Informed consent refers to the process through which a counsellor ensures that the client
3.1. Obtaining Informed Consent
Informed consent refers to the process through which a counsellor ensures that the client is aware of the potential risks and benefits associated with therapy, assessment, research, and/or other activities in which they may engage. Informed consent means that the client voluntarily agrees to the counselling process, has a right to understand its implications, and has a free choice about participating. Obtaining informed consent is a cornerstone of conducting ethical therapy, research, and assessment, and is required by ethical codes.
Review what the codes of ethics have to say about this topic and incorporate this into your discussions:
- Some may say that informed consent is really about protecting the professional from liability rather than respecting the client’s dignity and freedom. What are the strengths and weaknesses of this argument?
- What should the client know and understand to make a decision that is indeed informed?
3.2. Protecting Confidentiality
Confidentiality is the keystone of effective counselling and psychotherapy because it allows the client to freely share experiences without fear of unwarranted disclosure to others. Confidentiality refers to the ethical principle that compels psychologists to hold secret all information about a client and to keep private any information revealed by a client in confidence unless the client consents to the disclosure of the information to a third party or the law authorize the release of information without the client’s consent.
Review what the codes of ethics have to say about this topic and incorporate this into your discussions:
- Discuss some ways in which you can prepare clients for issues pertaining to confidentiality. What could you do to educate clients about the purposes of confidentiality and the legal restrictions on it? Examine how you would do this in various situations, such as assessment, school counselling, group work, couples and family counselling, and counselling with minors.
- During the counselling session, Paul mentions that he is sexually active, that he sometimes engages in sexual activity that could put his partner at risk, and that he has withheld from his partner that he is HIV positive. Does Paul’s behaviour constitute a threat worthy of a warning to the potential victim? As a counsellor, if you break confidentiality to warn a potential victim, what effect will that have on the therapeutic alliance with Paul and, ultimately, on Paul’s well-being? To whom you have a primary obligation—Paul or someone whom Paul might endanger?
Instructions
Consider the following case for analysis:
Upon completing the MACP program and receiving registration with CCPA six months ago, Emily Blackman as a new counsellor decided to add telephone counselling to the services she provides to clients. One of her clients, Karen White, a 50-year-old woman who struggles with emotional and physical isolation, has a very soft voice, and Blackman has difficulty hearing her accurately even after turning up the phone’s volume. Blackman tried diplomatically to ask her client to speak louder but to no avail.
Frustrated, Blackman decides to put Karen’s calls on speaker, increasing the volume to its maximum capacity. Blackman reasons that although Karen’s voice can now be heard in Blackman’s reception area, clients’ chances of hearing the conversation can be minimal because she is usually finished with Karen’s session before clients physically arrive for appointments.
For this reason, Blackman decides that she does not have to inform Karen that her voice is on speaker. To do so, she believes it would be intimidating and counter therapeutic.
Answer the following questions:
- Discuss Emily’s decision not to inform Karen that the speaker volume is on while she talks.
- What are the justifications for this, if any?
- What are the ethical and legal ramifications of this behaviour?
- Discuss the suitability of using the telephone counselling or other forms of technology in counselling practice for the types of issues with which Emily is presenting.
In the assignment, you must integrate the reference to ethical principles, standards of practice, relevant practice guidelines and legislation specific to the province or territory in which you intend to practice. You may use outside research, but not to replace the material from the course. All work must be cited according to APA format, current edition. Culture/Diversity and Legal/Ethical issues must be included when relevant. Do not type the case analysis into your assignment.
Specific requirements for formatting your Assignments #2:
The paper should be 4-5 pages, double-spaced (excluding the cover page, and the reference list), format your paper in Word (doc or docx only) and use APA style guidelines, current edition. You can write in the first person. Use the questions as headings in the assignment.
When you save your assignments on your computer, you should “save as” using the following formula: First Name Last Name -Course Number-Assignment Number (JohnDoe-PSYC6203-1).
All written assignments should have a cover page (including the title of the assignment, your name, the name of the course, and the date of submission) and be double-spaced throughout (without leaving an extra-space between paragraphs or references; make sure that the “Before” and “After” values for Paragraphs are 0 = zero).
This program uses 7th edition APA style. This is a guide for all professional communication. At the same time, please know that we have program expectations for assignments. These expectations include: 12pt text size, Times New Roman font and no running head. The reference list should only include sources that were used for in-text citations in the paper itself.
- No abstract, introduction or conclusion sections are needed for the assignment. Please include references. Focus on using peer-reviewed journal articles to support the arguments
- The project will be evaluated with respect to organization, clarity, and thoroughness of presentation, and justification of evaluation criteria.
Reminder: As a graduate-level course, student work should be based on critical thinking, not merely on summarizing or paraphrasing material.
Evaluation
The following rubric indicates those areas you should be focusing on in preparing your assignment, and how the professor will weigh these components relative to one another.
| Criteria | % of Assignment Grade |
Presentation, Originality, Relevance, Insight (10%)
| /10 |
Mastery of Material/Comprehensiveness (70%)
| /70 |
Written Quality (20%)
| /20 |
| TOTAL | /100 |
Expert Answer and Explanation
3.1. Obtaining Informed Consent
To some extend I can agree that informed consent is used in protecting the professional from liability rather than respecting the client’s dignity and freedom. The strength of this argument is that the counselor will not be accountable is something goes wrong yet the clients agree to the therapy and because the patient knew the consequences. The weakness of this argument is that the counselors will not be focusing on the dignity of clients.
The clients might agree to a medical process which is inhumane but because they have given their consent, the caregiver will go ahead and implement it. Therefore, it is recommended that informed consent should be accompanied by other codes, such as non-maleficence and respect of human dignity. Canadian Counselling and Psychotherapy Association (2020) note that the therapist must communicate the nature, benefits, risks, and the purpose of the therapy to the client.
Other treatment alternatives (if there are any) should also be communicated to the client to improve their decision-making. The client should also know the fees for the service and the most likely outcomes of the therapy and they should also know who will see their private data. Lastly, the therapist must evaluate if the client is in a capacity to sign the consent form and clients acknowledges that they are informed for the process to be indeed informed.
Reference
Canadian Counselling and Psychotherapy Association. (2020). Code of ethics. Retrieved from https://www.ccpa-accp.ca/wp-content/uploads/2020/05/CCPA-2020-Code-of-Ethics-E-Book-EN.pdf
3.2. Protecting Confidentiality
Clients can be prepared on issues pertaining to confidentiality using a six-step ethical model. The steps include preparation, telling the clients the truth in advance, obtaining informed consent before disclosure, responding to disclosure requests, evading avoidable breach to confidentiality, and talking regarding the issues. I can lecture and discus with clients about the purposes of confidentiality and the legal restrictions on it to educate them about the issues.
Lecturing and discussion can be applied in all the scenarios mentioned in the question. In my opinion, Paul’s behavior does not constitute a threat worthy of a warning to the potential victim because his partner might as well be engaging in sexual activity with other people. His partner might also be HIV positive but has kept it a secret. If I break confidentiality to warn a potential victim I will definitely loss trust of Paul and he might even decide to terminate the professional relationship.
The breach can also impact his psychology because his partner might decide to leave him (Canadian Counselling and Psychotherapy Association, 2020). My primary obligation is to Paul because his secret is not lethal and does not worth breaching confidentiality with the client.
Reference
Canadian Counselling and Psychotherapy Association. (2020). Code of ethics. Retrieved from https://www.ccpa-accp.ca/wp-content/uploads/2020/05/CCPA-2020-Code-of-Ethics-E-Book-EN.pdf
Case Analysis II
1. Discuss Emily’s decision not to inform Karen that the speaker volume is on while she talks.
Emily’s decision has to deal with informed consent. Though Blackman reasons that her client’s voice cannot be heard by other people because she is always finished before other clients come for a physical appointment. There is a possibility that their conversation can be heard because of their voices and reach the Blackman’s reception area. One day, one of her clients might bump in while they are talking, and this could jeopardize their confidentiality.
As a result, Blackman should give the client a chance to think and decide whether they can continue talking over the speaker despite the danger of their confidentiality being breached. Counseling is about the client and the belief that informing the client about the issue is intimidating and counters therapeutic makes the therapy about the counselor (Canadian Counselling and Psychotherapy Association, 2020). Also, failing to inform Karen about putting her voice on a loudspeaker denies her the right to make decisions about how her therapy should be conducted.
Blackman might face legal actions if Karen gets hurts by the therapy done on speaker volume. When asking about the client’s informed consent, Blackman should let her know why she is opting to put their conversation on the loudspeaker (CCPA, 2020). She can tell Karen that her voice is soft and cannot be heard clearly without putting the call on a loudspeaker. Blackman should also explain the consequences of putting the conversation on the loudspeaker and that it can be heard by other clients in the reception.
Blackman should also note that this can breach her confidentiality. The benefit of the action should also be explained so that the client can have a full picture of the situation. Karen should then be allowed to make an informed decision based on the information provided. If Blackman fails to tell the client of the situation, she would be breaching boundaries and risk cancelation of her license.
2. What are the justifications for this, if any?
There is no justification for this behavior. Failing to follow provided laws governing telephone counseling has no justification. The counselor is worried that informing the client will be intimidating and counter therapeutic. She is only concerned about her welfare and not that of the client. By doing this, the counselor would have gone against the following ethical principles.
The first ethical principle is respecting the dignity of persons and people (Canadian Psychological Association, 2017). The client would have obtained informed consent by explaining to the client the reasons behind the decision. However, failing to do so denied the client of her freedom of consent. The psychologist also failed to address the issue of privacy and confidentiality. She should have told Karen that putting her voice on a loudspeaker could breach her privacy and confidentiality, and as a result, it seemed that Karen was not treated humanely.
The second ethical principle that is being breached in the case study is responsible for caring. Emily is not being competent by continuing with therapy, yet she knows that the client’s voice can be heard as far as the reception. As described by the National Board for Certified Counselors (2016), competence can be achieved by maximizing therapeutic benefits and minimizing harms during counseling.
Emily can maximize the benefits of telephone therapy by using other alternatives, such as messaging to communicate with the client instead of putting Karen’s information at risk of being heard by unauthorized third parties. If Emily has a secretary, the secretary will hear the client’s voice in case they are in and the therapy session is taking place. Overall, based on the arguments I have raised above, Blackman is no ethical or legal justification to continue the therapy with the client’s voice on a loudspeaker.
3. What are the ethical and legal ramifications of this behaviour?
Emily’s behavior has many ethical and legal ramifications. The following are some of the ethical and legal ramifications for continuing with the therapy with the client’s voice on a loudspeaker. First, Emily might face disciplinary action if the client’s data is leaked to unauthorized people. She might be called by the National Board for Certified Counselors and asked not to conduct her duties for some time as a punishment for being careless (NBCC, 2016).
As a counselor, she is expected to protect the privacy and confidentiality of the client. When she is found guilty of negligence, she might even lose her practice license and banned from practicing in the territory she is or Canada (Noroozi et al., 2018). However, she will be provided disciplinary proceedings under the health professional’s regulatory statute to give her a chance of fair trial.
The client might even decide to sue Emily if the leaked information damaged her image and reputation. Therefore, Emily might be asked by the judicial system to compensate the client for damages suffered. The client might argue that she was not aware that her voice was on the loudspeaker and she has not consented to the action.
Ethically, Emily’s reputation and values might be damaged and no client will be willing to trust her again. Counseling is a profession that can only be achieved if the client trusts the counselor (Martin et al., 2015). However, if the clients lose trust in their psychologists, their relationship will be damaged automatically. Karen’s condition might worsen if their conversation leaks, and this goes against the ethical principle of not harming clients. Psychologists are required to do good and implement practices and are in the best interest of the client and avoid harming them.
4. Discuss the suitability of using the telephone counselling or other forms of technology in counselling practice for the types of issues with which Karen is presenting.
Telephone counseling or other forms of technology in counseling practice are suitable when clients cannot attend physical counseling sessions for one reason or another. Telephones are also available, accessible 24/7, and affordable compared to physical counseling. In the case study, Karen has said that she is struggling with emotional and physical isolation. In my opinion, telephone counseling will not be suitable for the following two reasons. First, when counseling a client with emotional problems, the psychologist is required to observe how the patient is behaving, her dressing code, eye contact, and other non-verbal communications (Byaruhanga et al., 2017).
However, when talking over the phone, the counselor cannot accurately measure the degree of the problem. Therefore, if I were Emily, I would select video counseling where I will see the client in more detail. Second, no seeing a counselor in person could be an issue for some people, especially Karen who feels physically isolated. Asking her to come to the therapy in person can allow her to meet friends even in the office. She can find other patients seated in the office and start bonding with them. The telephone is one of the technological elements that have improved physical isolation because instead of visiting friends, people prefer to talk through the gadget.
References
Byaruhanga, J., Atorkey, P., McLaughlin, M., Brown, A., Byrnes, E., Paul, C., … & Tzelepis, F. (2020). Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review. Journal of medical Internet research, 22(9), e18621. https://www.jmir.org/2020/9/e18621/
Canadian Counselling and Psychotherapy Association. (2020). Code of ethics. Retrieved from https://www.ccpa-accp.ca/wp-content/uploads/2020/05/CCPA-2020-Code-of-Ethics-E-Book-EN.pdf
Canadian Psychological Association. (2017). Canadian code of ethics for psychologists. Fourth edition. Ottawa, ON: Author. Retrieve from https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf
Martin, L., Shepard, B., & Lehr, R. (Eds.). (2015). Canadian counselling and psychotherapy experience: Ethics-based issues and cases. Ottawa, ON: Canadian Counselling and Psychotherapy Association.
National Board for Certified Counselors. (2016) Policy regarding the provision of distance professional services. Retrieve from https://www.nbcc.org/Assets/Ethics/NBCCPolicyRegardingPracticeofDistanceCounselingBoard.pdf
Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iranian journal of public health, 47(6), 875. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077627/
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FAQs
What is confidentiality in counselling?
Confidentiality in counseling refers to the ethical obligation of therapists or counselors to keep the information shared by their clients private and not disclose it to others without the client’s explicit consent. This principle is crucial in maintaining trust and creating a safe space for clients to open up and share their thoughts, feelings, and experiences during counseling sessions.
Why is confidentiality important in counseling a client?
Several reasons highlight the importance of confidentiality in counseling:
- Trust Building: Confidentiality is fundamental in building a trusting relationship between the counselor and the client. When clients feel assured that their personal information will not be divulged without their permission, they are more likely to be open and honest in their discussions.
- Safety and Comfort: Knowing that their information is confidential creates a sense of safety and comfort for clients. This psychological safety is essential for clients to explore sensitive and potentially distressing issues without fear of judgment or reprisal.
- Encourages Open Communication: Confidentiality encourages open and candid communication between the counselor and the client. Clients are more likely to share their deepest concerns, fears, and experiences when they believe that the information will be held in strict confidence.
- Legal and Ethical Obligation: In many jurisdictions, confidentiality is not just an ethical principle but also a legal requirement. Mental health professionals are bound by laws and codes of ethics that mandate the protection of client confidentiality.
- Respect for Autonomy: Respecting clients’ autonomy is a fundamental aspect of counseling. Confidentiality upholds the client’s right to control the disclosure of their personal information, promoting a sense of empowerment and control over their own therapeutic process.
- Promotes Effective Therapy: When clients trust that their information is kept confidential, they are more likely to engage in the therapeutic process fully. This, in turn, enhances the effectiveness of counseling and contributes to positive therapeutic outcomes.
- Reduces Stigma: The assurance of confidentiality helps reduce the stigma associated with seeking counseling. Clients may be more willing to seek help when they know that their private matters will be kept confidential, minimizing the fear of judgment from others.
It’s important to note that there are exceptions to confidentiality, such as when there is a risk of harm to the client or others. Counselors are typically obligated to breach confidentiality in situations involving imminent danger, child abuse, elder abuse, or when required by law.
Why is it Important to Gain Consent from an Individual
In our interactions with others, whether personal or professional, gaining consent plays a crucial role. Consent serves as the foundation for ethical and respectful communication, ensuring that individuals have the autonomy to make informed decisions about their own lives. This article explores the importance of obtaining consent from an individual across various contexts, highlighting the ethical, legal, and practical reasons behind this fundamental principle.
Definition of Consent
Before delving into the significance of consent, it is essential to establish a clear understanding of its meaning. Consent refers to the voluntary and informed agreement or permission given by an individual for a specific action, decision, or interaction. It involves understanding the relevant information, being mentally capable of making a decision, and providing consent without any form of coercion or manipulation.
Importance of Consent
Respect for Autonomy
Gaining consent from an individual is an essential aspect of respecting their autonomy. Autonomy refers to an individual’s right to self-governance and make decisions based on their own values and beliefs. By obtaining consent, we acknowledge and honor this inherent human right, allowing individuals to exercise control over their lives and choices.
Ethical Considerations
Consent is a cornerstone of ethical conduct in personal and professional relationships. It ensures that actions and decisions are made with the full knowledge and agreement of all parties involved. Without consent, actions may infringe upon personal boundaries, leading to emotional distress, conflicts, and even harm. Respecting others’ autonomy through consent fosters trust, empathy, and healthy communication.
Legal Implications
Consent holds significant legal implications in various domains. In many jurisdictions, obtaining consent is mandatory in specific situations, such as medical procedures, research participation, and contractual agreements. Failing to obtain consent can result in legal consequences, including civil lawsuits, criminal charges, and reputational damage. Adhering to consent requirements helps individuals and organizations stay compliant with legal frameworks and regulations.
Consent in Personal Relationships
Within personal relationships, obtaining consent is vital for maintaining healthy and respectful interactions.
Establishing Boundaries
Consent allows individuals to establish and communicate their boundaries, creating a safe environment for emotional and physical intimacy. By seeking consent, we demonstrate respect for personal limits and ensure that all parties involved are comfortable and willing to engage in specific activities.
Mutual Understanding
Consent fosters mutual understanding and communication between individuals. It encourages open dialogue, allowing partners to discuss their desires, preferences, and concerns. Through consent, individuals can navigate complex dynamics and negotiate agreements that are mutually satisfying and beneficial.
Building Trust
Consent forms the foundation of trust within personal relationships. By prioritizing consent, individuals demonstrate their commitment to respecting each other’s autonomy and well-being. Trust flourishes when individuals feel heard, valued, and empowered to make choices without fear of coercion or manipulation.
Consent in Healthcare
In the healthcare sector, obtaining informed consent is crucial to uphold patient rights and ensure ethical medical practices.
Patient Rights and Autonomy
Obtaining consent is an integral part of respecting patients’ rights and autonomy in healthcare. Patients have the right to be informed about their diagnosis, treatment options, potential risks, and benefits. Gaining their consent empowers them to actively participate in their healthcare decisions and promotes patient-centered care.
Informed Decision-Making
Consent enables informed decision-making in healthcare. Healthcare providers must present all relevant information to patients, including potential alternatives and associated risks. By obtaining consent, healthcare professionals uphold transparency and support patients in making choices aligned with their values and preferences.
Medical Research and Clinical Trials
Consent plays a crucial role in medical research and clinical trials. Researchers must obtain informed consent from participants before involving them in studies. This ensures that participants understand the purpose, procedures, potential risks, and benefits of the research. Respecting participants’ autonomy and obtaining their consent is essential for conducting ethically sound and valid studies.
Consent in Business and Marketing
Obtaining consent is also relevant in the context of business and marketing practices.
Privacy and Data Protection
Consent is crucial in maintaining individuals’ privacy and protecting their personal data. Businesses must obtain consent from individuals before collecting, storing, or processing their personal information. This ensures compliance with data protection laws and builds trust with customers, who have the right to control their personal data.
Email Marketing and Subscriptions
In email marketing campaigns, obtaining consent is vital to respect recipients’ preferences. Businesses should seek explicit consent before sending promotional emails or newsletters. This practice fosters a positive relationship with customers and reduces the risk of being perceived as intrusive or engaging in spamming practices.
User Consent for Cookies and Tracking
Websites often use cookies and tracking mechanisms to gather user data. However, businesses must obtain users’ consent before implementing such practices. This allows individuals to make an informed choice regarding their online privacy and helps businesses adhere to data protection regulations.
Consent in Legal and Law Enforcement
Consent holds particular significance within the legal and law enforcement domains.
Search and Seizure
Law enforcement authorities generally require a warrant or consent to conduct searches and seizures. Without consent or a valid warrant, searches may be deemed unconstitutional and infringing upon individuals’ rights. Consent plays a vital role in maintaining the balance between public safety and individual privacy.
Contracts and Agreements
In the realm of legal contracts, consent is a fundamental element. Contracts require the voluntary agreement of all parties involved. Obtaining consent ensures that individuals enter into agreements willingly, with a clear understanding of their rights, obligations, and potential consequences.
Criminal Investigations
Consent is also relevant in criminal investigations. For example, obtaining consent for search warrants, surveillance, or interviewing witnesses plays a crucial role in gathering evidence lawfully. Consent ensures compliance with legal procedures while respecting individuals’ rights.
Challenges in Obtaining Consent
Obtaining consent can present challenges that need to be navigated thoughtfully and responsibly.
Communication and Clarity
One of the challenges is ensuring clear and effective communication about what consent entails. Providing comprehensive information, addressing questions, and clarifying expectations can mitigate misunderstandings and ensure that consent is fully informed.
Power Dynamics and Coercion
Power dynamics can affect the ability to obtain meaningful consent. Individuals in positions of authority or influence may exert undue pressure or coercion, undermining the voluntary nature of consent. It is crucial to recognize and address these power imbalances to ensure that consent is freely given.
Vulnerable Populations and Informed Consent
Obtaining informed consent from vulnerable populations, such as minors, individuals with cognitive impairments, or those facing social or economic disadvantages, requires special attention. Extra safeguards must be in place to protect their rights and ensure their understanding of the situation and implications.
Steps for Obtaining Consent
To ensure effective and meaningful consent, several steps can be followed:
Clear and Understandable Information
Providing clear, concise, and easily understandable information is crucial for obtaining informed consent. Individuals need to comprehend the relevant details, including risks, benefits, alternatives, and their rights.
Voluntary and Freely Given Consent
Consent must be voluntary and freely given, without any form of coercion, manipulation, or pressure. Individuals should have the right to refuse or withdraw their consent at any point without facing adverse consequences.
Documentation and Record-Keeping
It is essential to document and maintain records of obtained consent. This documentation serves as evidence of the individual’s agreement and ensures compliance with legal requirements. It also helps in addressing any potential disputes or misunderstandings that may arise in the future.
Conclusion
Gaining consent from individuals is of paramount importance in various aspects of life. Whether in personal relationships, healthcare settings, business transactions, or legal contexts, consent upholds respect for autonomy, promotes ethical conduct, and ensures compliance with legal obligations. By prioritizing consent, we foster healthier and more equitable interactions, empowering individuals to make informed decisions about their lives.
FAQs
Q1: What happens if consent is not obtained? A: Failing to obtain consent can lead to various consequences, including damaged relationships, legal repercussions, and ethical violations.
Q2: Is consent always required? A: Yes, in most situations involving interactions with others, consent is essential for ethical, legal, and respectful engagement.
