Ethical Dilemma in Therapy Session
Ethical dilemmas are common in therapy sessions involving sexuality conditions such as compulsive sexual behavior. An example is when a counselor is dealing with a client with whom a series of secrets affecting his family arise during the sessions. For instance, a therapist may deal with a client husband attending the sessions without his wife, and during one therapy session confesses to having resumed engaging in anonymous sexual escapades with multiple partners but is not willing to disclose it to his wife. This is complicated further by the fact that the therapy has been ongoing for several months in which the client made significant progress towards overcoming his comparative sexual behavior.
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This situation presents the counselor with a significant ethical dilemma in sexuality. First, dealing with a client at this professional level requires utmost confidentiality. On the other hand, holding the information in confidentiality would make the counselor collude with the perpetrator in perpetuating a cycle of secrecy that is unhealthy. A counselor does not also have any ethical justification to unilaterally disclose the information to a third party especially given the fact that the client presumes the information they share to be confidential (Pope & Vasquez, 1998). Failing to disclose the information to the client’s wife would certainly amount to putting her in risks that come with promiscuity.
A therapist seeking to bring about a workable solution between the client and his wife would try to have their client share this information with the wife, if just to notify her of the status of events. However, the client is unwilling to do this because doing so would put his marriage in a high risk of divorce or separation. The therapist may opt to threaten discontinuing the treatment as a means of coercing the client to disclose the information for a healthier relationship. However, doing this would still amount to unethical behavior and would risk to be charged of abandonment (Corey & Callanan, 1998). As a counselor, all effort is put towards serving the interests of the client even if they are difficult to work with.
Dealing with patients of compulsive sexual behavior is not always easy and requires a counselor to be as ethical as possible. Whatever course of action or policy that the therapist opts to in this kind of situation, it should be made clear and communicated to all the affected parties. As much as the therapist is legally and ethically mandated to maintain high levels of client confidentiality, they would have to disclose relevant information to the affected parties especially when failure to do so would put them at emotional, physical, psychological risk (ACA Code of Ethics). An effective way of dealing with such situations is clarifying the options and consequences involved at the onset of the engagement with the client. Treatment is most effective when it is inclusive by involving the partners and close family members of the patient. Therefore, the counselor would have to have a session with the immediate family members at the beginning of the counseling relationship in order to make the client and the affected parties aware of the details and consequences of disclosure.
- ACA code of ethics: as approved by the ACA Governing Council, 2005. (2005). Alexandria, VA: American Counseling Association.
- Corey, G., Corey, M. and Callanan, P. (1998). Issues and Ethics in the Helping Professions. Pacific Grove , CA : Brooks/Cole.
- Pope, K. and Vasquez, M. (1998). Ethics in Psychotherapy and Counseling: A Practical Guide . San Francisco : Jossey-Bass.