Counsellors are privilege to clients' most personal information and are responsible for their mental well-being. As such, the counselling practice is subject to ethical guidance and issues that should be addressed for the protection of both the client and the counsellor. The information shared and the relationships between the client and counsellor should always be monitored.
Confidentiality and Privileged Information
Confidentiality concerns what a therapist does with what the client says during treatment. Most information remains privileged, meaning that the therapist does not have to divulge it to other people without the client's permission. There are exceptions to this rule, including reports of current abuse or potential specified danger to the client or others. Clients receiving court-appointed treatment may have certain details of treatment released to legal authorities. Depending on local guidance, information presented during treatment of minors may also have limited release to the legal guardians.
Dual or Multiple Relationships
When clients and counsellors have interactions outside of the therapy session, it is known as dual or multiple relationships. Dual relationships involve the client and counsellor; multiple relationships include the counsellor, client, and the relationships they have in common with others. While the relationships in themselves are not illegal, they can present ethical issues if the interactions are frequent and avoidable. For example, there may be cause for concern if counsellors accept goods and services in exchange for therapy, or if the client is the employer of the counsellor's spouse.
Boundary crossing occurs when treatment or the client/counsellor relationship extends beyond the normal therapy setting. Boundary crossing may be perceived as normal in certain types of treatment, such as a counsellor taking a client to a skyscraper in order to treat a fear of heights. This type of boundary crossing should be documented and explained in treatment notes. If the boundary crossing cannot be explained in terms of therapy, such as a counsellor meeting a client undergoing marriage therapy alone at a hotel, it may raise ethical questions.
Scope of Practice
The scope of practice entails what the counsellor is legally allowed to do in therapy. These laws are supported by local community regulations, although some laws are commonplace. For example, counsellors cannot prescribe mental health medications unless they are psychiatrists; they can only recommend them for prescription. Counsellors also cannot perform duties outside of the nature of therapy, such as acting as a custody case witness for a parent if both are being treated by the counsellor for marital issues.