Ethical Issues in Pastoral Counseling

1
Ethical Issues in Pastoral Counseling

• C. Jeffrey Terrell, Ph.D., M.Div., President,
  Psychological Studies Institute

2
Demonstrate competence, but remain alert to your
limitations.

• It is good to remember that when something is not
  working, you should stop doing it and do
  something different. Not only is this a basic
  assumption regarding a solution-focused approach,
  it is also true regarding the counselee's right
  to be referred to another counselor when no
  progress is being made.

3
Demonstrate competence, but remain alert to your
limitations.

• The American Counseling Association (ACA) states
  in its code of ethics "If the counselor
  determines an inability to be of professional
  assistance to the counselee, the counselor must
  either avoid initiating the counseling
  relationship or immediately terminate the
  relationship" (1988).

4
Demonstrate competence, but remain alert to your
limitations.

• The American Association of Pastoral Counselors
  (AAPC) states in its code of ethics "We do not
  abandon or neglect clients. If we are unable, or
  unwilling for appropriate reasons, to provide
  professional help or continue a professional
  relationship, every reasonable effort is made to
  arrange for continuation of treatment with
  another professional."

5
Demonstrate competence, but remain alert to your
limitations.

• A counselor using a solution-focused approach
  should be tenacious. My experience reveals that
  focusing on strengths is effective and in harmony
  with scriptural revelation. Yet a pastor is
  ethically constrained to refer if counseling
  remains ineffective. Keep in mind that major
  problems are rarely solved simply or quickly.
  Getting counselees on track to solutions is the
  priority of SFPC. If, after two or three
  sessions, the church counselor remains unable to
  encourage the counselee to achieve an
  outcome-focused shift in thinking, it is time to
  refer.

6
Demonstrate competence, but remain alert to your
limitations.

• If, after two or three sessions, the church
  counselor remains unable to encourage the
  counselee to achieve an outcome-focused shift in
  thinking, it is time to refer.

7
Demonstrate competence, but remain alert to your
limitations.

• A pastor or other Christian counselor should be
  well acquainted with the Christian counseling
  resources within the community. Professional
  Christian counseling agencies, peer self-help
  groups, support groups, crisis intervention
  services-such as those offered for battered wives
  or counseling regarding pregnancy, day-treatment
  programs as well as skill-building workshops-all
  are helpful as referral or adjunct services.

8
Demonstrate competence, but remain alert to your
limitations.

• Professional Christian counseling agencies, peer
  self-help groups, support groups, crisis
  intervention services-such as those offered for
  battered wives or counseling regarding pregnancy,
  day-treatment programs as well as skill-building
  workshops-all are helpful as referral or adjunct
  services.

9
Demonstrate competence, but remain alert to your
limitations.

• Every minister and church leader who is engaged
  in the ministry of counseling should also
  consider the following
• Counselors should have access to qualified
  supervision.
• Consultation with fellow pastors and counselors
  is crucial for maintaining professional
  accountability. The willingness to reach out for
  consultation is evidence of professional
  maturity.
• Consultation is also vital when one is counseling
  those who may be potentially suicidal or
  dangerous to others. I strongly encourage
  membership in a local pastoral counselors
  association when possible.

10
Demonstrate competence, but remain alert to your
limitations.

• It is imperative that suspected physical problems
  be examined by a physician when indicated. Also,
  it is good practice for the pastor to maintain a
  working relationship with a Christian
  psychiatrist for purposes of consultation
  regarding counselees who exhibit bizarre
  behaviors or are deeply depressed.
• Counselors should be aware of cultural
  differences and how they may affect the
  counseling relationship. A counselor may be
  acting unethically when cultural differences are
  not considered.

11
Operate from a clearly defined theoretical
framework.

• Assumptions guide us in the practice of
  counseling. The counselor must clearly
  understand these assumptions, and procedures
  should flow naturally from them. It is important
  for the counselor to have a clear methodology
  that he follows when counseling. Sharing some
  Scriptures or hoping he will think of something
  that will be helpful does not qualify as a clear
  theoretical framework for working with
  individuals who are in crisis.

12
Operate from a clearly defined theoretical
framework.

• Even though the counselee is the expert, the
  counselor must also be skillful and growing in
  proficiency in regard to his chosen methodology.
  He should be improving his skills and knowledge
  through continuing education, counseling
  journals, and publications-preferably with a
  solution-focused emphasis.

13
The rights of the counselee are primary.

• You cannot give what you do not have. The
  counselor models spiritual and emotional health.
  We who are pastors and leaders in the church do
  not need to be perfect, just honest about our
  imperfections. When dishonesty, either subtle or
  obvious, is allowed to take root, the counselor
  may become more concerned with meeting his own
  needs than meeting those of the counselee.

14
The rights of the counselee are primary.

• This dishonesty will be revealed in counseling
  through various facets of the counselor's
  personality. He may manifest any of the
  following a need to demonstrate power and
  control, a need for approval and affection, a
  need to feel respected and appreciated, a need to
  feel qualified as a counselor, a need to impose
  theological positions, a need to be needed, or a
  need to be nurtured. If the counselor has one or
  more of the above needs, he seeks to meet them
  through the counselee. He puts his own needs
  above the counselee's.

15
The rights of the counselee are primary.

• If the counselor has one or more of the above
  needs, he seeks to meet them through the
  counselee. He puts his own needs above the
  counselee's.

16
The rights of the counselee are primary.

• If the counselor is depending, consciously or
  unconsciously, on the counselee for his own
  emotional fulfillment, he may try to maintain the
  counselee in a position of dependence. If he is
  not able to do so, he may begin to resent the
  counselee or feel uncomfortable in his presence.
  It is essential to preserve clear guidelines to
  focus the counseling dialogue. It is more
  effective, and probably more loving, to conduct
  the counseling session professionally-with the
  counselor being primarily conscious of the
  counselee's need for empowerment.

17
Avoid messy dual relationships.

• It is quite difficult to be attentive to the
  counseling relationship while at the same time
  trying to sustain a personal friendship with the
  counselee. Although most SFPC is brief in
  nature, it still places the counselor in a
  position of authority and influence over the
  counselee. There is always a danger of
  indirectly misusing this position.

18
Avoid messy dual relationships.

• Therefore I always refer family members, elders,
  deacons, those who work for me, or those with
  whom I have personal friendships. The reason is
  simple-counseling changes the relationship. This
  is not to say that I would not listen to,
  support, educate, or minister to these
  individuals. What I avoid is a counseling
  relationship.

19
Avoid messy dual relationships.

• The AAPC states, "We recognize the trust placed
  in and the unique power of the therapeutic
  relationship. While acknowledging the complexity
  of some pastoral relationships, we avoid
  exploiting the trust and dependency of clients.
  We avoid those dual relationships with clients
  (e.g., business or close personal relationships)
  which could impair our professional judgment,
  compromise the integrity of the treatment, and/or
  use the relationship for our own gain."

20
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• Most professional codes of ethics maintain that
  the counselee has a right to be given enough
  information in order to make an intelligent
  choice about entering into counseling. For
  example, it is too late-and unethical-to explain
  to a teen from the church's youth group that you
  are going to inform her parents that she is
  pregnant and considering an abortion after she
  has revealed these facts to you.

21
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• Of course, not every church counseling session
  will require disclosure of these responsibilities
  and limitations. There is a balance between
  providing too much information and not giving
  enough. Nevertheless, I have discovered that
  some kind of "informed-consent document" is
  helpful. In it the counselor can briefly state
  in quickly read statements

22
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• the general goals and benefits of counseling
• risks involved in counseling
• limitations and exceptions to confidentiality
• the rights of minors
• the counselor's personal qualifications
• the counselor's responsibilities to the counselee
• the counselee's responsibility to the counseling
  process
• the services the counselee may expect to receive

23
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• Limitations and exceptions to confidentiality
  need to be given careful attention.
  Circumstances surrounding confidentiality are not
  always easily defined and discretion needs to be
  demonstrated. In general, professional
  counselors must break confidentiality when it is
  apparent that the counselee may do serious injury
  to others or to himself or herself. Abuse to
  children and the elderly are required by law to
  be reported.

24
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• In general, professional counselors must break
  confidentiality when it is apparent that the
  counselee may do serious injury to others or to
  himself or herself. Abuse to children and the
  elderly are required by law to be reported.

25
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• General guidelines for confidentiality include
  the following circumstances
• When the counselee may injure either himself or
  others (Do not keep a deadly secret.)
• When the counselor believes that the counselee's
  behavior is bizarre and that he may require
  hospitalization.
• When the counselor believes a counselee under the
  age of sixteen has been victimized through rape,
  incest, child abuse, or some other criminal
  activity.

26
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• It is also important for the counselor to
  remember that he should have no professional
  communication with family or friends of a
  counselee without written permission. Members of
  the AAPC who charge for their services adhere to
  the following statement "We do not disclose
  client confidences to anyone, except where
  mandated by law to prevent a clear and immediate
  danger to someone in the course of a civil,
  criminal or disciplinary action arising from the
  counseling where the pastoral counselor is the
  defendant for purposes of supervision or
  consultation or by previously obtained written
  permission."

27
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• "We do not disclose client confidences to anyone,
  except where mandated by law to prevent a clear
  and immediate danger to someone in the course of
  a civil, criminal or disciplinary action arising
  from the counseling where the pastoral counselor
  is the defendant for purposes of supervision or
  consultation or by previously obtained written
  permission."

28
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• When discussing a counselee in consultation or
  supervision, only first names are used or names
  are changed.

29
Confidentiality must be absolute, unless clearly
part of the informed consent process.

• Although a pastor or Christian leader who is
  counseling within the local church setting may
  not be under these legal obligations, he is
  ethically bound to inform the counselee what his
  criteria are regarding confidentiality.

30
Dont use techniques for which you have no
training.

• There are many diagnostic tests and assessment
  tools that are designed to assess the counselee.
  Therefore some professional therapists take
  social, family, and medical data, using
  personality tests, assess physical behavior, and
  evaluating thought content and mental statusall
  in order to add to their knowledge of the
  counselee and his situation.

31
Dont use techniques for which you have no
training.

• The church counselor should not use such tools
  unless he has been specifically trained to do so.

32
Dont use techniques for which you have no
training.

• Fortunately, SFPC does not depend on gathering
  information it s a treatment procedure.
  Although this counseling approach employs
  pastoral strengths and training, those who use
  it, or any other approach for that matter, should
  receive instruction and supervision.

33
Dont use techniques for which you have no
training.

• The primary challenge for those who follow a
  solution-oriented methodology is to use all their
  knowledge and training to help the counselee to
  become aware of his own expertise. The counselee
  is the expert on his life. Therefore we focus on
  co-creating solutions and trusting the intention
  of the Spirit.