Children see counsellors for a variety of reasons. During a counselling session, the counsellor evaluates the youth to look for concerns or symptoms of an emotional disturbance. A counsellor is supposed to remain objective regarding the information that his young patient shares. However, ethical dilemmas can arise and challenge the neutrality of the counsellor, thereby clouding his clinical judgment.
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The American Counseling Association understands that counsellors are often faced with hard decisions that challenge their ethical or moral code. As such, the ACA offers guidelines for clinicians to help them work through tough decisions. One of the most important things for a counsellor to remember is not to take the situation personally, and to make a decision that keeps the child -- and others -- safe. Counsellors are trained to emotionally remove themselves from a scenario to provide unbiased and objective advice to a child or his family.
The bond between a child and his counsellor can become very special, especially if the child is lacking parental or adult guidance in his life. While a strong connection is O.K., the relationship between the counsellor and his clients must remain professional and not cross any boundaries. An example of crossing a boundary is if the counsellor paid for the child to go on a field trip with his school because his parents could not afford it. Counsellors must also be careful to disclose too much information about themselves to their clients. Sessions are not a time for counsellors to self-disclose, nor is it appropriate to do so at any time.
The Health Insurance Portability and Accountability Act is a confidentiality law that prohibits the sharing of clinical information about a client without the proper release agreement forms. This means that if a child's teacher calls and asks the counsellor to see the notes from the therapy session, the counsellor must adhere to HIPAA and not release any information. Only the child's parents or guardians can determine whom to release certain information to. Some counsellors may find this to be an ethical dilemma, especially if they believe that a teacher, for instance, would benefit from having certain information. However, counsellors must not disregard HIPAA confidentiality laws or they can face fines and penalties for doing so.
A dual relationship is a clinical term used to describe when one counsellor provides therapeutic services to two people who are closely related by blood or association, such as siblings, a husband and a wife or two coworkers. Dual relationships can cause ethical dilemmas for counsellors if the two individuals talk about one another during their therapy sessions. It can become difficult for the counsellor to keep information private, especially if he feels that something challenges his personal values or belief system.
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