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Counselor Ethics & Politics

The practice of counseling is closely connected to the concept of mental illness and therefore, of social norms and value judgments. In 2005, the American Counseling Association (ACA) developed its 20-page code of ethics to deal with some of these issues. In a more political vein, Dr. Thomas Szasz has maintained that mental illness is a political and social construction that serves to enforce conformity.

  1. Counseling Ethics

    • The 2005 code of the ACA is fairly standard in that it deals with issue areas of practitioners. It does not deal with political issues per se. The ACA steers its members away from the "imposition" of its values upon patients, and seeks to protect patients by keeping their sessions secret and remaining sensitive to cultural norms of behavior. The ACA holds in its preamble that the purpose of counseling at its most general is to enhance "human development." In other words, it makes no claim to do anything except increase social utility.

    The Politics of Mental Illness

    • Szasz holds that the ACA cannot keep to its own code of ethics without putting itself out of business. While the ACA wants to keep value judgments out of the counseling relationship, Szasz holds that the very position of "counselor" reflects social values. It is a power relationship where the counselor, doctor or psychiatrist serves as the icon of "normality" while the patient is representative of "madness."

    Ethics and Politics of Counseling

    • Szasz maintains his famous and long-held position that "madness" or "insanity" are words that refer to nothing except social norms. Counselors serve as "agents of the state," enforcing social norms and even statute law by giving the state more reason to lock people away when the criminal justice system cannot. Counseling and psychiatry are immoral according to Szasz because they serve to enhance human development primarily by destroying the autonomy of the patient. The patient is not an equal to the counselor -- the patient is an object for the counselor, and therefore, is a means to an end rather than an end himself.

    Ethics and Coercion

    • The basic thrust of Szasz's famous attack on all mental health professionals is that this field is the only one that legitimizes open coercion in the name of "human dignity." The basic ethical norm of independence is sacrificed to social unity and law enforcement. All aspects of life are now medicated and treated as aspects of a mental illness that apparently knows no bounds. According to Szasz, the mental health establishment will not be satisfied until all, or nearly all, Americans are considered abnormal and brought under its power and suitably medicated. The stress on social utility and vague expression such as "quality of life" is such as to override the rights of individuals for the sake of the medically determined good of society.

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