The sensitive nature of mental health and the professional relationship between patient and therapist necessitates ethical standards. On a practical level, a code of ethics can help resolve ethical dilemmas, such as the issue of obtaining informed consent, and determine professional responsibility for certain actions. Among the professional associations that have their own code of ethics are the American Psychological Association (APA), the American Association of Marriage and Family Therapy (AAMFT), and the American Counseling Association (ACA).
The licensing board and/or professional association linked to a therapist’s license is responsible for instituting the ethical guidelines of their professional conduct. The code of ethics for therapists serves as a reference to the values and ethical principles under which the role of a therapist is held. It also establishes rules, regulations, and other considerations for providing professional services and resolving ethical concerns.
While many ethical guidelines overlap among organizations, specific values are promoted by each governing body, which stipulates its own professional standards. In this article, we’ll cover different codes of ethics for various mental health organizations and the professionals who belong to them.
Association Of Marriage And Family Therapy (AAMFT)
Like other professional organizations for therapists and counselors, the AAMFT outlines professional expectations aimed at “honoring public trust.” It includes multiple sections, such as:
- Aspirational Core Values. These core values include acceptance and inclusion of a diversity of members, excellence and specificity in the training of therapists, innovation and advancement of therapies, and “integrity evidenced by a high threshold of ethical and honest behavior within Association governance and by members,” among others.
- Commitment to Service, Advocacy, and Public Participation. This section underscores these values by urging therapists to participate in “activities that contribute to a better community and society, including devoting a portion of their professional activity to services for which there is little or no financial return.”
- Ethical Decision-Making. This section states that “If the AAMFT Code of Ethics prescribes a standard higher than that required by law, marriage and family therapists must meet the higher standard of the AAMFT Code of Ethics.” While therapists must comply with law mandates, they can assert their commitment to the Code of Ethics by taking the necessary steps to resolve any conflict of interest.
- Resolving Complaints. The AAMFT investigates any complaints of unethical behavior, even if the therapist in question resigns before the investigation is completed. Individuals are considered innocent by the Ethics Committee until proven otherwise.
- Responsibility to Clients. Under responsibilities to clients, there are many valuable sub-sections, including matters of informed consent. These guidelines state that therapists must “obtain appropriate informed consent to therapy or related procedures and use language that is reasonably understandable to clients.” In the case of a minor or person incapable of giving consent, the therapist is to seek it from a legal guardian. Informed consent applies to issues of capacity to consent, treatment processes and procedures, risks and benefits, consent without undue influence, and documentation of consent.
- Multiple Relationships. Also under responsibility to clients is the issue of multiple relationships, where therapists are encouraged “to avoid conditions and multiple relationships with clients that could impair professional judgment or increase the risk of exploitation. Such relationships include, but are not limited to, business or close personal relationships with a client or the client’s immediate family.”
- Sexual Intimacy with Clients. Other issues that fall under responsibilities to clients involve the prohibition of sexual intimacy with current or former clients or known family members, written consent to record any images or audio, and clarification of relationships with third parties. Therapists must obtain written authorization to release client information and offer clients access to their records. This section also covers confidentiality in consultations with other therapists; professionals must ensure that the identity of the client, research participant, or other person with whom the therapist has a confidential relationship is not revealed unless previous informed consent has been given.
- Maintenance of Professional Competence. AAMFT guidelines state that therapists are to seek to remain informed of developments in the field through continuing education, training, and supervised experiences.
Many other sections are also outlined including concerns pertaining to financial arrangements and issues related to technology-assisted therapy. Here, the AAMFT states the potential risks and benefits of other therapy mediums and outlines precautions to ensure the safety of both the client and the therapist.
The American Counseling Association (ACA)
The ACA maintains a thorough Code of Ethics for its professional counselors. The guidelines set forth by the ACA establish trust as the foremost consideration for professional counselors in fostering positive relationships with clients and offering services in a way that honors their professional roles and responsibilities. Many matters are covered within its nine sections and various sub-sections.
Under counselors’ primary responsibility to “respect the dignity and promote the welfare of clients” is the need to “create, safeguard, and maintain documentation necessary for rendering professional services.”
Section A covers the counseling relationship, confidentiality, and professional responsibility. An ethical dilemma pertaining to informed consent, for example, requires counselors to explain the responsibilities of clients and therapists toward each other in both verbal and written form. This is described as an ongoing process.
Qualifications of the therapist, the techniques used in therapy, and the goals, risks, limitations, and changes in modality or approach are also to be explained to the patient or guardian. Patients have the right to confidentiality but there are limitations to it, such as when shared information is shared among colleagues. The guidelines state that information should be clearly explained in language that the client is able to understand, and if an interpreter/translator is needed, the therapist should be prepared to ensure that they obtain the necessary arrangements. When informed consent becomes problematic, such as in the case of minors or incapacitated adults, the counselor should still aim to include them in the decision-making process as much as is appropriate and feasible.
In cases where clients have a relationship with other therapists, they are to “request release from clients to inform the other professionals and strive to establish positive and collaborative professional relationships.”
Intimate relationships with former clients or their family members are prohibited for five years and even then must be approached with careful deliberation.
Section B is titled “Confidentiality and Privacy.” Matters such as accepting gifts, respect for privacy and confidentiality (and its limitations), bartering, and more are covered.
Section C refers to various professional responsibilities, such as being qualified for employment, guidelines for engagement in specialty areas of practice, monitoring the effectiveness of treatment, the need for continuing education and remaining informed in current practices, considerations when advertising services, and other matters.
Subsequent sections cover areas such as relationships with other professionals, resolving ethical issues, research and publication, and more.
The APA states that “the Ethics Code is intended to provide guidance for psychologists and standards of professional conduct that can be applied by the APA and by other bodies that choose to adopt them.”
Divided into separate sections, the ethical guidelines set forth by the APA contain many sections and sub-sections, including general ethical principles and guidelines for resolving ethical dilemmas.
The ACA, APA, and AAMFT outline many shared values and responsibilities. For example, they all endorse the following:
- Professionals should contribute to their community and devote part of their professional activity to providing services with little or no financial return
- Professionals should be familiar with the code of ethics governing their license, and that lack of knowledge of ethical conduct does not excuse unethical conduct or actions
- The need to obtain informed consent
They differ in other matters, such as the AAMFT’s outright prohibition of intimate relationships with former clients or their family members, whereas the APA and the ACA state a prohibition period of two and five years, respectively.
Online Therapy For Therapists
Being a therapist or counselor can be challenging at times, posing multiple demands and ethical dilemmas. The need to safeguard and promote the welfare of others may be rewarding but simultaneously stressful. Prioritizing your own well-being and mental health along with your clients can help ensure that you are equipped to meet the demands of your profession. If you perceive that you are experiencing a lot of stress, it might be helpful to consider therapy—in-person or online.
A platform like BetterHelp can connect you with a licensed therapist who meets your needs and with whom you can have sessions through video chats, phone calls, or in-app messaging. Virtual therapy might be useful when you need to book sessions that fit into your busy schedule.
Choosing Between In-Person And Online Therapy
A recent meta-analytic study compared clinical interventions and assessments delivered via video-conferencing technology versus those offered in person. Their findings suggest that in-person and online therapy interventions deliver similar results. If you’re seeking mental health support, it may be comforting to know you can receive positive outcomes regardless of the format of therapy you choose.
Ethical guidelines not only serve to help resolve ethical dilemmas but also inform the values and principles of professional therapists and counselors. While they may overlap among different organizations, specific values are promoted by each governing body that provides its own professional code of ethics. Mental health professionals can ensure the efficacy and integrity of their practice by abiding by these guidelines as they help their clients.
Meeting the demands of a career in mental health can be challenging, but resources like online therapy can be useful for therapists who would like to prioritize their own well-being and mental health alongside their clients’. Therapists who participate in therapy may feel more gratification from their careers and experience an enhanced ability to serve their clients effectively.