Senerio : You have been counseling a family of Korean origin for the past 5 weeks. Specific family members have been suffering from generalized anxiety disorder, which is connected to family discord and what you see as blurred boundary issues. In your fifth counseling session, the teenage daughter tells you that her parents do not understand American culture and how it affects family rules. Having worked with over a hundred clients struggling with anxiety, you feel she needs to set clear boundaries with her parents. You instruct her to exercise more independence from her family and seek to become self-actualized.

As a competent Christian counselor, you also give her Mark 10:6-9 and Luke 14:26-27 and ask her to study them this week to see how individuals must distance themselves and become self-differentiated. In your reply, look for other confirmations in the codes that the therapist either did well or violated competent practice.

Would this be an accurate assessment? why or why not?

As professional counselors, the primary ethical obligation is to make clinical decisions that are grounded in promoting client welfare and avoiding harm (ACA, 2014, A.1.a., A.4.a.). In the case presentation, the family being counseled is of Korean origin. The choice to accept clients who are culturally or ethnically diverse from the counselor is an ethically appropriate practice (AAMFT, n.d., 1.1, ACA, 2014, C.5.). Assuming that the counselor is not a member of the Korean culture, to practice ethically, they would need to seek education to expand their knowledge of Korean culture (ACA, 2014, F.11.c.). Reading scholarly sources related to Asian culture, participating in continuing education, seeking supervision, and consulting with respected colleagues are ways to improve one's knowledge of a different culture (AACC, n.d., 1-250, ACA, 2014, A.2.c., C.2.e., C.2.f.). Asking questions in an open and respectful way about the client's culture can increase the counselor's knowledge and positively influence the therapeutic alliance (Hays & Erford, 2018).

A consideration that the counselor must keep in the forefront to avoid blurring the boundaries where there are multiple relationships because they are counseling the family as a unit (AAMFT, n.d., 1.3, ACA, 2014, A.8.). One way this can be managed is to ensure that the limits of confidentiality are made clear at the beginning of therapy through informed consent and revisited throughout the therapy process (AACC, n.d., ES1-310, AAMFT, n.d., 1.2, ACA, 2014, A.2.a.). With the teenage daughter bringing her parents' acculturation into the counseling space, the counselor should be mindful of who is the identified patient in family therapy (Goldenberg et al., 2017). The daughter's comment provides an opportunity to incorporate psychoeducation highlighting the differences and similarities in American and Asian culture so the family can discuss their perceptions and expectations in a safe space.

In the case presentation it sounds like the counselor is using her past counseling experience to make a generalization about individuals with anxiety. Anxiety is a broad spectrum mental health disorder and therefore treatments must be individualized. Reichenberg and Seligman (2016) posit that despite generalized anxiety disorder being one of the most common, there is not a clear understanding of what leads to its development. The contributing factors that have been cited are genetics, environmental risk factors, and temperament. By instructing the teenage girl to exercise more independence, the counselor appears to be ignoring the client's culture. Individualistic identity contradicts the Asian collectivistic value that the actions of one influence the integrity and welfare of the family (Hays & Erford, 2018). Encouraging behaviors that may be in direct opposition to the client's culture could be unethical (AACC, n.d., ES1-520, ES1-540).

Ethically the counselor should not explicitly introduce spirituality in the counseling space without the client's consent (AACC, n.d., 1-330.). By assigning biblical passages as a therapeutic intervention, the counselor is practicing unethically. Once a therapeutic alliance has been formed, the counselor can broach with the client their spiritual or religious involvement. Through open collaborative communication, the counselor can establish what if any spiritual integration is acceptable to the client. As a Christian counselor one can practice implicit integration through prayers of petition, personal Scripture study, and by interacting with the clients with respect and positive regard. Affirming the worth and value of the client is an ethical practice and it affords an opportunity to show Christ love through the attitude and actions of the counselor (AACC, n.d., 1-510). By selecting Bible verses that highlight a belief held by the counselor, the counselor is violating the ACA Code of Ethics by imposing their personal values (ACA, 2014, A.4.b.).

References

AACC code of Ethics. (n.d.). Retrieved from https://www.aacc.net/wp-content/uploads/2020/06/AACC-Code-of-Ethics-Master-Document.pdf

Advanced Solutions International, I. (n.d.). Code of ethics. Retrieved from https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx

American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved from http://www.counseling.orgLinks to an external site.

Goldenberg, I., Stanton, M., & Goldenberg, H. (2017).Family therapy: An overview(9th ed.). Brooks/Cole Publishing Co.

Hays, D. G. & Erford, B. T. (2018). Developing multicultural counseling competence: A systems approach. Pearson.

Reichenberg, L. W., & Seligman, L. (2016). Selecting effective treatments: A comprehensive systematic guide to treating mental disorders. John Wiley & Sons, Inc.