors must be aware of
own attitudes which might interfere with supporting such types of client, through learning to put
aside the personal judgments as well as focus on their needs, so that trust and rapport can be built
with them. Handling personal conflicts and dealing with a client’s negative mood with physical
and mental health issues, lead to arise a greater chance to poor counselling.
To be aware of negative responses of client with STD and own countertransference issues,
it is observed that counsellors must understand how client is dealing with the issues, that put
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severely impact on mental and physical conditions of an individual. Counsellor should
understand type of support he wants and way to deal with its negative mind (Schirmer, 2019).
Since, making sexual discourse with others also put life threat for others, so it creates challenges
to psychologists about how to deal with own values and work with maintenance of certain code
of ethics, so that standards of counselling as per Australian Counselling Association (ACA) can
be maintained. As counselling is considered as am important public health practice, but breaking
the transmission chain of sexually transmitted diseases (STDs), in present case of Client II it
requires from counsellors to provide information, assesse risks and emotionally support him
(Kumar, 2020). To fight against transmission of virus, counselling help in attaining potential
effectiveness because of its low cost of implementation and potential effectiveness. Along with
this, availability of preventive measures like condoms and post exposure prophylaxis can be
advice for addressing such diseases (Weir, 2020). But as per present case, since client has
informed counsellors that he made sexual relationship with its partner without informing her
about own STD disease. So, it arises difficulties in front of counsellor about how to respond and
support client for do the same. As it will infect others also, but as per ethics in this profession,
disclosure of information of client is not allowed to third party (Pelling and Burton, 2019). Along
with this, as ASA code of ethics, it is primary responsibility of professionals to respect the
dignity as well as promote welfare of users and must be culturally sensitive that bring them into
therapeutic relationship. Therefore, to support client in both cases, counsellor might be in distress
or facing conflict within personal and professional values, to handle the same.
2) Potential Ethical Risks and Implication
When a therapist allows own personal values for cluttering the interaction with client, then
its autonomy might be in threatened. It may cause harm to client by devaluing their personal
beliefs or values (Sommers-Flanagan and Sommers-Flanagan, 2018). Because if counsellor used
to judge client’s behaviour then in such case, this work doesn’t come in the category of its
welfare. Along with this, justice is also not served when conflicts concerned with personal values
result in treating client differently from others that highly affect dignity of them. A counsellor
while, if put himself before client then it also does not honour the professional commitments,
therefore, he must be truthful despite of judgement to self and recognize the personal triggers to
not affect client’s dignity (McMahon and et. al., 2017). But in context of present cases, where
chances of judgement for a therapist is high during counselling which lead to arises of potential
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ethical risks. But before exploring or commenting on such risks, it is recognised the principles of
Counselling ethics first, as mentioned below –
The APSCE i.e. Australian Psychological Society Code of Ethics for articulating and
promoting ethical principles, has established specific standards that guide both psychologists
(counsellors) and members of health public association to a clear understand their roles and
expectation regarding what is considered about ethical professional conducted by them during
counselling or treatment procedures. The Code of Ethics is mainly built on three main principles
that are – Respect for dignity and right of people; Propriety; and Integrity. Hereby, first
principles combine respect for maintenance of dignity and rights of clients during counselling,
including their rights to justice and autonomy. While, second principle i.e. Propriety, mainly
incorporates beneficence and non-maleficence to ensure that professionals must responsible for
clients’ welfare, own profession and society at large. Similarly, Integrity indicates requirement to
have fair behaviour and good character from professionals, with acknowledgement of high level
of trust which is intrinsic to professional relationship with clients and those who come in
interaction. In this regard, working on these principles that form particular standards of
professionalism, arise difficulties in handling the conflict in personal and professional values for
counsellors.
In context with present cases, for example Client II having STD issue, it has identified that
intervention approaches such as in-person counselling, videos, written materials, websites,
telephone support or text messages could be used. Here, most successful approaches to provide
counselling about STIs or STI transmission is assessing the individual’s risk for acquiring STIs.
The aim behind integrating of such process is to increase encouragement or commitment towards
safer sex practices like giving training for condom use, communicate about decision making to
include safer sex instead of unprotected sex, problem solving, etc. But interventions which
include the group counselling involve mostly high total contact times that delivered over in
multiple sessions, due to larger STI prevention effects (Santa Maria and et. al., 2017). So, it
might create conflicts in personal and professional values of counsellors, where supporting both
clients in present cases, counter the values of counsellors, in terms of feeling of guilt, supporting
with unwillingness and other types of strong emotions often are triggered. In both cases, where
harm of feelings even threat of transmission of severe chronic disease is high, so, emotions based
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on strongly held core values are violated then it directly impacts on counselling activities and
decision-making process, for welfare of clients (McMahon and et. al., 2017).
Overarching principles as per APS code of ethics, profession in counselling are based on
five moral principles, that are - Autonomy, which states to give and believe more in freedom of
choice and action of client; Non-maleficence, that directs the professionals to do not take any
decision that may causes harm to their clients; Beneficence, reflects on duty to act in such a
manner that provide benefits to clients; Treat clients equally; and last one is Fidelity, which is
found in acting in a manner that is faithful, loyal and honours the commitments. These principles
set ethical values for professionals as per set guidelines. In this regard, if conflicts arise between
personal values of client and counsellor then it arises difficulties for professionals to remain
objective throughout the counselling. Regardless, in both of the cases, if counsellor imposes its
values on clients, then it can negatively affect therapeutic relationship with them. Along with
this, it might also impact on stall development of the client autonomy, that lead to their feeling
disrespected, which could be resulted in harm to the client. Developing such types of interactions
will also place the well-being of both clients in jeopardy as well as cast profession of counsellor
in a poor light.
3) Practical Strategies
In order to deal with conflicts in personal values and professional ethics that arise in both
cases, where Client I hesitates to inform its partner about own infertility issue and Client II have
made unprotected sex even he has STD disease, so, understanding both of these cases and still
supporting welfare to them, creates a challenging role of counsellors (Sanabria and Murray Jr,
2018). Thus, without experiencing actual issue and problem of clients, counsellors cannot take
effective strategies to provide treatment or any options to resolve their issue, which reflects
personal goals despite of professionals. Therefore, to resolve conflicts issues in values, it is
essential to take effective practical strategies by counsellors so that desired outcomes could be
met. For this purpose, ethical decision-making model such as Counsellor Values-Based Conflict
Model (CVCM) could be applied to address way for proceeding, when values are considered at
the core of ethical dilemma (Santa Maria and et. al., 2017). This model helps in identifying both
professional ethics and personal values based conflicts, to determine process of deciding if any
referral option is appropriate for handling specific situation. It includes five steps which
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ultimately guide counsellors to implement client-centred resolution for values-based ethical
dilemmas i.e. conflicts in personal and professional values.
Step I – Counsellor is required to determine the nature of conflict first, i.e. analyse if ethical
dilemma arise due to personal values conflict or a professional values conflict. Generally, a
personal values conflict could stem from moral, religious, cultural or personal belief, including
the potential countertransference issue, which are tied up with professional own beliefs and
morals (McMahon and et. al., 2017). While, professional conflict includes a lack of requisite
skills and training which is required for developing counselling relationship and providing
services accordingly. In context with present cases, consulting the ethics codes and developing a
remediation plan, are the two thoughts that reflects professional conflicts. Therefore, exploring
the possible biases which underlie the conflict, as well as effectiveness of remediation plans as
per client’s best interest, helps in reducing the complications to handle both cases (Sommers-
Flanagan and Sommers-Flanagan, 2018) .
Step II – This step mainly focusing on determining the core reason behind personal values
that underlying the conflict, which emphasises on recognizing and identifying the biases, morals,
as well as religious beliefs that might be involved within ethical dilemma. Along with this,
personal experiences also might contribute to arise conflict, where, potential values-based
barriers affect counselling relationship and in delivering the appropriate client-centred services
(Pelling and Burton, 2019). In context with present cases, counsellors find it essential to provide
effective treatment to both the clients for promoting welfare of them and their partners, who are
equally at high risk to face dilemma.
Step III – Moving on third step of CVCM model, here, counsellor seeks and assistance
remediation to assist themselves in offering appropriate services. For this purpose, consulting the
Code of Ethics, taking advice from supervisors and utilizing the ethical bracketing will help in
finding ways for maintaining the personal values with integration of professional principles into
counselling services (Weir, 2020). Creating a remediation plan in present case, aid counsellors to
address their personal biases which impede the ethical services.
Step IV – On this stage, course of action can be determined and evaluated, by examining
the possibility of referral of cases to another counsellor by considering if it is ethically accepted
or not. Instead of this, in present case, counsellors will take support of seniors to discuss matter
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of seriousness especially for Client II who is STD infected and still engage in unprotected sex
(Schirmer, 2019).
Step V - Under this final step, the action could be planned and ready to be incorporated
within professional practices for ensuring the welfare and effectiveness of same for well-being of
clients. Only after ensuring that client well-being is the focus, the plan is put into place
(McLennan, Ryan and Randall,2018).
As the major complementary role of counselling service is to provide holistic patient-centred
care through multidisciplinary staff within fertility clinics, therefore, in case I, to counsel with
patient, professionals will seek to offer an opportunity first. Under this process, client is given
freedom to explore its thoughts, beliefs, feelings and relationship for better understanding the
meaning and choice of available options of treatment. Within an empathic and a non-
judgemental framework, this client is encouraged to find own solutions to overcome from such a
condition. In addition to this, therapeutic counselling will be provided, because it tends to be
more natural progression, where discussion could be made over different alternative lifestyles for
minimising distress and maximising conflict resolution. All these processes related to
counselling will be made under regulatory framework, to maintain ethics.
For Case II of patient having STI issues, client-centred counselling approach will be taken,
which tends to change focus of counselling to client’s need from a sole educative one. This
would help in tailoring needs, behaviour and circumstances to determine prevention needs and
provide assistance. Along with this, risk reduction approach also will be used to explore feeling
of this client regarding with sexual activity, by focusing more on safe sex planning and existing
knowledge of client about own infectious disease. Counselling for safer sex will be used under
this case, with purpose to prevent the further transmission of STI. Motivational interviewing
therefore, will help care providers to taken into account the readiness of this client for changing
their risky behaviour. This would help in resolving the ambivalence that is associated with
changing the behaviour. Furthermore, One-on-one counselling with meta-analytic process, aid to
review effects of overall counselling process as well as testing on the sexual risk behaviour to
reduce unprotected intercourse, increase condom usage and more actions.
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REFERENCES
Books and Journals
Donarelli, Z. & et. al. (2019). From telescope to binoculars. Dyadic outcome resulting from
psychological counselling for infertile couples undergoing ART. Journal of reproductive
and infant psychology. 37(1). 13-25.
Kumar, S. A. (2020). 47, XYY Syndrome and its Association with Male Infertility: Case
Report. International Journal of Innovative Research in Medical Science. 5(04). 132-to.
Arafa, M. M. & et. al. (2018). Chromosomal abnormalities in infertile men with azoospermia
and severe oligozoospermia in Qatar and their association with sperm retrieval
intracytoplasmic sperm injection outcomes. Arab journal of urology. 16(1). 132-139.
Janssen, D. F. (2018). Male-Factor Infertility: Factoring in the Male Experience.
In Intracytoplasmic Sperm Injection (pp. 1-8). Springer, Cham.
McLennan, V., Ryan, K., & Randall, C. (2018). Ethical Dilemmas Experienced by Australian
Rehabilitation Counsellors. Online Journal of Health Ethics. 14(1). 7.
Schirmer, J. (2019). From ethics to ethos: An expanded agenda for counsellor training and
development. Psychotherapy and Counselling Journal of Australia, 7.
Weir, M. (2020). Law and ethics in complementary medicine: A handbook for practitioners in
Australia and New Zealand. Routledge.
Pelling, N. J., & Burton, L. J. (Eds.). (2019). The Elements of Ethical Practice: Applied
Psychology Ethics in Australia. Routledge.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2018). Counseling and psychotherapy theories
in context and practice: Skills, strategies, and techniques. John Wiley & Sons.
McMahon, J. M. & et. al. (2017). Risk of intimate partner violence and relationship conflict
following couple-based HIV prevention counseling: Results from the Harlem River
Couples Project. Journal of interpersonal violence. 32(24). 3709-3734.
Santa Maria, D. & et. al. (2017). Nurses on the Front Lines: Improving Adolescent Sexual and
Reproductive Health Across Health Care Settings: An evidence-based guide to delivering
counseling and services to adolescents and parents. The American journal of
nursing. 117(1). 42.
Sanabria, S., & Murray Jr, T. L. (2018). Infusing human sexuality content and counseling in
counselor education curriculum. American Journal of Sexuality Education. 13(2). 190-
204.
Online
APS Code of Ethics. (2018). [Online] Available Through:<
https://www.psychology.org.au/getmedia/d873e0db-7490-46de-bb57-c31bb1553025/
APS-Code-of-Ethics.pdf>.
Adaptive coping strategies in male infertility, paramedical counselling as a way of support.
(2020). [Online] Available Through: <
https://www.tandfonline.com/doi/abs/10.1080/02646838.2020.1724918 >.
Counsellors’ practices in donor sperm treatment. (2018). [Online] Available Through: <
https://www.tandfonline.com/doi/10.1080/14647273.2018.1449970>.
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