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Analysis of Collaboration and Consultation
In case study 18: A Resistant Supervisee (Herlihy & Corey, 2006), the doctoral student, functioning as the supervisor for the intern/supervisee needs assistance in contending with the supervisee's escalating resistance. The doctoral student made an effort to seek support from her student supervision group; however, she has not consulted with the faculty member in charge of internships (Herlihy & Corey, 2006). As the doctoral student in this case, I would have consulted my supervisor immediately upon assignment to supervise an intern who was also a friend. If I had not discussed the dual relationship with my supervisor initially, I would have done so when the intern's resistance became apparent. I would also collaborate, as she did, with peers, but the situation should not have continued, and would not have if the doctoral student had immediately consulted with her supervisor.
Had the doctoral student sought supervision after the initial assignment, she would have been advised against supervising her friend. Providing supervisory services within a dual relationship is prohibited by the ethical codes of the American Counseling Association (ACA) (2005) (Standard F.3.d.) as well as the American Mental Health Counselors Association (AMHCA) (2009) (Standard III.5.). Dual relationships between a supervisor and supervisee can degrade the experience of both parties (ACA, 2005). It is unethical in most cases, except when there is a potentially beneficial aspect of such a relationship. In this case, no potential benefit exists.
Ethical Issues in a Past Employment Setting
An ethical issue that occurred during past employment took place in a hospice setting when a nurse was advised a client to limit disclosure to family members. Although in some cases, this might have been appropriate advice, in this circumstance, the client had transient bouts of hypercalcemia which left her confused and forgetful. The situation had been defined in informed consent and was agreed upon that every aspect of the client's treatment and therapy would be shared with the family.
In my position, I had no authority to direct or correct the nurse, although I reminded her of the stipulations in the client's initial agreement. She said I had no right to inform her about her patient and I should mind my own business. Following the protocol for this type of dilemma, I promptly sent an email to my supervisor and copied the attending physician with a brief summary of how the nurse was handling the situation. I also spoke to my supervisor shortly after emailing her and asked how we should handle this problem. She contacted the hospital liaison in charge of nursing staff for the hospice, and the nurse was removed from the case immediately.
Later that evening, I called a peer within the organization who functioned in a similar capacity to mine. I asked her opinion of how she would have handled the situation and how she contended with similar situations. This was helpful, not only to gain her opinion, but to have exposure to other difficult ethical challenges in the hospice environment. Although counselors may be exposed to numerous dilemmas and have seasoned experience in ethical decision making, consultation and collaboration continue to be beneficial, and even crucial, for the most optimal resolution of ethical issues (Remley & Herlihy, 2010). My first action was to contact my supervisor. In this case, I recognized the gravity of the situation and that my supervisor was the person who had the authority to correct the nurse's inappropriate action.
Ethical Decisions and Actions in the Above Dilemma
As an ethical counselor, I would have advocated for the client and would have taken action similar to that of my supervisor. In this situation, and in any agreement covered in informed consent, these boundaries must be respected and facilitated throughout the relationship. Although the nurse believed she was acting in her patient's best interest, from the perspective of her written directives, as well as the informed consent agreement with the client's hospice team, she was not. In a hospice setting, or in any counseling environment, acting within the guidelines of informed consent is critical, especially when clients may not be able to advocate adequately for themselves (ACA, 2005; AMHCA, 2009).
Additionally, now that I am aware of ethical decision-making models, I would have considered one of them in determining my actions in any ethical dilemma. For this example, I might have used Welfel's model since it includes consultation with a supervisor as well as peers prior to and after making the decision. Implementing an ethical decision-making model helps the counselor organize and gather pertinent information as well as rely on a more subjective composite of information. Cottone and Claus (2000) cited Kitchener's seminal work related to counseling "in the absence of clear ethical guidelines, relying on personal value judgments...(is) not adequate" (para.2).
Seeking Consultation and Supervision
In most situations, it is crucial to contact a direct supervisor when a complex ethical dilemma arises. Peer consultation can be as valuable as supervisory consultation in many situations. It is interesting to note that Haag Granello, Kindsvatter, Granello, Underfer-Babalis, & Hartwig Moorhead, (2008) found considerable value in the use of peer consultation to enhance supervisor cognitive development. Additionally these authors believe a correlation may exist between peer support and collaboration and the well-being of counselors. Haag Granello et al. (2008) used a multiple perspective model that they believed broadened the counselor's perspective and enhanced their ability to think critically whether or not they used the specific information at a later time.
Qualifications of Supervisor/Consultant
Supervisors or consultants should have an advanced degree in counselor education, or are doctoral students, as in case study 18 in Herlihy and Corey (2006) and have the experience and expertise to provide scholarly opinions and advice. They should understand the breadth of ethical decision making in a contemporary counseling setting, and have detailed knowledge of ethical codes (Remley & Herlihy, 2010). Additionally, supervisors should have an accurate sense of multicultural and diversity issues as well as experience in resolving ethical issues in various circumstances. As part of informed consent between the supervisee and supervisor, the supervisor must "make students aware of the myriad potential ethical issues facing counselors, including culture and diversity, technology, and boundary issues as contextual factors that affect the resolution of ethical dilemmas" (Herlihy & Corey, 2010, p. 237).
Evaluating My Role as an Ethical Counselor
Working Alliance
Herlihy and Corey (2006) believe "a strong working alliance between supervisor and supervisee is essential for supervisee growth and development" (p. 235). This relationship assists the supervisee as he or she becomes an ethical and competent counselor. As an ethical counselor seeking supervision, I will not hesitate to express my mistakes as well as my fears to my supervisor. In return, I will expect encouragement, constructive and fair criticism, and direction (Corey, 2006). When a supervisor cannot help, he or she will refer me to a professional who has information or experience necessary for my development and growth.
Competence
Prior to engaging in supervising counselors, I will obtain specific training, and as the ACA Code of Ethics (2005) states, before counselors supervise others, they will be trained in appropriate supervisory methods (Standard F.2.a.). Furthermore, I will foster the characteristics and competencies of effective supervisors listed in the Ethical Guidelines for Counseling Supervisors (Association for Counselors Education and Supervision, 1993). As an ethical counselor, I will keep abreast of contemporary research as well as advances in counselor supervision, and understand the need for continuing education. For supervisors and consultants, the ACA (2005) Code of Ethics prohibits falsely representing expertise, experience, and knowledge. When seeking supervision or consultation, I will expect this same level of competence (Remley & Herlihy, 2010).
References
American Counseling Association. (2005). 2005 ACA code of ethics [White Paper]. Retrieved from the ACA website: http://www.counseling.org/Files/FD.ashx?guid=ab7c1272-71c4-46cf-848c- f98489937dda
American Mental Health Counselors Association. (2010). 2010 AMHCA code of ethics [White Paper]. Retrieved from the AMHCA website: https://www.amhca.org/assets/news/AMHCA_Code_of_Ethics_2010_w_pagination.pdf
Association for Counselor Education and Supervision (ACES). (1993). Ethical guidelines for counseling supervisors [White Paper]. Retrieved from the ACES website: http://files.acesonline.net/doc/ethical_guidelines.htm
Cottone, R. R., & Claus, R. E. (2000). Ethical Decision-Making Models: A Review of the Literature. Journal of Counseling & Development, 275-283.
Haag Granello, D., Kindsvatter, A., Granello, P. F., Underfer-Babalis, J., & Hartwig Moorhead, H. J. (2008, September). Multiple perspectives in supervision: Using a peer consultation model to enhance supervisory development. Counselor Education & Supervision, 48(1), 32–47.
Herlihy, B., & Corey, G. (2006). ACA Ethical Standards Casebook (Sixth ed.). Alexandria, VA, USA: American Counseling Association.
Remley, T. P., Jr., & Herlihy, B. (2010). Ethical, legal, and professional issues in counseling (3rd ed.). Upper Saddle River, NJ: Merrill/Pearson Education.
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