Informed Consent in Counseling

Introduction

Counseling is associated with various ethical issues that may lead to adverse effects for the client, the counselor, or a third party. Informed consent is often regarded as a method to address many problems closely linked to such areas as confidentiality, clients’ safety, and well-being, as well as other people’s safety (Wheeler & Bertram, 2015). Informing clients is also essential for ensuring that their rights will be safeguarded (Bond, 2015). At the same time, informed consent is not a panacea due to the peculiarities of counseling that is based on the principles of no harm, trust, and confidentiality. This paper includes a brief analysis of the importance of informed consent. It is concluded that this document should be as detailed as possible and developed in close collaboration with the client but it can and should often be breached.

It is necessary to start with the discussion of the primary benefits of informed consent. One of the most important tasks for counselors is the development of trustful relationships with clients (Welfel, 2015). It has been acknowledged that counselors can achieve this goal through the discussion of the measures to be taken and approaches to be applied. In simple terms, clients are more collaborative when they are aware of the methods, strategies, and objectives related to the counseling process (Wheeler & Bertram, 2015). Brown, Armstrong, Bore, and Simpson (2017) also claim that informed consent is a way to avoid numerous legal and ethical issues. Counselors tend to address ethical problems in their attempt to act in the best interest of the patient. However, some situations need the involvement of third parties (especially when it comes to working with vulnerable populations), which tends to compromise clients’ confidentiality rights.

In many states, the breach of informed consent is liable in case of high risks of serious harm inflicted on the client or another individual. According to the ACA Code of Ethics, counselors have to take the corresponding measures in case of the presence of predictable harm (Lloyd-Hazlett, Moyer, & Sullivan, 2017). For instance, the well-known Tarasoff case is illustrative as it involved the presence of foreseeable serious harm to a female (Welfel, 2015). Although the mental health professional notified certain authorities, the potential victim was not informed about the threat, which eventually led to her death. The partial disclosure of information resulted in a homicide as the client learned about the breach of confidentiality and stopped attending the sessions.

It is possible to consider another case. Hedlund vs. Superior Court (1983) involved an issue associated with informed consent and confidentiality as well as the protection of third parties (Corey, Schneider Corey, Corey, & Callanan, 2014). A married couple received therapy from a psychological assistant who was told about the client’s intention to harm his partner. The assault occurred in the presence of their child, which led to the legal issue as the mental health professional failed to protect the child. The court decided that the therapist had to undertake all possible measures to protect the potential victim as well as people close to her.

Case Under Analysis

The case under consideration involves the client, Ann, aged 17. Ann has severe depressive symptoms. The girl is quite ready to discuss various issues with the counselor. The counselor suspects that the risk of self-harm is rather high. She decides to address Ann’s parents and discuss possible solutions. However, Ann’s mother is not collaborative and even rejects any problems. Eventually, Ann stops sharing with the counselor, and soon after the conversation between the counselor and Ann’s mother, the teenager drops out and moves to another city.

In this case, the counselor made several mistakes. When treating such cases, it is essential to use the following framework. The counselor has to make sure that the client is aware of their rights. Informed consent is the most effective instrument to reach this goal (Welfel, 2015). The counselor should inform the client about certain cases when they will seek the assistance of other stakeholders. The client should understand that some situations require the involvement of parents, faculty, or even authorities. Of course, this may lead to a certain deterioration of trustful relationships between the counselor and the client.

At the same time, this will ensure the avoidance of legal issues. More importantly, the client can be prepared to address others, and the disclosure of any information will be well-thought. The counselor will understand the severity of symptoms and the readiness of the client to include others in the discussion of the existing problems. However, it is important to remember that the counselor can breach informed consent if there is a high risk of harm as counseling is associated with various unpredictable outcomes.

Conclusion

To sum up, informed consent is an effective tool counselor should use with every client. This instrument can help avoid numerous legal and ethical issues. Mental health professionals can help their clients to collaborate more effectively and cope with their issues faster. Nevertheless, if there is the presence of predictable harm, the counselor has the right and even responsibility to breach informed consent in order to ensure the safety of the client and other individuals.

References

Bond, T. (2015). Standards and ethics for counselling in action (4th ed.). Thousand Oaks, CA: SAGE.

Brown, T., Armstrong, S. A., Bore, S., & Simpson, C. (2017). Using an ethical decision-making model to address ethical dilemmas in school counseling. Journal of School Counseling, 15(13), 1-30.

Corey, G., Schneider Corey, M., Corey, C., & Callanan, P. (2014). Issues and ethics in the helping professions with 2014 ACA codes (9th ed.). Stamford, CT: Cengage Learning.

Lloyd-Hazlett, J., Moyer, M. S., & Sullivan, J. R. (2017). Adolescent risk-taking behaviors: When do student counselors break confidentiality? Journal of Child and Adolescent Counseling, 1-16. Web.

Welfel, E. R. (2015). Ethics in counseling & psychotherapy (6th ed.). Boston, MA: Cengage Learning.

Wheeler, A. M., & Bertram, B. (2015). The counselor and the law: A guide to legal and ethical practice (7th ed.). Alexandria, VA: John Wiley & Sons.