Issue One: Breaching Confidentiality in Counseling Minor leagues
Before we move into the subject. we want to research the issue of confidentiality in reding. This is applicable to non merely bush leagues but besides all age groups. faiths. civilizations and genders. Remley ( 1985 ) stated that confidentiality is an ethical criterion that is a regulation of pattern set Forth by a profession. The American Counseling Association’s ( ACA ) Code of Ethics and Standards of Practice require that counsellors respect their clients’ right to privateness and avoid illegal and indefensible revelations of confidential information. The ACA codification lists the exclusions to confidentiality as when revelation is required to forestall clear and at hand danger to the client or others or when legal demands demand that confidential information be revealed. When reding clients who are bush leagues or persons who are unable to give voluntary. informed consent. parents or defenders may be included in the guidance procedure as appropriate. Counselors act in the best involvement of clients and take steps to safeguard confidentiality.
Confidentiality should be for the benefit of the client be it whether the client is a minor or non. Should parents or defenders be involved in the guidance procedure. the counsellor must move with extremely professional expertness when unwraping confidential information. There is an ethical duty to obtain the minor’s permission before let go ofing information. For reding to be effectual and to supply an environment in which the client feels free to portion concerns. the counsellor must be able to guarantee minor clients that personal information will be kept confidential to construct trust between them.
There are hovering precedences between the rights of the kid. school policy. guardians’ rights. and dictates of Torahs and ethical codifications ( Glosoff & A ; Pate. 2002 ; Lawrence & A ; Kirpius. 2000 ) . There is a tenuous reconciliation act among the parents who desire liberty in raising their kids. the governmental bureaus safeguarding public public assistance. and the child who deserves both privateness and protection. The ACA Code of Ethics ( 1995 ) highlights the demands for the counsellor to clear up client relationships in households to straight turn to any possible struggles. and to advance flexibleness in the determination to affect a defender in the guidance procedure every bit long as confidentiality and the client’s best involvements are safeguarded. Recognition of the demand for a thorough apprehension of ethical and legal demands besides applies to the issue of responsibility to warn. A counsellor with a flexible orientation toward confidentiality will normally do an independent determination based on virtues of each separate instance that promotes the moral rule of fidelity in which the child’s trust is protected by maintaining the promises built-in in confidentiality issues ( Glosoff & A ; Pate. 2002 ) . An rating of what is in the child’s best involvement will rule. which underscores the moral rules of beneficence. This is seen as an equivocal procedure that is influenced by the counselor’s cultural background and personal values and prejudices.
Conversely. no warrant of confidentiality erodes the foundation of trust in therapy. taking to increased client opposition and premature expiration. In this state of affairs. from the beginning an stripling will be loath to come in a guidance relationship with a professional who seemingly views the mentioning bureau. tribunal. school. or guardian as the existent client instead than the adolescent. An attitude of flexibleness toward confidentiality offers the ability to be adaptable to assorted state of affairss. but throws the counsellor into the cloudy country of seeking to negociate the balance of ethical and legal dictates. A more moderate stance embraces the advice of the ACA Code of Ethics sing elucidation of reding relationships and can pull the stripling into the decision-making procedure. which strengthens curative resonance. Similarly. a counsellor inquiring the child’s permission before revelation gives the child a sense of control and helps diminish harm to swear when sharing information is necessary.
In the class of work when working with bush leagues. I sometimes can be ill-defined about my ethical duties refering confidentiality. particularly with striplings. When they mention activities such as shrinkage. alcohol addiction. drug experimentation and the most slippery instance of sexual wonts. it becomes a hard issue. The inquiry of confidentiality in moralss come into inquiry and the counsellor. or myself in this instance. will fight with edifice trust with the client and affecting the parents in the guidance procedure. Let’s see a instance survey.
Joseph’s parents divorced when he was 5 and he has been populating with his female parent since. His female parent used to go to therapy with him when she noticed he was really recluse and didn’t pass on really much since the incident. The therapy went on for a twelvemonth. Now at age 16. he has been sent to his counsellor after his signifier instructor has noticed his changeless late coming to school and besides looking listless and distracted during lessons. His classs have besides taken a crisp dip. His close friend. Kenneth. tells the instructor that Joseph has been go toing nightlong parties and has started to experiment with drugs and intoxicant. Joseph doesn’t say much during the guidance Sessionss except adverting that he has got a girlfriend now. who is 7 old ages his senior. and wants to travel in with her. They met at a party and got sexually involved with each other and he now feels responsible for taking attention of her. He insists the relationship is built out of love and that his parents should non hear or hold a say in any of this.
His counselor has shared her concerns with Joseph and is fighting with whether she has an duty to unwrap anything to his parents. It would be helpful to see this instance from three positions: that of jurisprudence. clinical pattern and moralss. The jurisprudence by and large states that bush leagues can non accept to intervention and a parent or defender will accept on the minor’s behalf. The parent who consents on the minor’s behalf by and large has the right to cognize the content of the child’s intervention until the minor reaches the legal age of ( normally ) 18. From a clinical position. the state of affairs is more complex. An of import facet of intervention is to further an individual’s liberty. and a great pleasance of handling striplings is to watch as they come to bask their turning independency. One facet of independency is privacy. As a kid grows into adolescence and maturity. the environing zone of privateness should increase. therefore doing room for a more defined sense of ego and a greater sense of liberty.
A paradox therefore arises: Good clinical intervention may necessitate what the jurisprudence by and large refuses. that is. a zone of privateness. I feel that early in the relationship the counsellor should do clear what relationship she will hold to each of the parties ( the child and the parents/guardians ) . It should be accompanied by an account of how information-sharing will work. what information will be shared. with whom and when. in a mode appropriate to the minor’s age and apprehension. As the kid develops and grows up. the construction of the therapy may alter for clinical grounds and this will hold ethical deductions. The minor’s greater sense of ego and enhanced capacity for liberty may necessitate greater regard for the child’s need for privateness. The counsellor will therefore necessitate to revisit earlier treatments and explicate that. for clinical grounds. the construction of the therapy should alter. Such boundary renegotiation is clinically and ethically indicated. However. a counsellor can non assure a minor that information will be kept from a parent who has legal detention. A parent with the legal right to intervention information may take. nevertheless counterproductive in the counselor’s eyes. to exert that right. Clinical opinion will besides be able to bespeak to what extent keeping an adolescent’s privateness is cardinal to the intervention. A counsellor may reason that an adolescent’s want non to hold information shared reflects an appropriate separation and so should be honored or he may besides reason that sharing certain information would be helpful.
If so. the ethical criterions from the subdivision on “Privacy and Confidentiality” gives the counsellor permission to make so. Nonetheless. regardless of whether an adolescent acquiescences to hold information disclosed to a parent. it makes both clinical and ethical sense to state the stripling beforehand. what information will be shared. and when. Ideally. the stripling would be portion of such conversations. There may besides be times when a counsellor will be mandated to unwrap information. Serious menaces of injury. disregard and maltreatment falls under compulsory coverage Torahs and must be disclosed in many provinces. Adolescents should be told that serious menaces of injury to self or others will besides non be kept confidential. A counsellor may experience strongly that uncovering information to a parent could harm the child or be destructive to the intervention. Refusal to unwrap in such a instance. even in the face of a parent’s petition. may be lawfully bearable. A counsellor in this place should seek both legal advocate and audience from co-workers. Joseph’s healer revisited the issue of confidentiality when Joseph expressed a want that she non talk with his female parent.
A via media was reached whereby the healer would talk to Joseph’s female parent merely with Joseph nowadays. The issue of confidentiality became more complicated when the healer felt that certain information should be shared and Joseph refused. The healer should gently research with Joseph the grounds behind this refusal. During some Sessionss. the healer should be direct with Joseph about her uncomfortableness with his behaviour. particularly the illegal activities. and point out the sorts of hazards he was taking. Hopefully. over clip. they would hold that Joseph himself would get down to talk to his female parent about these issues. and that the healer could follow up with a phone call. It is of import to discourse each and every contact between the healer and female parent exhaustively with Michael. every bit good as to back up his independent usage of psychotherapeutics. Issue Two: Transcultural Issues in Counseling
As a counsellor. we will be working with clients from assorted civilizations. In order to work efficaciously with culturally diverse persons and groups. it is of import to cognize what civilization means in people’s lives and to recognize differences that might be culturally-based. The thought of civilization is interesting and of import. but can be really difficult to specify and understand. Culture is a set of significances that provides a kind of design for how we should believe. experience. and act in order to be a portion of a group. It includes forms of traditions. beliefs. values. outlooks. and symbols ; in fact. every facet of who we are that isn’t biological in beginning. Often people are portion of more than one civilization ; for illustration. we may belong to a professional group. a spiritual group. and societal groups each of which has its ain manner of speech production. dressing. and acting. Often we don’t recognise facets of our civilization until we encounter cultural thoughts or patterns that are different from ours. Knowing our ain civilization is an of import facet of self-awareness. nevertheless. because we need to be able to recognize culturally-based differences.
Some cultural differences that affect reding relationships include communicating manners. for illustration the manner words and phrases are used. the grade of importance given to non-verbal communicating. and the appropriate grade of assertiveness in pass oning. Different attitudes toward struggle. for illustration whether struggle is positive or should be avoided. whether struggle should be resolved in face-to-face meetings. Different attacks to finishing undertakings. for illustration whether or non it is of import to construct a relationship with another individual in order to work with him or her on finishing a undertaking. Different manners of decision-making. for illustration bulk regulation or consensus. Different attitudes about unfastened emotion and personal affairs. Different attacks to cognizing. for illustration through symbolic imagination and beat. library research. sing people who have had similar challenges. As a counselor. we will be working with kids and households from assorted cultural backgrounds.
One of the most of import things to retrieve is non to presume that another individual has the same values. beliefs. and patterns that you do. We have to utilize our observation. hearing. and oppugning accomplishments to larn what is of import to the other individual and how they see the universe. We need to be unfastened to larning about other ways of seeing and populating in the universe.
Counselors need to be cognizant of their ain ethnicity and how it influences their interactions with other cultural groups. Problems need to be understood within the context of the person’s ethnicity. We learn from our civilization. appropriate ways of reacting to illness. For illustration. one group of people may be given to kick about their physical jobs. while another may deny holding any hurting and see it as a signifier of penalty. Attitudes towards seeking aid besides vary from one cultural group to another. It is of import to clearly spell out the undertakings of the first session to all household members and explicate in item the client-counselor relationship. The outlooks the household may hold about the brush might be based on its experience with the medical profession. The household may anticipate the counsellor to take charge and supply advice. By being direct. active and utilizing a structured attack. the counsellor establishes resonance with the household. The cultural group may comprehend the household as the primary beginning of support for its members. If this is the instance. the household may be sing shame and guilt for non being able to work out its ain jobs. For illustration. an person may turn to the household for support and seek our foreigners for support as a last resort. In some civilizations. it is non acceptable to show personal concerns with a alien ; hence. the clients follow the counsellor into their household. There may be frights and embarrassment about non being able to talk the linguistic communication of the dominant civilization good plenty to show troubles. As a consequence the counsellor may see the client as inactive and immune.
Culture influences the family’s orientation toward being internally or externally controlled. An internally oriented household has the belief that their accomplishments. or deficiency of accomplishments. are determined by their ain actions. therefore determining their fate. On the other manus. an externally oriented household has the belief that accomplishments and non accomplishments occur independently of their actions and that the hereafter is predicated on opportunity. An externally oriented household may be interpreted by an internally focussed counsellor as postponers. Another of import dimension when working with the people who are from civilizations different than our ain is the venue of duty. Locus of duty assesses the sum of duty or fault given to the client or the clients system. Determining if the person or the system is the cause of the behaviour is of import when doing an appraisal and finding intercessions. In Canadian civilization frequently the person is seen as being responsible for his/her actions. Racial and cultural minorities whose behaviours deviate from the in-between category are labeled as pervert.
Be cognizant of ethno cultural functions and hierarchy. If the male parent is considered the authorization figure. do certain you address him. first demoing regard for his cultural places. In trying to seek information from the kids. it is of import to get permission before continuing with the interview. Ask about issues that may be specific to a peculiar cultural group. Family members are frequently delighted to learn counsellors about the cardinal “insults” of their cultural group. If you experience opposition. look into to see if you have violated a civilization norm. We need to take note when the counsellor becomes excessively concerned about the family’s ethnicity to the point where one loses position as to their ground for seeking aid.
A major premise for culturally sensitive guidance is that counsellors can admit their ain inclinations and the bound of their civilizations on other people. Therefore. it is indispensable for counsellors to understand their civilizations and their worldviews before assisting and helping other people. Harmonizing to Padilla. Boxley. and Wagner ( 1973 ) . there is increasing grounds that the trained counsellor is non prepared to cover with persons who are culturally different from them. Cultural sensitiveness remains as one of the of import features of effectual guidance. Padilla et al’s authorship besides shows that one of the features of an effectual counsellor is the ability to acknowledge diverseness and cultural differences. It is undeniable that the demand to go to multicultural diverseness of clients is more obvious when counsellors and clients have different cultural backgrounds.
Culture is the nucleus of internal ways in which human existences develop their sense of ego. including values. beliefs. thought forms. perceptual experiences. and worldviews. All these qualities help find and determine one’s external civilization – the ways in which one establishes and maintains a relationship with the environment and others through inexplicit norms. linguistic communication. traditions. rites. and loyalties that influence attitudes. behaviours. and imposts ( Gushue. 1993 ) . While it is true that Singapore is a mix of different cultural groups. each group has retained much of its single alone cultural character. This is because Singapore’s policy has ever been geared towards multiculturalism. where every cultural group is allowed to continue its ain civilization while peacefully interacting with others. In the visible radiation of this. guidance and intercession is ever presented within the cultural context and restraints built-in in our widely distributed society. The apprehension of a client’s alone civilization is necessary in order for a counselor to efficaciously assist the former behave and experience otherwise in a trusting relationship so as to accomplish their ends. Psychological judgements are ne’er free from the influence of therapist’s ain cultural values. In intercession. counselors need to be knowing of the civilization of their clients because each civilization holds different thoughts about what constitutes jobs in life.
As we have grown up in a widely distributed environment. we are immersed in assorted orientations of different cultural groups. Our consciousness of our ain civilization merely increases when we go to topographic points where our civilization is non the norm. Similarly in a guidance room. when we are with our client from a different civilization. our consciousness of our ain civilization tends to increase excessively. We are cognizant excessively of the diverseness bing within the same civilization as people may pass on and interact in a whole scope of ways. Our worldviews as cultural bulk are extremely correlated with cultural upbringing and life experiences. There is a inclination to take for granted that the cultural minority has full cognition of our civilization since it is permeant in the society. On the other manus. some of us harbor tinted positions of the cultural minority that cause us to inadvertently enforce upon them stereotypes and preconceived impressions. In my sentiment. sensitiveness includes regard and credence of who they are. the manner they are and their beliefs.
Peoples of the minority race should be treated reasonably and every bit. There isn’t a demand to handle them with understanding ; otherwise. it would merely remind them that they are being differentiated. I learned from my Indian and Malay friends at school about their feelings as minority races in Singapore and that they prefer to be seen as peers. To be more effectual counselors. we have to first analyze ourselves or be cognizant of our personal values. beliefs. biass and motivations for assisting people. For case. my ain cultural beliefs that work forces should be stronger and be able to take on the universe and work out their jobs rationally and expeditiously do me more sympathetic toward my female clients. The wonder to research the deeper significance of our ain cultural behaviour will surely edify and do us more sensitive to the differences or similarities bing in different cultural groups. A wise counselor would ever seek to exceed such barriers and enter into the frame of mention of his client and operate from at that place.
The clients we see include pupils from every bit immature as 6 old ages old. aged patients at Nursing Homes/hospital. We besides have twosomes with matrimonial. household and fiscal issues. Their age group ranges from early 20s to the seventies. They are a mix of Singaporean Chinese. Malay. Indian and some immigrants. Our clients are chiefly from low to mean income group with basic instruction. English and Mandarin are the chief linguistic communications used. Dialects are used when reding the aged folks.
Each member in the group shared both common and alone cultural issues they face in reding. The sexism issue Annie on a regular basis encounters involves female victims of domestic force in Indian household whose work forces predominate in places of power. Most laden Indian adult females necessarily choose non to respond for fright of being ostracized by their ain household and community. Harmonizing to Yeo ( 1989 ) . Asiatic derives their individuality from rank in a household and a community and concentrating on the person might good estrange the individual from the household.
Peter and Juliet shared about the common gender issue where parents think they must remain with boies merely. while struggles with daughters-in-law are common issues excessively. Some parents choose to remain on their ain to avoid mortifying their boies. Medical and emotional jobs may ensue from solitariness. hapless ego attention and diet.
Jennifer related her early experience:
I’ve encountered troubles on many occasions with clients of a different race. peculiarly Malay clients. in covering with issues on gestation crisis. My early feeling was that they were either non willing to portion nor receptive to research other options and options refering to their determination to end their gestation. The session became more fruitful merely after I acquired greater apprehension of the Malay civilization.
For Magdalene. while she is competent in colloquial accomplishments with some idioms. trying to use reding techniques or accomplishments present a existent challenge. Majority of the guidance attacks are western in beginning. The constructs and account are all in English. It is easy to lose the deeper niceties when she attempts to use or interpret them into idiom or linguistic communication which she is non to the full competent in.
Both Magdalene and Ruth observed that it is culturally the norm of the older coevals to impute crisis to some external causes and to seek aid from temple mediums. The words of the mediums will so be accepted as truth. It can be a existent challenge to counselors from a different religion.
Ruth. the youngest member in our group. perceives age as a faltering block to effectual guidance when her clients are much older. In the Asiatic context. age is a mark of adulthood and wisdom. With aged clients. we are expected to demo regard and humbleness. non as person to work out their jobs.
Annie faced the social-economic issue when she encountered Singaporean work forces who resorted to increase their socio-economic position by taking married womans from the poorer ASEAN states. The married womans function more as domestic assistants or
attention suppliers to the elderly/invalid parents or immature nephews and nieces within the drawn-out household. The relationship is further strained by linguistic communication barrier and other cultural issues.
Western Counselling Models in Singaporean Context
The group is matter-of-fact in our guidance attack. incorporating different therapy theoretical accounts to run into the client’s alone demands. With cross-cultural interaction comes the possibility that the client’s purposes and actions may be misperceived. misinterpreted. and misjudged notably. when we employ the western guidance theoretical accounts on culturally different clients. We are cognizant that some of these theoretical accounts may non even fit people from western civilizations due to within-culture diverseness and other diverseness factors beyond civilization. ( Egan. 2005 )
The 2nd subject that emerged was the demand to understand the worldview of culturally different clients in order to cognize how best to incorporate the western guidance theoretical accounts in our guidance work.
Magdalene commented that the construct of individualization in Bowen Theory is culturally non in tandem with many aged Chinese clients. who come from an environment where the household. community. or clan takes case in point over ego ; hence distinction of ego can be foreign to them.
A person’s individuality is formed and continually influenced by his or her context. Working efficaciously with clients requires an apprehension of how the person is embedded in the household. which in bend requires an apprehension of how the household is affected by its topographic point in a pluralistic civilization. ( Sue. Ivey & A ; Pedersen. 1996 ) .
Bowen Theory encourages the healer to look into the Family of Origin to analyze the interlacing relationships. This can show itself negatively as in-laws or household members may non be forthcoming when it comes to speaking about sensitive and conflicting issues bring downing the household. Juliet presumed Bowen Theory will be better understood and accepted by the English-educated clients. but she found out to her discouragement that some constructs contradict their cultural beliefs.
Peter found Rational-Emotive Behavioral Therapy ( REBT ) to be excessively confrontational in manner. Stating a client that he is “horriblising” and “catastrophising” his life issues when he is seeking understanding from a counselor in his minutes of anxiousness is non traveling to be welcomed. Asians by and large seek familial aid when they have jobs. The construct of traveling to a counselor who is a alien is already a major divergence from their societal norms. Confronting a ambitious counselor may present as a humiliating experience for some.
Solution-focused Brief Therapy ( SFBT ) focuses on what clients want to accomplish through therapy instead than on the job ( s ) that made them seek aid. The attack does non concentrate on the past. but on the present and future alternatively. This goes down good with the clients she sees who are matter-of-fact and time-conscious.
However. Magdalene observed that inquiring the miracle inquiry to a matter-of-fact aged client may present a challenge. Some of them have mentalities that have been profoundly entrenched in their being ; they do non see the demand to alter. Similarly. to dispute the Irrational Beliefs ( Cognitive Behavioral Therapy ) of the aged whose sense of ego has been conditioned to follow a resigned temperament can be an acclivitous undertaking.
The usage of `hot-seat’ phantasy technique to assist clients show their feelings where there is unfinished concern may non be favored by the more ‘conservative and traditional’ clients as unleashing negative emotions towards the deceased is considered a tabu.
Magdalene related her brush:
Using Gestalt attack. I encouraged him to conceive of that the female parent was present at the minute. and for him to state her what was on his head. He responded. ‘she is already dead. what is at that place to state? ’ I realized subsequently
that while he might be bad mouthing and faulting her for his current predicament. it was culturally non appropriate for him to face her.
Ruth felt incompetent when she encountered aged people who frequently interrupted her during conversation to rectify her. Her age and deficiency of cognition in idioms made it hard for her to show herself competently. But she found Carl Roger’s Person-Centered therapy utile when working with clients who question her abilities.
The challenges we face as counselors in a multicultural environment require that we know and understand the client’s civilization so as to be congruous with the frame of the universe that the client is in during guidance. i. e. . persons are best understood by taking into consideration outstanding cultural and environmental variables. Regardless of the therapist’s orientation. it is important to listen to the clients and find why they are seeking aid and how best to present the aid that is appropriate for them. ( Corey. 1996 ) In this pluralistic and post-modern age. no 1 assisting attack has all the replies for the clients we see due to the complexness of human existences. as expressed by Sue. Ivey and Pedersen ( 1996 ) .
The 3rd subject that emerged was the demand for healers to make curative schemes that are congruous with the scope of values and behaviors that are characteristic of a pluralistic society.
Jennifer had this to state:
Without a deeper apprehension of the Malay civilization and faith. my counselling Sessionss with the Malays would surely be unfruitful. There are household and societal force per unit area to larn within the context of faith and civilization. The Malay clients who are pregnant out of marriage find themselves choosing for abortion as the lone manner to avoid go againsting household tradition. I have to work on intercessions that are congruous with the values of the clients.
It is a mark of regard that counselor choruss from make up one’s minding what behavior should be changed. Through adept oppugning on the counsellor’s portion. cultural minority clients can be helped.
The procedure of internalising a new civilization is an ongoing project. By and large the group is willing to be exposed to all sorts of clients so as to open up our ain universe positions of the different civilizations in our society. This includes interacting with people of different races at societal events and gay jubilations. We recognized that with the culturally-constraint client we have to travel slow during the first guidance session. The clients can be invited to learn the healers about the important parts of their cultural individuality.
We all acknowledged the importance of supervising and counsel when we are diffident and need elucidation. We besides will be seen as more professional if we master the basic nomenclatures of reding attacks in other languages/dialects.
Having an enquiring and speculative head about the different civilizations will assist broaden our positions. Formal instruction on the multicultural facets of guidance will assist to hone our accomplishments. We can besides derive penetrations by reading articles and books related to multicultural guidance. There are brawny enchiridions offering the theoretical background. practical cognition. and developing schemes needed to accomplish multicultural competency. ( Pope-Davis. Coleman. Liu. & A ; Toporek. 2004 ) . In add-on. there are extremely elaborate research surveies offering farther penetrations in multicultural competency. ( Darcy. Lee. & A ; Tracey. 2004 ) . The greater our deepness and comprehensiveness of cognition of culturally diverse groups. the more we can be effectual practicians ( Corey. 2001 ) .
In drumhead. the qualitative enquiry has promoted self-awareness of our ain personal civilization as we develop a sense of the universe. Courage. openness and humbleness are some of import elements we identified to procure trust and
credence by our clients of different civilizations. Our group will surely endeavor to incorporate appropriate guidance attacks to make curative schemes that are congruous with the client’s scope of values and behaviors. without renouncing our ain deepest beliefs and values.