Couples and family counseling is a tough business. As convoluted and complicated as families are, so too can be the directives that guide counselors. Regardless of the many ethical and legal codes that are in place for counselors working with families of all kinds, there are many dilemmas and situations that are brought to the table that simply aren’t specified in written documents (Patten, Barnett, & Houlihan, 1991). Often times, counselors are left to weigh the ramifications of one approach over another which requires knowledge, competency, and an ever present ideal of doing no harm. There may be no correct answer and having a thorough knowledge of the law, ethic codes, and the wishes of the clients is crucial to being a competent counselor (Hecker, 2003). So, how competent is your counselor? Without a rule book for every situation, how do you know he or she can help you?
The counselor you chose for your relationship or family counseling should be aware of ethical codes such as those listed by the American Association for Marriage and Family Therapy (AAMFT, 2001), the American Counseling Association (ACA, 2014), and the International Association of Marriage and Family Counselors (IAMFC, 2010) as well as have a full understanding of the legalities involved, both nationally and within your state. And that’s just the beginning.
So, how would you know that about your therapist? Well, simply asking is a good start.
Think about the last time you went to the doctor or dentist or even to your dog’s veterinarian. We tend to roll our eyes when the “spiel” comes and think we know what that person is going to say and tune out. Or we don’t read that piece of paper that the office person has us sign. Or we don’t take a copy, waiving it away because we don’t want to be bothered. In fact, many times, we don’t even question the person’s education or know about his or her experience.
You have a right to all of these things. Don’t be afraid to find out. Listen to the spiel. Read the fine print. Take a copy for future reference. Look for the degrees on the wall. Ask some questions. Look for red flags.
Do your research on your counselor. What is his or her background? What degrees does he or she have? What is the theoretical orientation? What is the office policy on payment, on no shows, on protecting you and your rights? If a counselor seems to sputter through your questions and does not address them fully, this is a red flag.
Does your counselor know what he or she needs to know from you in order to help you in your own growth? One way you can know this is occurring is if your counselor is gathering complete information from you and that your goals and treatment outcomes are talked about and agreed upon. If not, this is a red flag.
Does your counselor know about ethical codes, laws, and principles that are important to the mental health field as a whole? For example, your counselor should be clear on what “confidentiality” means and both of you should be able to initially agree to the term’s semantics both verbally and in written documentation. Sometimes, these are up for negotiation and sometimes they are not. If confidentiality is not brought up, this is a red flag.
One big area of confidentiality that tends to not be brought up until it’s too late is the role of secrets. Yep, secrets. We all have secrets. But how do we handle them in a counseling room? If this isn’t covered in an initially consult, this is a red flag.
Confidentiality issues, such as secret telling, can cause great ramifications within the therapy room if such concerns are not discussed in initial sessions. According to IAMFC Ethical Codes, Section II.B.3 (2010), members of a family are allowed to tell the counselor information individually and fully expect that it not be shared with the rest of the family unless other arrangements have been made beforehand. Hecker (2003) recommends having “secret policies” which are part of the initial consultation with a couple or family that explains what is considered confidential and what is not (p. 501). This way, the family members themselves take a more central part in what happens during therapy. So, if secret policies are not in place, a counselor cannot and will not share these secrets with the other members, as requested. It also means that he or she will not keep your secrets from your partner or family member if agreed upon together initially. This is a big deal – make sure you know before you start spilling. If you don’t, this is a red flag.
Confidentiality is a funny thing. Counselors will keep your secrets. But there is a difference between a moral secret and a legal one. If laws are being broken, such as child abuse or harmful intent, then the counselor is obligated, by both law and ethic code, to break confidentiality. This should be covered in the initial informed consent and also be verbally explained (IAMFC, Section II.C.1-7, 2010, p. 4.). If it’s not, this is a red flag.
So, what this all means is, if you are seeking relationship or family counseling, tough questions may happen. If fact, they should and will. Especially when secrets are involved. A counselor must weigh the ramifications of these ideals for the good of the family and its members. Is this secret creating harm? What are the consequences of keeping the secret? What would happen if this secret was shared? Working with the family toward a healthy state, such as creating trust and respect and working toward negotiation and personal responsibility may be in jeopardy if secrets are kept (Wilcoxon, 1985). Such ramifications of sharing or not sharing need to be explored fully with the member who confided the secret and the counselor in order to understand what needs to take place in future sessions. If it’s not, this is a red flag.
Successful outcomes rely on the therapeutic alliance and the responsibility a counselor has to the family as a whole. The family members’ intentions, beliefs, morals, and goals need to be understood and respected fully. According to the American Association for Marriage and Family Therapy (AAMFT, 2001) Ethical Code, Principle 1, Section 1.8, counselors must “respect the rights of clients to make decisions and help them to understand the consequences of these decisions [and] advise the clients that they have the responsibility to make decisions regarding relationships such as cohabitation, marriage, divorce, separation, reconciliation, custody, and visitation” (para. 15). If you don’t think this is happening, this is a red flag.
So, like I said, couples and family counseling is a tough business. For everyone. Red flags are everywhere. But when you know what you are getting into, you can easily turn away from the red flags and get on with the green ones. You deserve the best counselor you can find – they are out there with their green flags waving high, willing to tell you everything you need to make an informed decision. By eliminating red flags right away and knowing what is before you, you can get on with the business of working toward your goals as a healthy couple and family.
So, know thyself? Definitely. Know thy counselor and what counseling is all about before you start? Even better – it will get you to the know thyself bit a whole lot easier.
American Association for Marriage and Family Therapy (AAMFT). (2001). Code of Ethics. Retrieved from http://www.aamft.org/resources/LRM_Plan/Ethics/ethicscode2001.asp
Hecker, L. (2003). Ethical, legal, and professional issues in marriage and family therapy. In Hecker, L. L., & Wetchler, J. L., (eds.). An Introduction to Marriage and Family Therapy (1st ed.). Binghamton, NY: The Haworth Clinical Practice Press
International Association of Marriage and Family Counselors (IAMFC). (2010). Ethical Code. Retrieved from http://iamfconline.com/PDFs/Ethical%20Codes.pdf
Laureate Education, Inc. (Executive Producer). (2008). Introduction to couples and family counseling. Couples and Family Counseling. [DVD]. Baltimore: Author.
Patten, C., Barnett, T., & Houlihan, D. (1991). Ethics in marital and family therapy: A review of the literature. Professional Psychology: Research and Practice, 22(2), 171–175. Retrieved from the PsycARTICLES database. (AN pro-22-2-171)
Wilcoxon, S. A. (1986). Engaging non-attending family members in marital and family counseling: Ethical issues. Journal of Counseling and Development, 64(5), 323–324. Retrieved from from the Academic Search Premier database. (AN 4963099)