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Ethical Dilemmas in Children's Counseling

Children see counselors for a variety of reasons. During a counseling session, the counselor evaluates the youth to look for concerns or symptoms of an emotional disturbance. A counselor is supposed to remain objective regarding the information that his young patient shares. However, ethical dilemmas can arise and challenge the neutrality of the counselor, thereby clouding his clinical judgment.

  1. Decision-Making Dilemmas

    • The American Counseling Association understands that counselors are often faced with hard decisions that challenge their ethical or moral code. As such, the ACA offers guidelines for clinicians to help them work through tough decisions. One of the most important things for a counselor to remember is not to take the situation personally, and to make a decision that keeps the child -- and others -- safe. Counselors are trained to emotionally remove themselves from a scenario to provide unbiased and objective advice to a child or his family.

    Crossing Boundaries

    • The bond between a child and his counselor can become very special, especially if the child is lacking parental or adult guidance in his life. While a strong connection is O.K., the relationship between the counselor and his clients must remain professional and not cross any boundaries. An example of crossing a boundary is if the counselor paid for the child to go on a field trip with his school because his parents could not afford it. Counselors must also be careful to disclose too much information about themselves to their clients. Sessions are not a time for counselors to self-disclose, nor is it appropriate to do so at any time.

    HIPAA

    • The Health Insurance Portability and Accountability Act is a confidentiality law that prohibits the sharing of clinical information about a client without the proper release agreement forms. This means that if a child's teacher calls and asks the counselor to see the notes from the therapy session, the counselor must adhere to HIPAA and not release any information. Only the child's parents or guardians can determine whom to release certain information to. Some counselors may find this to be an ethical dilemma, especially if they believe that a teacher, for instance, would benefit from having certain information. However, counselors must not disregard HIPAA confidentiality laws or they can face fines and penalties for doing so.

    Dual Relationships

    • A dual relationship is a clinical term used to describe when one counselor provides therapeutic services to two people who are closely related by blood or association, such as siblings, a husband and a wife or two coworkers. Dual relationships can cause ethical dilemmas for counselors if the two individuals talk about one another during their therapy sessions. It can become difficult for the counselor to keep information private, especially if he feels that something challenges his personal values or belief system.

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