This paper deals with the dilemmas that counselors and psychiatrists face during ethical counseling in professional fields. The relevant literature has been evaluated thoroughly in order to raise awareness about various ethical issues. Examining the studies of eminent authors and psychiatric practitioners, the focus has been given on developing a clear understanding of such issues.
However, the main objective of this paper is not to provide a set of tangible solutions to the ethical dilemmas, but to inquire into them from multiple perspectives so that future studies may arrive at a working principle which can be applied to specific cases and scenarios. Introduction Multicultural counseling in today’s era of globalization faces the most crucial challenge of combining varied working principles into an accepted norm that can be applied seamlessly to all professional setups.
The multicultural, pluralistic element in counseling has to be taken into consideration while working with people belonging to different ethnic backgrounds and geographic locations. Now what seems to be executable for one group is unlikely to yield satisfactory result for another. Moreover in counseling psychology, there is hardly any ethical guideline that can be adequately referred to as being independent of value judgments. Value judgments are typically based on an individual’s own perspective and it can be imposed in situations that demand different approaches.
Hence, the dilemma arising out of the futility in any singular counseling practice has triggered the requirement of having a profound understanding of culture-specific awareness. This paper is going to evaluate the prevalent trends in ethical decision making in multicultural setups. In the process, the paper will also look into the functional aspects of multicultural counseling preparations and practices. Body As argued by Axelson (1999), the practice of counseling in modern world has been grounded on cultural pluralism.
It is a sine qua non that the desired outcome can only be achieved if external factors concerning language and habits unique to different ethnic groups are channeled through a sieve of unifying parameters. Counseling needs to be as far interactive as possible, so that knowledge and skills of those participating in the counseling can be utilized to the optimum effect. An interactive mode is also going to help bridging the linguistic loopholes that are common to clients participating from different language zones.
Considering the ambit of the topic, literature on ethical decision making has been subject to close scrutiny since the publication of Kitchener’s originative work. The key ethical propositions in counseling have been discussed from manifold perspectives involving ethics of psychology or moral ethics as well as practical issues. It might be noted that the topic in question has a significantly broader scope than any other professional counseling methodology. The purview of study requires a thorough analysis of interdisciplinary conceptual areas such as philosophy and theory.
In addition to this, counselors also need to draw inference from empirical evidences in order to be certain of success in reality. The primary framework of cross-cultural (equivalent to multicultural) counseling, which has been in existence since the inception of work-related settings across the globe, is based on theoretical and philosophical models. This is quite self-explanatory since ethical decision making being an auxiliary part of counseling clearly lacks in preset norms that can be held true for each and every professional circuit.
Observation, intuition and critical thinking form the introductory approach to the field, which is later to be given the necessary impetus from empirical supports. This absence of fixed paradigm calls for reactionary methodologies that are unique to specific cases. Kitchener suggests an integrated model developed by Hare in his famous 1981 work Psychiatric ethics which advocates for moral thinking as a precondition for ethical decision making. What makes this model stand out from contemporary theoretical accounts is its focus on “ethical “rule” of fidelity” (Cottone and Claus, p.
275). Now in our spectrum of study, we would primarily consider Hare’s principles related to the philosophy of ethics. The seemingly contradictory constructs of absolute thinking and utilitarian thinking are considered to be indispensable in ethical decision making practices in modern times. The former is concerned with a utopian and idealistic mindset which is least effective in practical scenarios. It basically concentrates on moral obligations that are true in the actual sense of the term, but are likely to be rendered null and void in dealing with problems that are case-specific.
On the other hand, the latter is ostensibly closer to organizational benefits from both horizontal and vertical indices. If applied to a patient who needs attention and treatment, the latter is a far more potent device capable of delivering the best possible result. The dilemma, however, still persists in one crucial aspect. It is the vagueness of intuitive thinking that seems to pose the main problem. Hare argues that the intuition of a counselor cannot be taken as the final benchmark since it is susceptible to being qualified as insufficient.
Hence the modus operandi or intended course of action based on a misleading intuition is likely to lead to a faulty functional outcome. Hare suggests an alternative methodology involving utilitarian thinking to nullify this possibility (Hare, p. 33-46). It is taken as a premise that human intuition, however infallible it may appear, must not be applied to the task of decision making in a blindfold manner. Theories of moral development have been sought highly relevant in professional ethics.
These theories basically involve moral reasoning and decision analysis. Rest’s seminal work, which was produced categorically for the applied branch of psychology, also discusses a model which critically analyzes a set of procedures involving the production of ethical conduct. Built on four elements, this model addresses some of the focal areas of counseling. Since majority of the components deal with subjectivity of a given situation, it is imperative that we treat the psychological assumptions with due respect.
Prior to the publication of Rest’s work, the practice of counseling was typically restricted to the context of Europe and America (Pedersen, p. 23-28). Preoccupation with psychological assumptions made the study difficult since researchers, counselors and psychiatrists could not identify any generic definition of so-called normal behavior. Moreover, an increasingly volatile economic condition of the nation-state gradually dissolved the concept of collectivism, and propagated that of individualism.
Consequently, unidirectional thinking was necessitated to complement utilitarian thinking, as stated earlier. The idea that emerged out of such a preparatory ground was that “each cause has an effect and each effect has a cause” (Sadeghi et al. , p. 180). For the counselors, this causal principle set a clear working methodology in which they focused on adapting an individual to fit the system instead of the other way round. It has been noticed time and again that ethical counseling done in a professional manner has come under the constraint of ethnic diversity.
To put it precisely, counseling clients belonging to a particular ethnicity has turned out to be far more result-oriented than counseling a cross-cultural clientele (Sue, p. 616-624; Sue & Zane, p. 37-45). The most probable reason cited for this ineffectuality is the absence of culture-specific study materials or other resources available to counselors. Hence, the quality of preparation has always suffered, especially after these practices came to be widely known across geographical frontiers. What seems to fall short of its intended goal is the reach to ethnic minorities.
Counseling methodologies are yet to be imbibed with effective techniques that can settle behavioral and cultural disputes among people who do not have a well-defined or stable cultural identity in a given country. As with any other training and teaching program, ethical counseling too requires identifying areas where the fruition of research can be successfully implemented. Till date, this is markedly absence in matters of ethically minor races. To address such a sensitive issue, researchers and counselors have steadily maintained an approach that would not disprove of pluralistic methodologies.
In a pluralistic model, it is imperative that no particular premise is encouraged to develop. The moment any particular social, political or theoretical viewpoint is put forth as the primary component of the model, the model itself will start malfunctioning in its dealing with case-specific scenarios. Therefore, a sense of balance must be obtained in its entirety for attaining the state of culturally adaptable counseling procedures. Following the notion of adaptability, it is of paramount importance that the ethics of counseling must embody a cross-cultural outlook.
It must oversee external factors including race, cultural plurality and linguistic differences. As stated earlier, the utilitarian mode of thinking may be ideally suited to creating a framework that can take into consideration all these facets simultaneously. What follows next in the line of discussion is the incorporation of certain codes that are mandatory as sophisticated, modernistic tools for ethical counseling. Considering the vagueness and rather tacit aspects of ethical counseling, it is very important that these codes are properly followed to meet the standards of the same.
As per definition, ethical counseling attempts at developing professional relationships grounded on moral principles. The interaction between counselors and clients is preconditioned on certain core values. Any violation in these values is equivalent to breach of trust and hence, leading to the termination of the professional rapport. A counselor should always bear in mind to value personal dignity and individualism of the client. Moreover, the societal side of counseling comes to the fore as the counselor must pay heed to the legal aspects of his practice.
The essential codes of counseling involve a set of principles based on professional integration. Under no circumstances the counseling authority should indulge in practices that are likely to prove defamatory to the person being counseled upon. Similarly, the task of a counselor must, at all cost, be directed at blending individualistic aspects with cultural norms. If we go by the diversified nature of the clientele, which is usually the case, we will be able to understand how crucial it is to wade through an ambit of ethnically versatile client philosophies.
The experience may be a rich one for the counselor, presenting a vast scope of learning, but at the same time, it may also demand utmost care on the counselor’s part. Another important component of the proposed regulatory framework involves good judgment and intent. Ethical counselors must not promote wrongdoing of any sort in their designated fields of work. It is absolutely amoral that any practitioner of ethical counseling should act irresponsibly or whimsically to contravene the client’s trust and sense of dependence.
Therefore, ethical counseling must be propagated as a beneficial cause rather than a harmful one. Valuing the client’s trust is of paramount importance in the practice of ethical counseling. This aspect cannot be underrated as the client, mainstream or minority, seeks confidantes to express their concerns. Hence, it is a matter of serious integrity that the counselor must ensure a comfort zone that would allow the client to feel at home. The counselor’s moral firmness is at stake here since he/she acts like an ethical agent who is responsible for influencing the client’s decision.
The principle of autonomy or helping the client express his/her own value expectations is a serious contention in this regard. It is the duty of the counselor to refrain from impressing the client with his/her own values. The client must be made aware of the fact that instead of depending blindly on the choices prescribed by the counselor, he/she has the right to ask for what he/she wants (Stadler, p. 3). Albeit it is presupposed that the primary field of study entails intuition and action in accordance with the same, the fact cannot be overlooked that ethical counseling also involves the welfare of families and communities.
It rather acts as an indirect offshoot of the fundamental counseling procedure that whatever is done to a particular client is also reflected in the immediate family and community of the patient. So the counseling body should always adapt a procedure or set of procedures that would encourage a broader well-being and safety measures. Similar to any other professional discipline, ethical counseling is also concerned with providing the clients with a range of choices from which they can pick and choose as they please.
It serves the purpose of client satisfaction just as much as it improves counseling skills. Moreover, if a client is given a spectrum of opportunities, there is a high probability that he/she would come back again in future, should there be further necessities. The very concept of professional morality in the wider reference frame of ethical counseling is manifested in the way the counseling organization and its staffs treat one another. Just casting a glance at the ambience of the organization, it is decipherable whether it is qualified as a reliable and efficient functional body or not.
In addition to this criterion, it is also important that the counselor’s decisions must conform to what the client opines. Again, this has direct implication with the practice of respectful treatment of the client. Multifarious channels of communication between the examining party and the examined one help opening up prospective courses of decision making as well as action. For instance, the counselor must first of all decide for himself/herself if he/she is the ideal person to treat a particular client. So understanding one’s own limitations is the foremost prerequisite of counseling practices.
If required, the client needs to be sent to another counselor for better treatment. The likelihood of success is another consideration which the counselor has to take into account before redirecting a client. Empirical evidences have unearthed the fact that chances of success increases when the counselor acts according to the client’s consent. Imposing a decision on the client is less likely to result in intended outcomes. One of the major and often disputable issues in counseling relationships involves the appending of fees.
It is mandatory that all the pertinent discussion over the fee structure and modes of disbursement are settled prior to the commencement of the counseling. Any lingering issue may eventually blow out of proportion, leading to misunderstandings and legal hassles from either end. Moreover, arranging the fee structure needs to comply with market standards and quality of the treatment. William West from the University of Manchester raises one crucial question which may be treated as a lasting dilemma in ethical counseling. It is to do with the idea of ‘informed consent’ or getting a voluntary go-ahead from the client.
West (2002) argues that it is impossible for a client to give consent if he/she is unaccustomed to counseling or appears in his/her maiden counseling session. This clearly suggests that a particular client needs to have that experience under his belt to fully realize the operational methodologies of ethical counseling. The involvement of ethics and moral issues makes the task all the more difficult since a lot of potential hazards may surface in later stages. For example, the client may be seeking therapeutic treatment for a grave problem disrupting his/her routine schedule.
Now this fact alone is enough to deter the person from providing any willful and sensible suggestion that would be beneficiary for his/her own cause in the longer run. Moreover, a psychological loophole may also generate while obtaining consent from the client. The client may be completely in the dark about the likely implications of the consent while giving it. A classic case study cited by William West in this regard concerns the inadvertent malpractice on the part of the physician while asking for a client’s consent in the presence of another person (West, p.
262-263). Formulating a distinctive and reliable agendum for recognizing dilemmas in cross-cultural counseling practices is to a great extent problematized by a veritable paucity of research initiatives. The Delphi methodology, which has been developed specifically as a combination of qualitative and quantitative approaches, is regarded as a benchmark tool for assessing dilemmas (Linstone & Turoff). In a way, this methodology seems to be aptly suited to the interactive mode of communication between the client and the counselor.
Based on formal interviews with minority clients in particular, this methodology helped identifying 15 cross-cultural ethical dilemmas. The subsequent review of literature brought out 4 additional dilemmas which were drawn exclusively on psychology. It is clear from the findings that the proposed model is quite adept at dealing with the topic from a qualitative perspective. Once the analysts were through with the qualitative process, it was time for substantiating the data quantitatively. It was necessary because the theoretical part of the therapeutic studies could not have been supported empirically.
The quantitative analysis was performed through a process called the ‘content validity ratio’ (Cohen, Swerdlik & Phillips). A team of expert counselors was appointed to study the degree and likelihood of ethical dilemmas in the aforesaid 19 cases. Conclusion So we have seen how different models determine the basic research parameters at various levels. While majority of literature on ethical decision making depends on hypothetical measurements, the fact still remains that there are certain key areas that function consistently with evidential limits.
The postulate of rational decision making in ethical counseling is still at large guided by interpersonal skills and motivations. It is nearly impossible to alter the ethical codes according to yardsticks of social righteousness. However, it must be mentioned that minority clients tend to show a far greater inclination toward inconsistency than mainstream clients. If we are to assess this finding, we may come to the conclusion that indigenous clients are socially bounded and hence, their psyche functions in a synchronized manner, as opposed to minority clients who are rootless in majority of situations.
So the working rationale behind ethical decision making has to be drawn from societal factors that correspond to external issues and considerations. What is defining in the study is the feasibility of the discussed models with regards to obtaining inferences from steady and consistent observation. As an applied branch of ethics, one could not have asked for more, especially if one considers the practical constraints of such a vast topic. References Axelson, J. A. (1999). Counseling and development in a multicultural society (3rd ed. ).
Pacific Grove, CA: Brooks/Cole. Cottone, R. R. , & Claus, R. E. (2000). Ethical Decision-Making Models: A Review of the Literature. Journal of Counseling & Development, 275, 78. Hare, R. (1991). Psychiatric ethics (2nd ed. ). Oxford: Oxford University Press. Pedersen, P. (1997). The cultural context of the American Counseling Association code of ethics. Journal of Counseling & Development, 76, 23-28. Sadeghi, M. , Fischer, J. M. , and House, S. G. (2003). Ethical Dilemmas in Multicultural Counseling. Journal of Multicultural Counseling and Development, 31, 180.Sample Essay of EduBirdie.com