Confidentiality and Virtue Ethics

Confidentiality and Virtue Ethics

Confidentiality is a fundamental ethical principle in counseling that emphasizes the importance of maintaining the privacy and trust of clients. It involves the protection of sensitive and personal information shared by clients during the therapeutic process. Confidentiality is essential for creating a safe and secure environment where clients can freely express themselves and seek help without fear of their information being disclosed without their consent.

Virtue ethics provides a moral framework for understanding and evaluating ethical decisions and actions. It focuses on the development of virtues or positive character traits that guide individuals in making ethical choices. In the context of confidentiality, virtue ethics emphasizes the virtues of trustworthiness, integrity, and respect for autonomy.

Counselors are entrusted with confidential information by their clients, and upholding confidentiality is a demonstration of their trustworthiness. It requires counselors to respect the boundaries of confidentiality and not disclose any information without the client’s explicit consent, except in specific circumstances outlined in the ethical guidelines (e.g., when there is a risk of harm to the client or others).

1. Ethics

Ethics guide professional behavior, and codes of ethics provide specific guidelines for counselors to ensure the well-being of clients and themselves. Codes of ethics serve multiple purposes, including providing information on ethical practice and addressing complex ethical dilemmas. Counselors must understand and apply ethical standards to navigate these challenges.

Codes of ethics also promote accountability and professional growth. They hold counselors responsible for their conduct and provide a framework for maintaining ethical behavior. In addition to mandatory ethics, which are the minimum standards, codes may include aspirational ethics that encourage counselors to continually improve their knowledge and skills.

In summary, codes of ethics inform counselors on ethical practice, hold them accountable, and promote professional development. They provide guidance for ethical decision-making and contribute to the reputation of the counseling profession.

1.1 Principles of Ethical Codes

In various professions, including counseling, codes of ethics incorporate fundamental principles that guide ethical behavior. In counseling, these principles are autonomy, nonmaleficence, beneficence, justice, and fidelity. Familiarity with these principles can assist counselors in recognizing ethical violations and determining appropriate actions.

Autonomy recognizes clients’ right to make independent decisions. Counselors respect and support clients’ freedom to choose, even if they disagree or have different perspectives on what is best for the client.
Nonmaleficence emphasizes the duty to do no harm. Counselors prioritize the well-being and safety of their clients, ensuring they are not harmed physically, mentally, or emotionally due to the counselor’s actions.
Beneficence emphasizes actively promoting the clients’ welfare. Counselors strive to enhance the clients’ well-being and work toward their positive growth and development.
Justice emphasizes fairness and equality. Counselors avoid discrimination, treat all clients equitably, and ensure that everyone receives fair and unbiased treatment.
Fidelity emphasizes trust, faithfulness, and keeping commitments. Counselors establish and maintain trust with their clients, honor their obligations, and follow through on their promises.

In certain situations, these principles may come into conflict, requiring counselors to prioritize one over another. Each case calls for thoughtful judgment in determining which principle should take precedence.

1.2 Ethical Decision Making

When confronted with ethical dilemmas, counselors can utilize decision-making models to navigate the complexities. One such model described by Herlihy and Corey in the ACA Ethical Standards Casebook offers valuable guidance for counselors in their ethical decision-making process:

Identify the problem or concern.
Study pertinent codes of ethics and research.
Reflect on the principles of autonomy, nonmaleficence, beneficence, justice, and fidelity.
Consult with other professionals.
Maintain an awareness of your emotions to ensure that emotions do not cloud your judgment.
Include the client in the decision-making process whenever feasible.
Decide how you would like to see the situation resolved and brainstorm courses of action.
Examine the possible consequences for all courses of action and then select the one you would like to take.
Assess your chosen course of action.
Take action.

2. ACA Code of Ethics

ACA publishes its Code of Ethics as a guiding framework for counselors, offering a foundation for ethical behavior, a resource for addressing ethical concerns, and a process for handling ethical complaints. Since its inception in 1961, the Code of Ethics has undergone several revisions to remain relevant and comprehensive. The latest edition addresses emerging topics such as technology, multiculturalism, confidentiality, and counseling interventions. It is crucial for counselors to stay updated on any changes to the code to uphold ethical standards as the counseling profession evolves.

There are the nine sections that constitute the ACA Code of Ethics:

The Counseling Relationship
Confidentiality and Privacy
Professional Responsibility
Relationships with Other Professionals
Evaluation, Assessment, and Interpretation
Supervision, Training, and Teaching
Research and Publication
Distance Counseling, Technology, and Social Media
Resolving Ethical Issues

You should review the most current version of the ACA Code of Ethics prior to taking the NCE or CPCE. Visit http://www.counseling.org/Resources/aca-code-of-ethics.pdf to access the entire document.

2.1. Section A: The Counseling Relationship

Section Highlights Counselors must:

Keep accurate records and document their activities as required by their employer and by the law.
Develop realistic counseling plans in conjunction with clients.
Obtain informed consent (verbally and in writing) from clients.
Obtain assent from those unable to give informed consent (e.g., minors).
Seek permission to make contact and work collaboratively with any additional counselors or mental health professionals whom their client is seeing.
Avoid any romantic or sexual relationships with clients, their significant others, or their family members. In addition, counselors must not engage in any romantic or sexual relationships with previous clients, their significant others, or their family members for five years after the date the client was last seen professionally.
Avoid any virtual relationships with current clients, including through social or other media.
Avoid any interactions with clients outside of the professional context unless the interaction could be potentially beneficial (e.g., attending a wedding, graduation, or funeral). If counselors decide to engage in a potentially beneficial interaction, they must gain consent from the client and document their reasoning in writing.
Gain consent from the client before changing roles in the counseling relationship (e.g., switching from acting as an individual counselor to a family counselor).
Advocate on behalf of clients, with their consent, to help them overcome barriers to improvement, and encourage clients to advocate on their own behalf when possible.
Screen potential group members prior to starting a group, and only select clients whose goals align with the group’s purpose.
Establish appropriate fees, and discuss openly with clients how nonpayment of fees is handled.
Refrain from engaging in bartering unless it is fair, suggested by the client, and an admissible convention in the community.
Exercise prudence when offered a gift from a client. Consider the potential effect on the counseling relationship before deciding to accept or decline the gift.
Terminate the counseling relationship when it is evident that the client no longer needs or is benefiting from treatment.
Make arrangements for clients to continue to receive care in the case of extended absence, illness, or death.

2.2. Section B: Confidentiality and Privacy

Section Highlights Counselors must:

Address the issue of confidentiality in a culturally sensitive manner, inform clients of the limits to confidentiality, and refrain from divulging confidential information about clients to outside parties without client consent or a legal or ethical rationale.
Request private information from clients only when it is clinically warranted.
Understand exceptions to confidentiality such as when:
- There is a duty to protect the client or identified others from serious and foreseeable harm.
- Clients disclose that they have a life-threatening and communicable disease that they may be infecting an identified other with and refuse to inform that person of their disease.
- However, counselors are only “justified” (ACA, 2014 , B.2.c) in breaking confidentiality under these circumstances, not required to do so.
- Terminally ill clients who wish to hasten their lives request confidentiality and applicable laws and professional consultation regarding the specific circumstances allow a counselor to maintain confidentiality.
- Counselors are ordered by the court.
Communicate their plans to break confidentiality to the client, if possible and appropriate.
Only disclose the minimum amount of information required when breaking confidentiality is necessary.
Obtain client consent before sharing confidential information with treatment teams or third-party payers.
Ensure that any confidential discussions with clients occur in private settings.
Discuss confidentiality and its limits when conducting group work, marriage counseling, or family counseling.
Recognize the rights of parents and legal guardians to access confidential information of minor clients and work in concert with parents and legal guardians to meet the needs of the minor.
Keep records in a safe location, protected from those who do not have the authority to access them.
Allow clients to have “reasonable access” (ACA, 2014 , B.6.e.) to their records, and answer any questions clients have about the information found therein.
Obtain consent before recording a session with a client, observing a session with a client, or showing a recorded session to an outside party.
Discuss the limits of confidentiality with research participants, and refrain from publishing information about any participants that could reveal their identities, unless consent has been obtained.
Protect the identity of clients when consulting with other professionals, unless the client has given his or her prior consent.

2.3. Section C: Professional Responsibility

Section Highlights Counselors must:

Practice within the parameters of their education, training, and experience.
Only accept jobs that align with their qualifications; only hire employees who are capable and qualified.
Evaluate the effectiveness of their skills and techniques and work to improve any weaknesses identified.
Participate in continuing education and professional development to stay informed about current techniques and procedures and to improve their effectiveness.
Remain cognizant of their own level of functioning and abstain from performing professional duties when they are experiencing an impairment (e.g., emotional, psychological, and physical) that is likely to interfere with their ability to help their clients.
Select a “records custodian” (ACA, 2014 , C.2.h.)—a colleague whom they will inform of their plan regarding what should happen to their records and clients in the event of their death, impairment, or discontinuation of practice.
Truthfully represent their services in advertisements.
Refrain from pressuring individuals with whom they are in a professional relationship to buy their products (e.g., books).
Honestly represent their qualifications and credentials (e.g., counselors should not put the prefix “Dr.” before their name if their doctoral degree is in a field unrelated to counseling).
Accurately represent the accreditation status of their degree program, as well as their professional membership statuses.
Denounce and avoid participation in any culturally based discriminatory behavior or sexual harassment, whether physical, verbal, or nonverbal.
Ensure representations made on reports or through media for public consumption are objective, scientific, and based in sound professional practices. Counselors are to clarify when they are speaking from their personal perspective rather than professional opinion.
Engage in pro bono work in the public.
Use non-harmful techniques that are “grounded in theory and/or have an empirical or scientific foundation” (ACA, 2014 , C.7.a.) or else label their techniques as “developing” or “unproven,” and make sure to discuss any possible risks with the client.

2.4. Section D: Relationships with Other Professionals

Section Highlights Counselors must:

Show respect for professionals and organizations that use counseling procedures or techniques that are different from the ones they use.
Strive to create positive relationships with other professionals (inside and outside of their field) to enrich their own practice and effectiveness with clients.
Protect client confidentiality and promote the welfare of the client when working in interdisciplinary teams.
Recognize that by accepting employment at an organization, they are indicating their accordance with that organization’s practices and procedures.
Notify their employer about any improper or unethical organizational practices that negatively affect clients, or counselors’ ability to provide services, and work to change those policies.
Refrain from firing or persecuting an employee who has revealed, in an ethical manner, improper or unethical practices within his or her organization.
Only function in a consultative capacity in areas for which they are trained and qualified.
Obtain informed consent before providing consultation.
Ensure that the problem to be addressed and the goals to be worked toward during the consultation process are constructed in collaboration with the consultee.

2.5. Section E: Evaluation, Assessment, and Interpretation

Section Highlights Counselors must:

Safeguard client welfare by making accurate interpretations of assessment results, explaining to clients the results and their interpretations in terms they can understand, and working to ensure that other professionals do the same.
Only use assessment tools that they are trained and qualified to use.
Monitor the use of assessment techniques by any individuals under their supervision to ensure that they are being used appropriately.
Obtain informed consent prior to engaging in an assessment of a client.
Release to relevant parties and qualified personnel accurate and appropriate assessment interpretations.
Make culturally sensitive diagnoses of mental disorders, recognizing historical and social prejudices associated with diagnosing pathology.
Consider abstaining from making a diagnosis if they think it would damage the client in any way.
Only use assessment tools with sound psychometric properties.
When choosing assessment tools for culturally diverse populations, exercise discretion to ensure their suitability. If counselors use assessments that were not normed on the client’s population, they make sure to report the results in the appropriate context. For example, if a counselor uses an assessment for depression that was not normed on any Native American individuals, the counselor would take that into account when making an interpretation of a Native American client’s results.
Administer assessment tools “under the same conditions that were established in the standardization” (ACA, 2014 , E.7.a.), document any “irregularities” or disruptions that occur during administration, and consider any irregularities or disruptions in the interpretation of results.
Ensure technologically administered assessments function properly and provide accurate results.
Refrain from using any assessments or results from assessments that are dated or no longer used in the evaluation of a certain construct.
Follow the appropriate, contemporary procedures when creating assessments.
Refuse to perform forensic evaluations on current or former clients, as well as refuse to accept clients who are currently or have previously been evaluated for forensic purposes.

2.6. Section F: Supervision, Training, and Teaching

Section Highlights Supervisors must:

Observe the performance of counselors-in-training and ensure that clients’ needs are being met. To that end, counseling supervisors discuss cases with supervisees, observe live counseling sessions, and watch recorded sessions.
Ensure that supervisees discuss the limits of confidentiality with clients in regard to the supervisory relationship.
Complete training in supervision before supervising counselors-intraining.
Avoid romantic or sexual relationships with supervisees.
Refrain from entering into a supervisory relationship with family members, friends, or significant others.
Avoid any interactions with supervisees outside of the professional context unless the interaction could be potentially beneficial (e.g., attending a wedding, graduation, or funeral). If counseling
supervisors decide to engage in a potentially beneficial interaction, they must gain consent from the supervisee and document their reasoning in writing.
Recognize that they, along with their supervisees, may end the supervisory relationship at any time provided that sufficient notice and rationale are given.
Provide supervisees with regular formal and informal evaluation and feedback. If counseling supervisors notice that a supervisee is struggling in a certain area, they help him or her in gaining assistance to improve his or her performance.
Propose supervisee dismissal from his or her training program if the supervisee exhibits an unreasonable lack of skill in his or her performance.
Endorse supervisees who they believe are competent and ready for employment or to move forward in their training program.

Counselor educators must:

Be knowledgeable about ethical, legal, and regulatory aspects of the profession and perform their job in an ethical and professional manner no matter which type of class modality (e.g., traditional, hybrid, and online formats).
Teach only within areas of knowledge and competence, and when technology is used, deliver instruction with technology in a competent manner.
Integrate information about multiculturalism into all classes to foster counselors who are culturally competent.
Involve students in both academic coursework and supervised practical training regardless of the class modality.
Teach students about the ethical issues related to the counseling profession and their ethical obligations as students.
Use client, student, or supervisee information as case examples in instruction only when there is consent to do so, or the information has been appropriately deidentified.
Develop procedures for assigning students to field placements, ensuring that all site supervisors are qualified to carry out their duties. In addition, counselor educators must ensure that both
students and supervisors understand their responsibilities and ethical obligations.
Give prospective students sufficient information and orientation about the counseling program’s goals, requirements, and expectations —as well as appropriate career advisement.
Use discretion when integrating activities or assignments in class that involves self-disclosure, making it clear to students that their level of self-disclosure will not affect their grade in the class.
Require as appropriate that students address personal concerns that may hinder their professional practice.
Provide students with regular formal and informal evaluation and feedback. If counselor educators notice that students are struggling in a certain area, they help them in gaining assistance to improve their performance.
Refrain from engaging in person or electronically in romantic or sexual relationships with current students in a program or those whom they have power or authority.
Prior to engaging in social, sexual, or other intimate relationships with former students, discuss with them potential risks of entering those relationships.
Avoid any interactions with students outside of the professional context unless the interaction could be potentially beneficial (e.g., attending a wedding, graduation, or funeral). If counselor educators decide to engage in a potentially beneficial interaction, they must gain consent from the student and document their reasoning in writing.
Promote the recruitment of diverse faculty members and students.
Actively infuse multicultural competency in academic training and supervision practices.

2.7. Section G: Research and Publication

Section Highlights Counselors who conduct research must:

Abide by relevant ethics and laws pertaining to research practices, including approval of research on human subjects through an institutional review board (IRB) as applicable.
Hold themselves accountable for the safety of research participants.
Understand that the principal researcher holds the greatest responsibility for ensuring ethical conduct, although others involved in a research project are, of course, also obligated to adhere to ethical standards.
Take appropriate preventative measures to avoid creating disturbances in the lives of research participants.
When students or supervisees have an opportunity to participate in a study, ensure they are aware that their decision whether to participate has no influence on their academic standing or the supervisory relationship.
Obtain informed consent from research participants, ensuring that participants know that they may choose to drop out of the study at any time.
Avoid using deception as part of a research study unless it is necessary, is justifiable, and will not cause harm to the participants.
After the study is complete, researchers inform the participants about the deception and the rationale for using it.
Keep confidential any information gleaned about research participants during the study.
Explain the exact purpose of the study to research participants once it has been completed.
Report the results of the study to pertinent organizations, sponsors, and publications.
Dispose, in a timely manner, of any materials related to a completed study that contains confidential information about participants.
Consider the risks and benefits of extending the researcher participant relationship beyond “conventional parameters” (ACA, 2014 , G.3.a.), and document why other activities outside traditional research activities were undertaken and how, if relevant, unintended harm was addressed.
Recognize that romantic or sexual relationships with research participants are not permitted.
Faithfully report the results of their studies, even if the results are negative or discouraging, and include an explanation about the limitations of the study. Take reasonable steps to bring attention to and correct any published errors.
Disguise the identities of participants in any information disseminated about the study, unless participants have given their consent.
Publish enough information and detail about their study so that interested researchers can replicate it.
Use client, student, or supervisee information as case examples in research and publication only when there is consent to do so, or the information has been appropriately deidentified.
Give credit in publications through such means as “joint authorship, acknowledgement, footnote statements” (ACA, 2014 , G.5.d.) to individuals who have made substantial contributions to the research.
Refrain from submitting articles for consideration to more than one publication outlet at a time.
Maintain author confidentiality when serving as a professional reviewer for a publication. In addition, counselors should only evaluate submissions that they are qualified to review.

2.8. Section H: Distance Counseling, Technology, and Social Media

Section Highlights Counselors must:

Be knowledgeable and skilled when engaging with technology in distance counseling, technology and social media, attending to ethical, legal, and technical considerations.
Obtain informed consent from clients involved in distance counseling, technology, and social media within the counseling process, sharing that they may withdraw at any time.
Acknowledge to clients the limitations of confidentiality through electronic means.
Acknowledge to clients the limitations of technology itself in the counseling process, including related to technology applications and the counseling relationship itself.
Verify the identity of clients before engaging in distance counseling, technology, and social media.
Ensure that clients are capable of using the appropriate technology before engaging in distance counseling, technology, and social media.
Terminate distance counseling when it is determined to be ineffective.
Consider communication differences that exist between face-to-face and electronic communication, minimizing the impact of these differences to the extent possible.
Maintain electronic records in accordance with relevant laws and statutes.
Provide electronic resources that are accessible to clients for links such as licensure and professional certification boards.
Ensure that Websites are language- and disability-accessible to prospective and current clients.

2.9. Section I: Resolving Ethical Issues

Section Highlights Counselors must:

Familiarize themselves with the ACA Code of Ethics, along with any other relevant codes of ethics (i.e., codes of ethics from other professional associations).
Realize that not understanding the Code of Ethics is not a valid excuse for acting in an unethical manner while carrying out their professional duties.
Try to resolve any conflicts that arise between the code of ethics and the law. When unable to do so, counselors may follow the law.
Confront counselors who they believe are violating, or may be violating, the ethical code, and try to resolve the issue informally.
Report any ethical violations that cannot be resolved informally to ACA’s Ethics Committee or other applicable committees.
Consult with colleagues, supervisors, organizations, or other professionals when in doubt about the ethical, appropriate course of action to take in a situation.
Only file ethical complaints when they have sufficient information to back up the claim.
Refrain from discriminating against individuals based only on the knowledge that they have filed ethics complaints or have had ethics complaints filed against them.
Cooperate with any investigations made by ethics committees.

3. National Board for Certified Counselors Code of Ethics

The NBCC Code of Ethics (2016) applies to certified professional counselors and those seeking certification. It consists of mandatory ethics and covers several important directives:

NCCs take appropriate action to prevent harm. This directive references standards related to issues of confidentiality and client privacy, gifts and bartering, multiple relationships with current and past clients and supervisees, sexual harassment, sexual or intimate relationships with previous clients after two years but never with current clients or supervisees, availability of the counselor and protection of records, gatekeeping responsibilities of supervisors, confidentiality of client information during consultation, handling of assessment and research data, and the use of social media.

NCCs provide only those services for which they have education and qualified experience. This directive alludes to the mandate for counselors to engage only in clinical, assessment, and other professional activities in which they are generally and multiculturally competent, and to seek supervision or consultation when necessary.

NCCs promote the welfare of clients, students, supervisees, or the recipients of professional services provided. Counselors and supervisors are to provide adequate information about their respective activities to individuals with whom they work. In addition, this directive highlights guidelines for with whom and how counselors consult and how assessments are to be administered and interpreted appropriately with clients.

NCCs communicate truthfully. This directive asserts that counselors accurately represent their credentials to others; provide accurate records for clients, supervisees, and other relevant parties; and integrate assessment and research information into their work honestly.

NCCs recognize that their behavior reflects on the integrity of the profession as a whole, and thus, they avoid actions which can reasonably be expected to damage trust. Counselors are to act responsibly with client records by retaining them for at least five years, releasing client information appropriately; understand restrictions for which they may provide forensic evaluations; interact with clients professionally and avoid any conflicts of interest and situations with the potential for exploitation; and provide accurate information about clients when working with other professionals or integrating assessment data.

NCCs recognize the importance of and encourage active participation of clients, students, or supervisees. This directive requires counselors to work collaboratively with other professionals with whom clients are working, outline limits to confidentiality when working with multiple clients at a time, provide and obtain informed consent related to the counseling process, respond to client requests for records within a reasonable time frame, work collaboratively with clients and keep ongoing records, discuss termination or provide referrals as necessary, and provide clients with accurate information related to assessments and research.

NCCs are accountable in their actions and adhere to recognized professional standards and practices. This directive relates to counselors’ responsibility to comply with procedures and policies of NBCC and university/work settings, as well as follow assessment and research guidelines.

These directives emphasize ethical conduct, client welfare, professional integrity, and accountability in counseling practice.

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