Tag Archives: Ethics

Why love and counseling don’t mix – ethical Loophole 4

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Falling in love in recovery.
Photo courtesy of Pixabay.com

This time love is not the answer.

We thoroughly enjoy our romance. Everyone can connect with the story of Cinderella and the price, wouldn’t it be nice if every commoner girl could find and marry her prince charming?

There is a whole category of books devoted to romance. There are plenty of films that script out the story of someone who finally meets this wonderful person who makes their life complete, and they live happily ever after. It is when we try to bring that fantasy into the real world that things go wrong.

Men, particularly older men have this fantasy, that should some woman, usually, a beautiful younger woman, enter their life, they will have wild passionate sex and live happily ever after. As long as this stays in the world of fiction this may cause few problems.

When these fantasies make their way into the counseling room this looks less like a flowery romance and more like a fatal car crash viewed in slow motion.

It is not unusual for a client to find they are falling in love with their therapist. They may be weak, vulnerable, and needing love and affection. Clinicians are taught to be aware of this and to work on helping the client learn to love again without taking unfair advantage of the client and becoming that new romantic partner.

Some codes of ethics say that a therapist or counselor should never date or become romantically involved. Some set limits, 2 years, five years, or more. The thought here is that after many years of not being in a professional relationship, then should you meet a former client on a cruise or at a school function you might establish a relationship. Even here the counselor is supposed to make a note in the chart indicating they thought about this, that enough time has passed and they believe this will not harm the client.

This is critical; will falling in love with former client harm them? By the way, ending therapy and giving the client a love letter saying call me in two years on date X and then we can date. That is just as bad as starting up the relationship while the counselor is still seeing them.

Given all these warnings why do counselors still engage in romantic and sexual relationships with clients?

Every time the new professional magazine arrives we see a list of professionals whose licenses have been suspended or revoked. Counselors who started using drugs or abused alcohol is always a big one. But right up there, sometimes in first place, are the reports of therapists that engaged in sex with a client.

Why does this happen? What is the ethical loophole that people stick their heads through that ends up strangling them?

Frequently this ethics issue begins with the counselor entertaining the notion that yes sometimes it is possible to fall in love with a client and live happier ever after. No, they would not do it, but they can see how it might be all right sometimes for some counselors and clients.

This can also start with the idea that it is possible for a counselor to develop an outside social relationship or friendship, without it becoming sexual. Sometimes it starts with attending a social event, going to a movie or having dinner together. There are all the usual excuses, the client needs to feel safe going out, we are helping them learn to make friends or socialize.

But having once said that it may be OK to have some dual relationship with a client that sometimes it might be OK for some counselors and clients to fall in love and have a romantic sexual relationship, it becomes possible that this time, they and this client, that is one of those exceptions to the rule.

Once we start making exceptions, looking for loopholes, sooner or later we are at risk to put our heads through that hole. Why should we care if an occasional therapist has sex with a client, maybe the code of ethics is too strict?

We should care because those relationships are inherently unequal and have a serious potential to harm the weaker party, commonly this weaker person is the client.

Falling in love with a client, that one is always a bad idea. Beware the tendency to look for loopholes. Many an unwary counselor has tried to put their head through this one and ended up hung.

David Joel Miller, LMFT, LPCC

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Money and Friendships can cost you – ethical loophole #3

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Ethics

Ethical loopholes strangle.
Photo courtesy of Pixabay.com

Dual relationships get a lot of counselors and clients into trouble.

Having multiple relationships can mess up therapy.

The big obvious one is sex, we will talk about that one later, but there are a bunch of other dual or “multiple” relationships that can cause problems. Here are some examples.

The client doesn’t have money to feed her kids; can I pay her to clean my house?

This sounds harmless enough. Counselors want to help people, that is why they became a counselor in the first place. So they might try to help out. Maybe give the client a little money. What about bus fare home? What about hiring the client to do a part-time job around the house? All this sounds good until it goes wrong.

You give that client bus fare once. They tell some friends who all ask you for bus fare. You have to start saying no. Now you have to tell that first client no. Then they all complain to your boss. Why does client X get bus fare and I don’t? Why did you give it to me and then take it away when I did not do what you wanted? See how that good deed can come back to get you?

What about paying them to help you? They could mow the lawn or clean your house. What if the lawnmower goes missing right after they cut that lawn? What do you do if your jewelry is missing? Can you make a police report on a client? Doesn’t that violate confidentiality? How can you explain that away?

The client is new to the city and does not have any friends. The counselor invites them, to attend church with them. The counselor goes and picks the client up and takes them to church. What could be wrong with that?

You are their therapist; you have power over their life. They are in a weak vulnerable position and you tell them they need to attend church and you are taking them to yours. Can they really say no? Will you withdraw care, stop seeing them if they say no?

What if their religious or spiritual tradition is one you do not approve of? Will you pressure them to convert? What if they consider your religion a “cult” will they be able to say no?

Think this doesn’t happen? Clients tell me, they have been told that their child protective services worker wants to be sure that their children are being raised in a “good Christian home.”  Does that constitute bias? Can the client say anything if they risk having their children taken away or if they have a mental health issue or substance abuse problems? Could those problems be used against them?

Revealing your religious preference to a provider can result in discrimination, loss of jobs, denial of promotion, or even make you the victim of physical violence. That’s why in this day and age members of some religious traditions still need to use the “decline to state” response to the question about religious preference.

I am not saying that all discussions of religious or spiritual values should be off the table in therapy. People with a spiritual connection do better in recovery. What is a problem is when the therapist crosses the line from listening to the client about what the client believes to doing a sales pitch or enabling the client to follow the counselor’s religion.

Encouraging them to practice a religious or spiritual tradition is a yes. Telling them they need to come to Zoroaster is a no.

Counselors do not have to stop going to church or another religious gathering place because their client attends, but they need to be very careful about transporting or arranging to meet clients there. It is probably an ethical boundary violation to be seeing someone in therapy that you also sit in a religious service and socialize with.

Wow! That new client just told me about this great money-making deal.

Money and client relationships, what a dangerous mix. Yes, we have to think about money. We need to get paid. But when we start thinking about money or other things first this can be a trap.

Investing money in a client’s business or investment opportunity or asking them to invest in one of yours, these are all bad ideas.

Lending money to your therapist is an absolute NO! If your counselor asks to borrow money run as fast as you can. Consider lodging a complaint on your way out to the appropriate person.

Think also about insider trading issues. Do you want to end up in court because you made an investment based on a tip from a client? Clients, do you want your therapist testifying in court about your therapy session and how this investment idea came up in the first place?

All of these ethics issues can start with just that little finger through the ethical loophole. Giving someone bus fare out of your own pocket, paying them a few bucks to mow their lawn, becoming involved in their religious or social activities, all of these can lead to trouble.

Client, I know that you may like your therapist, want to do something nice but remember that their ethics code like a priest vow of poverty may preclude them from accepting gifts, stock tips or other offers by you to do things for them.

For me, as a therapist, the best gift a client can give me is to tell me that something we did in session has helped them have the happy life they want. Hearing that I have been able to help, that makes my day.

Sorry if we can’t hang out or attend some social events together. I like you as a person but I respect our professional relationship and you as a client too much to mess this up by getting into another dual relationship with a client.

Next Friday ethics part 4 – the bad news for all you romantics at heart. Why falling in love with clients or your therapist so often ends so very badly.

David Joel Miller, LMFT, LPCC

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

4 Ethical Loopholes strangle therapists

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Ethical loopholes strangle.
Photo courtesy of Pixabay.com

4 Ethical Loopholes Strangle Therapists – Part 1.

Therapists who violate codes of ethics harm clients; they also may lose their licenses or ruin their carriers. Often these ethical breaches start with thinking that there might be sometimes when it is OK to make an exception to an ethical standard.

Not following ethical guidelines can harm clients. Making exceptions to ethical codes can be fatal flaws.

Therapists are taught codes of ethics in school. We take exams that include questions on laws and ethics or may even need to take a separate law and ethics exam. Every few years most of us have to take a refresher course in law and ethics. Still, people violate these guidelines. Why?

Somewhere down the line, some professionals start looking for loopholes, exceptions to those ethical requirements. When they do this, put their head through that ethical loophole, too often they can get strangled and lose their licenses or lose the trust of their clients.

Four ethical violations seem to create the most problems for clients and therapists. Most of these violations start with the professional think that while this rule is a good one there might be times when someone, not them of course, but another therapist, might do this and that would be OK. Once you have been able to picture a time when there might be an exception to this ethical rule it is likely that you will cross that boundary and try to put your head through that loophole.

Most therapists think immediately about the ethical standard that says no sex with clients. They know that if you think that might EVER be OK then you are at risk to do it. While this is huge for therapists, it may not be the ethical violation that harms the client the most.

Here are the Big 4 ethical violations in their order of harm to the client

1. Not keeping what clients say confidential.

When I get away from other professionals, out in the community this comes up more than I thought it would. Look at the list of top posts on this blog. Month after month people search for information about what is and is not kept confidential. Unfortunately, I also hear too many stories about how a therapist told that client’s story somewhere, someone recognized them from the story and this has hurt them when a family member, friend, or boss found out.

Knowing that the way counseling helps is because of the relationship and that strict confidentiality is fundamental to that confidentiality, how do so many professionals cross that line?

The first stretch through this loophole often happens innocently. Here is a HYPOTHETICAL example.

The therapist is somewhere and is asked about a particular mental health disorder. “Is there any treatment for Trichotillomania?”

“Sure there is, the therapist says. “I saw a client recently with Trichotillomania. She has suffered a trauma and began pulling out her hair uncontrollably, almost unconsciously. I treated her using treatment “X” and she got better.”

So far so good. But the therapist wants to sound great, impress this person, and get more referrals. He or she is thinking maybe I should become the authority on treating trichotillomania in this town. So they go on to tell more.

This was a tough case you know. Her family is very influential in this town. Her father is a prominent politician in this town and he did not want this getting out in his district or it might affect his reelection campaign. That district on the “X” side of town is awful conservative.

Is there a problem now? Sure there is. This is way too much information and has identified that client to anyone who thinks about this for over 5 seconds.

One little story – what harm?

But the next time the story gets more elaborate and before long this clinician is talking about their clients all over. They even decide to warn their church group about that sexual offender that has moved in on the same block as the church. What harm can there be in helping people keep their children safe?

The harm comes first because they have violated that client’s trust and eventually someone will find out and then it turns major. The harm may also include attacks on that client. Sometimes that registered sex offender, the one that the counselor warned people about, what he did was when he was 18 he had sex with his 17-year-old girlfriend and her parents pressed charges. This couple since has gotten married but he could still turn up on a list of sexual offenders.

If this therapist has a private practice and people find out about this they may just stop going to see them. But if the clients are low-income and have to go to a government-funded clinic they may not be allowed to change therapists. They may just stop coming and they will be counted, not as victims of the system but as treatment failures and drop-outs.

You would think a profession like counseling would police itself. Not usually. The complaint in this situation is most effective if it comes from the client. But then the client already afraid because of the harm done to them, that registered sex offender or Muslim may be getting death threats at this point, probably just wants to escape the system.

Other professionals may hesitate to report this. It is their word against the others. Whistleblowers can and do get punished. Also because this happened to a client there may be minimal ways that this can be reported by another counselor without violating this client’s confidentiality again. All of these are ethical and practical concerns.

Oh my! I am past 900 words and have only talked about one of four ways ethical boundary violations hurt clients.

One caution here – Ethical guidelines are just that “Guidelines” not hard and fast rules. So any professional, at any point, is in danger and may have a problem with something. What I am talking about here are the big problems and the professionals who repeatedly break these ethical principles.

In the future, I want to talk about other ethical problems also. My plan is to talk about one of these problems each Friday for the next three weeks. This post was mainly aimed at counselors and would-be counselors, but then I thought others might be interested in the ethical dilemmas we confront.

Here are ethical issues number two, three, and four.

2. Thinking that it is OK to party a little. If you just chip on the weekends how can that hurt clients?

3. Dual Relationships, hiring clients to work for you, getting them to loan you money or loaning them money, especially getting into investments together.

4. Falling in love and getting into sexual relationships with clients. We all want to believe in Snow White and Prince Charming but if a therapist falls in love with a client who came to him with a mental illness, this may turn out more like a sexual predator than a prince.

Let’s look at these three problems over the next three weeks.

Since we are over on words today I will skip the links to other stuff, you know where to find me. Check the categories to the right for more on other mental health and substance abuse issues.

David Joel Miller, LMFT, LPCC

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Does your family know right from wrong? Moral Reasoning

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Ethics

Ethical loopholes strangle.
Photo courtesy of Pixabay.com

How did those in your life learn right and wrong?

If you look around these days you start to wonder if anyone knows the difference between right and wrong. All-day and every night the media is full of stories about wrongdoing. Each successive incident seems to top the last for cruelty and wrongness. It would be easy to become pessimistic.

The optimist will point to any number of past incidents of wrongdoing and say we are making progress. There are laws designed to prevent wrongdoing on an individual level and more worldwide awareness that when something wrong occurs anywhere in the world it affects all of us.

Occasionally we see a young child who has done some great deed of kindness and at a tender age has an apparent grasp of right and wrong, but that is the exception and not the rule. There are always more stories about some youth who has done some unspeakable deed.

Think for a moment about how you learned right and wrong. Did you have to figure it out for yourself or did someone teach you? If someone taught you, who? Have you continued to accept everything they told you or did you ever question? If you have children how are they learning right and wrong, from you or from someone else?

How do people learn right from wrong and how might we increase the number of people who know the difference?

There appears to be a process that people need to go through to learn the difference between right and wrong. What they learn depends on the student, the teachers, and the way the lessons are presented.

Just because you act well around your children or your spouse does not mean that those family members will learn your understanding of right and wrong. There are lots of things that can interfere with the process of learning right from wrong.

First the process of learning right and wrong and then how it can go awry. In my life, plenty of people have tried to tell me the difference between right and wrong. Most times they did not agree and they have various formulas for determining the difference between these two options. A few people assert that there really is no difference, that truth and falsehood like right and wrong are all relative.

This relative position may have appeal as a philosophy, but it is not much help if you are being beaten, robbed, or raped or if your teen is standing before a judge charged with a felony.

The idea that people learn the skill of “moral reasoning” comes from the work of Lawrence Kohlberg. I was first exposed to this concept when I read Dr. Lakona’s book Raising Good Children. These steps or stages of moral reasoning are sometimes subdivided as they develop and change over time. I will summarize their ideas from memory so if errors creep in they are my errors.

A. Primitive right and wrong.

It is fair if I get what I want and not fair if I do not get what I want. The young child might say “It’s not fair I did not get a red one and I wanted a red one.” Fairness and right and wrong are all about getting what you want. Other people’s wishes do not enter the equations.

This approach is understandable in very young children and dictators of countries but we expect most other people to outgrow this way of seeing right and wrong. Our prisons and banks are full of people who do not appear to have outgrown this way of determining right and wrong.

B. You do for me and I will do for you.

In this version, we trade right and wrong. This comes from learning to share with siblings and playmates. So if you do something nice for me I owe you a good deed. If I do for you and you do not reciprocate then I can do whatever I want.

This stage of moral reason comes up sometimes in relationship or marriage counseling. One party believes they have been wronged by the other and therefore they are justified in doing something to hurt the other party.

People who stay stuck in this tit-for-tat stage of moral reasoning are destined to be disappointed and have a life full of conflict or they become a permanent victim as others let them down.

C. Mommy says.

Eventually, most people begin to resolve their moral dilemmas by resorting to authority’s opinions. At first, it may be mommy and then later it will become the teacher.

Plenty of people abrogate their need to determine right or wrong by following a leader and asserting that if the leader says it is right then they should know.

This faith in authority explains why people can be convinced to follow a leader and do horrific things because that leader told them it was the right thing to do. If that leader can convince you that God or correct politics is on his side then you might be convinced that killing others was a moral thing to do. Even if in the back of your mind you question this leader, the weight of others who follow the same leader will pressure you to adopt that leader’s version of right and wrong.

Peers are also authorities.

Somewhere in the adolescent years, our peers start having more influence on us than adults. If you join a gang, then their norms become your criteria for right and wrong. If you hang with drug addicts then you develop a “hustle” and stealing or other criminal activities stops being wrong and becomes acceptable.

In a previous post, I wrote about why trying to resist peer pressure is a choice doomed to failure and why sooner or later all humans give in to peer pressure or change their peers.

D. The rule or the law.

Many people come to believe in the rule of law. They memorize the law, regulation, or bylaws of an organization. Their appeal for right and wrong always goes to what the law says. People quote the constitution or other law as evidence for their belief in what is right and wrong. We have a supreme court to make just those fine distinctions as both sides in the argument can see how the law agrees with what they want the right and the wrong to be.

Others resort to a particular religious book, the Bible the Koran, or what have you. They are often adept at finding a verse to quote that establishes that they are correct in their view of right and wrong. As with other laws, these religious documents may also have other portions that lead to a different interpretation and there are religious wars a plenty over which religious book is the right one or the wrong one.

It is reassuring if you can find guidance in a book or law that eliminates the need to judge right and wrong but it does not always lead to a correct way of behaving.

E. Higher Values.

Beyond all these ways of separating right from wrong, there is in most of us a gut sense that regardless of what the authorities say, what our friends may tell us, or the holy book appears to be revealing, there is this fundamental thing that just does not feel right.

We have established by war crime trials, though some will disagree with this, that just because your party, leader, law, or religious book seems to sanction a practice there are some things that are inherently wrong and should not be done regardless of who says to do them.

Not everyone reaches or wants to reach this higher level of moral reasoning but it should be something that is encouraged if we want to avoid the excess of relying on leaders who might use their position, the law, or the religion, to justify doing fundamentally wrong things.

These are some thoughts about ways moral reasoning may develop. In a future post let’s look at the errors that may creep in along the way to better moral reasoning.

Here is wishing you the happy life you deserve. David Joel Miller, LMFT, LPCC

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel