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548 pages, Unbound
Published May 26, 2015
One of the very first claims made by the authors is that this edition (the 10th) was “carefully reviewed and updated to present current thinking, research, and trends in practice” (Corey, Corey, and Corey, 2019). However, much like the webpage for the Commission for Rehabilitation Counselor Certification (CRCC), Corey et al (2019) continue to showcase outdated and inaccessible models of ethical decision making. While Corey et al (2019) do not embrace a particular ethical decision-making model, they do express what may be included in that model. This can be interpreted to mean that the counselor is left to pick and choose a model, as long as it is a model of ethical decision-making.
While the CRCC website does list a variety of different decision-making models – and interestingly enough, they are the same ones recommended by Corey et al (2019), both could probably benefit from updating these models using the latest research and evidence-based practices in the field. From the rehabilitation counseling perspective, there are many ethical decision-making models available. While some of the models are better than others, namely, evidence- and research-based, by leaving the code so vaguely written, it places the obligation on the counselor to ensure the model they pick works well for the dilemma they are encountering.
For example, in researching and reviewing the components of ethical decision-making models, Ling and Hauck (2016) found that the contemporary models of ethical decision-making – which include those suggested by the Corey et al (2019) and the CRCC website (i.e., Tarvydas, 1998; Cottone, 2001; Garcia, Cartwright, & Borchukowska, 2003; Herlihy & Watson, 2007; Corey, Corey, Corey & Callahan, 2014) – were (1) designed for use within in a limited context of ethical cases; and, (2) created before the advent of the most recent Code of Professional Ethics for Rehabilitation Counselors (CPREC [2016]). Further, research conducted by Barnett, Behnke, Rosenthal, and Koocher (2007) suggests that contemporary ethical decision-making models were not theoretically grounded, nor did they lead to any significant improvement in the ethical decision-making process. Moreover, Corey et al (2019) still lists the outdated (2010) CPREC as the reference for ethics in the rehabilitation counseling profession.
Notwithstanding this introductory critique of the obvious defects within the intent of the text, I will proceed with this review by offering some reflective self-disclosure. I love moral philosophy. The culmination of my undergraduate degree in philosophy was based on a defense of Rawls’ (1999) principles of justice. Therefore, the introductory chapters in Corey et al (2019) were akin to snuggling up to a warm fire on a cold winter night.
I share with Corey et al. (2019) a passion for the study of ethics in that it requires the use of critical thinking skills and strengthens the individual’s ability to make judgments within a preferred decision-making process.
Next, the readings in chapter 3 on the intersection of (personal) values and the helping
relationship brought up some interesting reflections on areas of value judgments that I have been
working through. I am a firm adherent to the existential worldview in which the understanding is
that everyone is a unique being-in-themselves. Moreover, the values, behaviors, and feelings that people express, are not viewed as a dichotomous choice between normal or abnormal; rather, the perspective is one in which there is no such thing as normality in an inherent sense. Normality is a social construct (Iacovou & Weixel-Dixon, 2015).
Although a full review of this text includes many reflections on chapters 4 through 9, due to the limited amount of space, I will now go to the subject matter in chapters 10 through 13, and provide a concluding statement.
In the final chapter’s (10-13), I appreciated the assessment and diagnosis table that covered the theoretical perspectives. Although I was already familiar with the Existential viewpoint on assessments, it was presented in a very clear way that would transfer over easily to a professional disclosure statement on assessments.
Perhaps the most disturbing reflection about this chapter, for me, was the section about diagnosis within an insurance context. It is almost ridiculous that this chapter states, “Although it may be tempting for a clinician to present an ‘acceptable’ but inaccurate diagnosis, this is both unethical and fraudulent" (Corey et al., 2019, p.382). I would love to see the ethical decision-making model on that one. Honestly, I can’t count the number of times clinicians have unabashedly done this and are open about it. If you think critically enough, you will recognize the problems inherent in this entire section. A clinician states that they have to make a diagnosis at the first appointment (45-60 minutes). The clinician defends this action with claims of procedure and policy. It is then justified with further claims of possible adjustments to the diagnosis later. Further, look at the last paragraph in this section,
With some managed care mental health companies, a therapist may call a company with a diagnosis. A technician [emphasis added] may then look up the “appropriate” treatment strategies to deal with the identified problem (if indeed, the diagnosis meets the criteria for reimbursement). This raises significant ethical issues as important treatment decisions may be made by a non-professional who has never seen the client and who lacks a depth of understanding of mental health issues [emphasis added] (Corey et al., 2019, p. 383).
You think?! I don’t know, maybe Rogers (1961) aversion to diagnoses was important?!
While the entire section on evidence-based therapy practice was insightful, the two main points that resonated with me were (1) “There is evidence that clients make the single strongest contribution to outcomes” (Bohart & Wade, 2013, p. 219; as cited in Corey et al., 2019, p.391); and, (2) “The relationship [emphasis added] between therapist and client is the best predictor of treatment outcome” (Corey et al. 2019, p. 392).
I am intrigued by the systems theory concept so, chapter 11 – although heavily focused on ethics issues – was one I was looking forward to reading. From an ethical perspective, the important points that stuck out to me were (1) in the informed consent process, it was important to clearly outline the role that secrets will play in the client-counselor relationship. Further, from the multi-person treatment perspective, I found it important to answer the question “What are my ethical responsibilities to each of the parties in this case” (Corey et al., 2019, p.403).
An important statement – pertinent to any counseling discipline – was “If we are unaware of our own vulnerabilities, we might misinterpret our client’s comments or steer them in a direction that will not arouse our own anxiety” (Corey et al., 2019, p. 404). I find that statement to be very insightful and helpful. One other important statement of agreement between systems theory and the Corey’s theoretical leanings (I bring this up because G. Corey focuses heavily on existential themes in his counseling style) was “We agree with the systems perspective that a ‘problem child’ often reflects problems within the family system” (Corey et al., 2019, p.412). I agree with the Corey’s on their agreement.
Further, I concur with Corey et al. (2019) that groupwork “raises unique ethical concerns” (p. 424). Particularly in the realm of confidentially. This is due to the realization that confidentiality cannot be so easily protected in the group environment and it requires a thorough explanation of this phenomena to each group participant. Additionally, I was intrigued by the explication of Yalom’s (2005) suggestions for screening people who may be poor candidates for group therapy – along with – the suggestions of the types of problems that may be better suited to the group encounter (Corey et al., 2019).
Ultimately, along with the particular presentation on the importance of confidentiality, I found the discussion on the distinctions between evidence-based practices (EBPs), practice-based evidence (PBE), and feedback-informed treatment (FIT), to help me in the formulation of what I perceived to be important – from a theoretical vista – in the conduct of group therapy; viz., that as a practitioner of the existential approach that FIT and PBE may be more suited to predicting outcomes than EBPs.
At the risk of being overly cynical, my reflection on chapter 13 deal primarily with Corey et al. (2019) assertion that “Many homeless [V]eterans of war struggle to function in society due to immobilizing PTSD symptoms, substance abuse [use], and low social support” (p. 454). If one of the intents of this chapter – which I understand it to be – was to empower the counselor to “…[S]trive for social change by challenging colleagues who have made erroneous assumptions regarding marginalized client populations,” then I think it is time to call out the authors.
I am going to reflect on a little secret that is so obvious it pains me to even have to mention it. First, many Veterans of wars, do not struggle to function in society. To generalize by using the term many is to further marginalize this population. Additionally, what exactly is the definition of society? If you just take the dictionary definition of society, then guess what the military is? You guessed it, a society. How can the claim be made that “…[V]eterans or struggle to function in society,” when that is exactly what they did in their society; viz., function.
Secondly, I would be extremely careful about establishing causal or even correlative fact about homeless Veterans. While a bias may very well be that they struggle with mental health conditions, there is no causative nor correlating evidence to suggest that it was due to their military service (or war experiences). This myth needs to stop being perpetuated. It is a well-known assertion that some people are more susceptible to certain mental health conditions than others. While we know this information, it is not used as a screening condition for those going into the military. Further, it is known that there are some common characteristics amongst those who do choose to enter the military. I am sure if you do some research on this (sorry, it is outside of the scope of my point to present this information) you will find some possible overlap between preexisting conditions that may make those who choose to serve more susceptible to the presentation of certain mental disturbances.
Consequently, if I wanted to reflect on what I learned most from this chapter it is that the stigma of assigning labels to Veteran’s is alive and well in the counseling profession. Instead of focusing on the individual or societal factors that may contribute to or enhance the probability of a mental illness, Corey et al. (2019) has opted to take the path of least resistance in this particular aspect of the community and social justice perspectives, and instead, opted to present the mythos of the homeless Veteran as one involving their inability to adapt to the author’s perception of society.
Notwithstanding the above critical interpretation of the author’s choices, I do think that the subject matter covered was important. Perhaps the most significant thing I took away (positively) was that as counselor’s
[W]e are expected to translate our awareness of inequities and societal conditions into various forms of social action. Part of our ethical and moral obligation is to advocate with the aim of creating a just society in which all people have equal opportunity and resources to strive toward their personal goals (Corey et al., 2019, p. 474).
In conclusion, the entirety of this text was troubling. As mentioned before, I have a background in moral philosophy – both academically and professionally – as such, I sensed a certain pathos of distance between myself and the writer’s expressions and understanding of ethics. At times, I would feel poorly about myself because my thinking would be something like this, “what are we even discussing here? Has anybody even researched Ethics?” Or, I would start to feel like I had some incredible knowledge to share, but that due to the perceived simplicity of the text – particularly within the field of moral philosophy – comments like this would race through my mind: “What am I reading? Grade school Ethics? This is philosophy 101 stuff. Why are we even discussing it?” I did not like those feelings, nor did I particularly like my thinking that way. To counter these thoughts and feelings I attempted – on many occasions – ask myself questions that would attempt to understand the worldview of other readers and stimulate their thinking. However, I also thought it was at least a way to allow others a space to explore and grapple with ethical issues.
Ultimately, if anything, through this experience, and my reading of ethical application particular to the counseling profession, I have learned the importance of patience and attempting to view ideas through the lens of others. To be sure, this has been a valuable exercise for me which I am sure will pay dividends in my interactions with others. For that I am grateful.
There are two other key themes that I wanted to reflect on inre ethics. First, this text has forced me to look at the issue of education from a philosophical perspective. During my reading of this book, I spent some time talking with various philosophy professors about the
upcoming Next Gen model that will be replacing the Liberal Arts Core. These conversations deal primarily with how to keep philosophy (particularly, critical thinking, logic, and ethics) an
integral part of the model; and, how to better advocate for philosophy as a necessary part of the academic curriculum. My experience, through reading this text, has provided me with a better
understanding of why this is important and hopefully will enhance my social advocacy skills at
using philosophical based thinking as an appropriate mode of interacting with future clients, coworkers, and the community I will practice in.
Lastly, the second point, and one I feel strongly reflects my experience of reading this text, is that it forced me to re-examine some of my earlier groundwork in ethics. In particular, I was drawn to the idea of tragedy and how it is similar to the idea of an ethical dilemma. While researching this, I ended up pulling out my well-worn copy of Hegel’s Phenomenology of Spirit and which led me further to this quote that sums up, for me, how people, in modernity, really make ethical decisions, as opposed to how ethics were viewed at other times throughout history.
The heroes of ancient classical tragedy encounter situations in which, if they firmly decide in favor of the one ethical pathos that alone suits their finished character, they must necessarily come into conflict with the equally [gleichberechtigt] justified ethical power that confronts them. Modern characters, on the other hand, stand in a wealth of more accidental circumstances, within which one could act this way or that, so that the conflict is, though occasioned by external preconditions, still essentially grounded in the character. The new individuals, in their passions, obey their own nature... simply because they are what they are. Greek heroes also act in accordance with individuality, but in ancient tragedy such individuality is necessarily... a self-contained ethical pathos... In modern tragedy, however, the character in its peculiarity decides in accordance with subjective desires... such that congruity of character with outward ethical aim no longer constitutes an essential basis of tragic beauty (Hegel, 1927, pp. 567-8).
Happy Reading!
References
Bohart, A.C. & Wade, A.G. (2013). The client in psychotherapy. In M.J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th ed., pp. 219-257). Hoboken, NJ: Wiley.
Commission on Rehabilitation Counselor Certification. (2010). Code of professional ethics for
rehabilitation counselors. Schaumburg, IL: Author.
Commission on Rehabilitation Counselor Certification. (2016). Code of professional ethics for
rehabilitation counselors. Schaumburg, IL: Author.
Corey, G., Corey, M., & Corey, C. (2019). Issues and ethics in the helping profession (10th ed.). Belmont, CA: Brooks/Cole.
Cottone, R. R. (2001). A social constructivism model of ethical decision-making in
counseling.Journal of Counseling Development, 79, 39-45.
Garcia, J., Cartwright, B., Winston, S., & Borchukowska, B. (2003). A transcultural integrative
ethical decision-making model in counseling. Journal of Counseling and Development, 81, 268-276.
Hegel, G.W.F. (1927). "Vorlesungen uber die Asthetik", in Glockner, Hermann, Samlichte Werke, Translated by W. Maker.14, Stuttgart: Fromann. Translated by W. Maker. Retrieved from https://www.marxists.org/reference/ar...
Herlihy, B. & Watson, Z. E. (2007). Social justice and counseling ethics. In C.C. Lee
(Ed.), Counseling for social justice (2nd ed., pp. 181-199). Alexandria, VA: American
Counseling Association.
Iacovou, S. & Weixel-Dixon, K. (2015). Existential therapy: 100 Key points and techniques.New York, NY: Routledge.
Ling, T.J., & Hauck, J.M. (2016). The ETHICS model: Comprehensive, ethical decision making. VISTAS Online, Article 18. Retrieved from https://pdfs.semanticscholar.org/13d3...
Rawls, J. (1999). A Theory of Justice. Revised Edition. Cambridge, MA: Belknap of Harvard University Press.
Rogers, C. (1961). On becoming a person. Boston, MA: Houghton Mifflin.
Tarvydas, V.M. (1998). Ethical decision-making processes. In R.R. Cottone & V.M. Tarvydas (Eds.), Ethical and Professional Issues in Counseling (pp. 144-154). Upper Saddle River, NJ: Prentice Hall.
Yalom, I., with Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
"In the 1960s Gilbert Wrenn (1962), one of the pioneers in the counseling profession, characterized a culturally encapsulated counselor as having some of the following traits:
• Defines reality according to one set of cultural assumptions
• Shows insensitivity to cultural variations among individuals
• Accepts unreasoned assumptions without proof or ignores proof because that might disconfirm one's assumptions
• Fails to evaluate other viewpoints and makes little attempt to accommodate the behavior of others
• Is trapped in one way of thinking that resists adaptation"
"In a historic and far-reaching decision, the U.S. Supreme Court officially reversed Roe v. Wade on June 24, 2022, declaring that there is no constitutional right to abortion, upheld for almost a half century, no longer exists. The decision dismantled 50 years of legal protection and paved the way for individual states to curtail or outright ban abortion rights. State laws range from complete abortion bans with criminal penalties to abortion protections that include funding for clinics, and legal protections for clinicians. Several states have already outlawed provision of abortion services, and more states are expected to act in the near future. Justice Clarence Thomas wrote that certain other landmark rulings should be reconsidered, including established rights to contraception access, same-sex relationships, and same-sex marriage.
An inability to obtain a safe and legal abortion will directly affect the physical and mental health of women. Women who require an abortion and are unable to legally obtain one may seek the procedure from sources other than a medical professional, risking serious harm in doing so. If women are forced to carry a pregnancy to term and place the child for adoption, they may experience feelings of remorse or guilt. If a woman is unable to care for a child but cannot obtain an abortion and does not place the child for adoption, she and the child face considerable health risks. The decision for overturning Roe v. Wade necessitates that counselors, counselor educators, and counselors-in-training reflect on their personal beliefs regarding abortion and ensure their ability to bracket their own values, beliefs, and attitudes that may harm clients."
Although values and ethics are frequently used interchangeably, these two terms are not identical. Values pertains to beliefs and attitudes that provide direction to everyday living, whereas ethics pertains to the beliefs we hold about what constitutes right conduct. Ethics are moral principles adopted by an individual or group to provide rules for right conduct. Morality is concerned with perspectives of right and proper conduct and involves an evaluation of actions on the basis of some broader cultural context or religious standard.