Importance of Initial Consultation and Ethical Issues Facing the Therapist The WritePass Journal

Importance of Initial Consultation and Ethical Issues Facing the Therapist Introduction Importance of Initial Consultation and Ethical Issues Facing the Therapist ). There are some who do not charge for initial consultations, and it is important that the client is informed whether the therapist does or does not charge for the first session (Wheeler, 2014).   A potential problem may ensue with the use of a free initial consultation. This is because clients may feel committed after the initial consultation and may have difficulty declining further treatment because the initial consultation was free of charge. Some might even regard this practice as taking advantage of clients and may perhaps be seen as undue influence mentioned in the code of ethics (Welfel, 2013). Another ethical issue that may ensue during initial consultation is sexual attraction between the client and the therapist, which is identified as a boundary ethical issue (Houser et al., 2006). The client may have emotional or sex-related problems that he/she initially presents to the therapist, which the therapist must approach objectively. Albeit discussion of these feelings can foster therapeutic progress, it is still unethical and counter-therapeutic to act on them. Even when it may seem sound to become sexual with a client with sexual problems as an intervention, engaging in such unethical activity is definitely against established ethical standards and codes. Rather, the best intervention that the therapist may adopt for his/her client with sexual problems is sex therapy with the client and a significant other.     The several malpractice suits filed against therapists relating to sexual relationships with their client only confirm the unethical and counter-therapeutic sta nce of sexual relationship between the therapist and client (Kohlenberg and Tsai, 2007).   Even at the onset of the initial consultation, sexual attraction may already spark, which the therapist, being the more responsible person, must put a wall against. Emotional tyranny is also a common ethical issue that may occur even during an initial consultation. It is a term describing abuse of power by psychotherapists to the disadvantage of their clients, caused by the power imbalance between them. For example, during the initial consultation, the therapist’s power is seen in how he establishes the therapy session, how long   the session should last, how often he and the client should meet, how much the session costs, and what the permissible and impermissible behaviour must be within the session (Kohlenberg and Tsai, 2007). The realm of ethical decision-making involves the aspects of ethical dilemma, the client and the therapist’s values, race, gender, personal history, etc.; local and national laws; professional knowledge; and codes of ethics (Houser et al., 2006). The therapist may also face violations relating to dual relationships. Such relationships are nonsexual that may involve counseling a friend, relative, or neighbour, as well as receiving referrals from people who know the client and the counseling process. An ethical dilemma of dual relationships may potentially occur when the therapist has several roles with a client; in that apart from being a client, the person is also a friend, a neighbor, a relative, etc. to the therapist. It has been suggested that accepting referrals from existing clients may constitute a boundary violation (Houser et al., 2006). Indeed, even at the initial consultation, the therapist is already face-to-face with the issue of whether to continue with the professional relationship, or terminate it right away upon seeing his or her friend across the table as a client seeking therapy. Self-disclosure is another ethical issue besetting the therapist. Even during the initial consultation, the issue of self-disclosure may occur. Relating to this issue, it is important to determine the extent of information a therapist should share with the client and the types of self-disclosure to be made as well. Another example of ethical issue involving boundary is socialising with a client outside the counseling session and negotiating for fees (Houser et al., 2006). One possible ethical dilemma facing the therapist during is confidentiality, which deals with maintaining privacy and nons of these are those surrounding harm that may involve the client who is contemplating about suicide or is expressing thoughts about inflicting harm to others;   court-involved clients; child abuse reports; and clients with medical conditions who express engaging in precarious acts relating to their condition (e.g. HIV) (Houser et al., 2006). Further, it was found that successful outcomes ensue when clients change their personal values and take a close resemblance of that of the therapist/counselor. A relevant ethical dilemma with regard to this is in order for the counseling to be successful, how similar the client’s values must be to the counselor. Moreover, another dilemma is whether fostering such similarity is ethical and helpful enough to the client. A question for the profession is whether therapists utilise moral and ethical frameworks reflecting society’s norms as the only basis of their ethical decision-making, or whether therapists come to an ethical decision whilst taking into account the values, morality, and ethical stances of their diverse client population (O’Donohue and Fisher, 2009; Houser et al., 2006). These issues are being dealt with even upon an initial consultation. Conclusion This paper dealt with the importance of initial consultation and the ethical issues facing the therapist in the performance of his profession. An initial consultation is important because it forms the basis of the client’s diagnosis. It generally covers finding out the reasons as to why the client seeks help and what he or she aims to obtain as a result of the psychotherapy experience. The ethical issues faced by the therapist in the conduct of his profession during the initial consultation are those involving a decision to charge the client for a specific fee or not for the initial consultation; potential sexual attraction between them; the issue of confidentiality and client consent; emotional tyranny; violations relating to dual relationships; and self-disclosure. Having laid down these ethical factors besetting a therapist, the conclusion being arrived at is that the therapist is bound by set standards and ethical codes through which the expected functions of his performance must be based, and that he/she should conduct the initial consultation and further sessions objectively. References Boylan, J. C., Malley, P. B/, and Reilly, E. P. (2011) Practicum Internship: Textbook and Resource Guide for Counseling and Psychotherapy. Third Edition. NY: Brunner-Routledge. Corey, G. (2013) Theory and Practice of Counseling and Psychotherapy. Ninth Edition. 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