Ethics in Counselling and 
Psychotherapy

By Jimmy Judge

In this article, I am attempting to explore some of the less obvious, yet equally
 important areas of ethics in Counselling and Psychotherapy. This issue can
 sometimes be a highly contentious one, particularly among therapists who find 
themselves comfortable with different, or even opposing, systems of thought or
 belief. Therapists who belong to a particular agency or centre may be bound to the
 code of that place, assuming, of course, that the agency is recognised, credible and a 
professional body. So far so good. However, the questions that arise for me around
 this area are: what makes someone a Professional Counsellor or Therapist? How do
we really know we are credible or worthy? The late Frank Lake addresses this issue 
as follows:

“To counsel professionally is a different matter. The questions arise, by what right do
 I offer counsel? Who vouches for me? I am a member of the Royal College of 
Psychiatrists but would what I practice meet with their approval? In a tight corner
 from where do I derive my resources? On certain matters I might well consult a
 colleague who is a member of the college, in other matters I would have more 
confidence in my spiritual director, or prayer.”¹

It would seem that the kernel of the ethical situation often falls within religious and 
spiritual territory. Because, after all, we are meeting the very heart of humanity in 
psychotherapy, and anyone attempting to counsel without support, belief and
 guidance from a spiritual source, is indeed treading on shaky ethical ground.
 The whole area of qualification and the hotly debated realm of accreditation are, in 
my opinion, vital aspects of ethical concern. There are other practical and extremely
 important considerations to reflect on and discuss, such as the delicate complexities 
around confidentiality in psychotherapy. I do acknowledge the efficacy of this and 
other aspects of ethical concern, yet I am drawn to the more uncomfortable and 
sometimes unspoken (especially among therapists) questions which ask: does
 therapy really work? Is it a big con job? A power trip on behalf of the therapist? Jeffrey Masson, who has been described by Dorothy Rowe as a ‘Trouble Maker’
 would certainly believe (and goes to great lengths to point out) that the practice of 
psychotherapy is basically damaging, harmful and deceitful to those who seek help. 
In his challenging, provocative best seller Against Therapy Masson conducts a direct 
assault on psychotherapy from all the various disciplines:

“To attempt to impose one’s own views on patients goes against the canons of most 
forms of therapy, but in reality this is what most therapists do. Freud, at the age of
 eighty two. wrote a strong statement against attempts to turn patients into mirror
 images of their analysts. However much the analyst may be tempted to become a 
teacher, model and ideal for other people and to create men in his own image, he 
should not forget that this is not his task in the analytic relationship, and, indeed, that he will be disloyal to his task it he allows himself to be led by his inclinations. If he 
does, he will only be repeating a mistake of parents who crushed their child’s 
independence by their influence, and he will only be replacing the patient’s earlier
 dependency by a new one.”²

Masson raises some interesting points that I believe ought to be explored fully by 
anyone actually practising psychotherapy or those thinking of doing so. After all, it 
is impossible for any human being to be completely wrong all of the time. In the
 same book, Masson not only attacks the older styles of therapy with their rigid, harsh
 and sometimes obvious lack of concern for the clients well-being, but also prods 
irritatingly at what we assume are more humane ‘person centred approaches.’ One 
of the more poignant points for reflection raised by Masson is this:

“The therapist is not a real person with the client. If he were, he would have the 
same reactions he would have with people in his real life, which certainly do not 
include “unconditional acceptance, lack of judging or real empathetic 
understanding.” We do not really accept everyone we meet, we are constantly 
judging them, rejecting some, avoiding some (and they us) with good reasons. No 
real person does any of these things Rogers prescribes – in real life.”³

It is important to note that, however important these views are, they are the views 
of one person and do not represent the world of psychotherapy. However, ethically,
 we cannot refuse to acknowledge what may be the shadow self of psychotherapy. 
For me, these questions are the core of ethics: how I feel about myself, my client,
 the world around me and God’s existence, or not, as the case may be. These issues
 could very well determine how we adhere to ethical codes and what they might be.
 As far as I can see, the key area in ethics in psychotherapy is that of power, in line
 with the medical model of therapy (from which, in my opinion, we are still suffering 
unpleasant side effects). The doctor, psychiatrist, counsellor or helper’ are clearly in 
control. They assume total power, make the decisions, determine the therapy style,
 duration and, of course, the financial cost. Even though the person seeking help may
 outwardly accept this arrangement, her inner feelings about the direction of her life
 may not find appropriate expression. Staying with this model and its basic
 assumptions, any decision around confidentiality, sexual orientation, finance, legal 
complications, religious and spiritual practice, and the clients’ basic rights to 
freedom are completely in the hands of the ‘expert therapist.’ This seems quite scary, 
really, because one is really depending on the counsellor’s ‘basic goodness’ or what 
kind of mood he or she might be in at a given time. If the therapist is not affiliated 
to an agency or association which requires personal therapy for the counsellor,
 ongoing supervision and consultation, the client may well be side open to abuse in
 many subtle forms, even if the therapist has the best of intentions (I trust that most 
human beings do). It would appear that many people find it difficult to resist the
 seductive feelings and sensations that accompany being in control, or having power 
- which is often disguised and cloaked in “what’s best for the client.” Obviously 
personal therapy for the counsellor is crucial in order to work through these various 
transferences and projections, reinforcing our commitment to honour our own journey and not allow it to become entangled with the client’s story. The
 counsellor’s own therapy needs to go hand in hand with ongoing supervision with 
experienced, open minded practitioners. This is imperative if we are to journey 
effectively with another human being, embracing all of the various ethical 
difficulties that may arise along the way.

The psychotherapeutic movement has progressed considerably since the time of
 Freud and his disciples. The gradual shifts away from the ‘mechanistic world view’
 is indeed a welcome one, which I believe has tremendous ethical significance.
 Professor Stanislas Grof, who is well known for his pioneering work evoking deeper
 aspects of consciousness as a way towards healing and wholeness, offers some
 interesting insights into the whole area of mental health and what is deemed to be 
normal and okay. With the more recent approaches to psychotherapy, the client is
 seen (and rightly so) as the expert, in control and totally responsible for bringing 
about change in his or her situation. The key role of the therapist is to acknowledge 
this and to assist the client to tap into their own rich, resourceful healing process…
therefore it is the client who decides what is mentally healthy for him or herself. In 
the following quote, Grof highlights the irony and arrogance of how we have been 
taught to live and what we should aspire to. As we will see, it is anti-therapeutic and 
does great violence to the human soul; “Mental health is defined in terms of absence 
of psychopathology “psychiatric disease”. It does not require active enjoyment or 
appreciation of existence and the full life process. This can best be illustrated by
 Freud’s famous description of the goal of Psychoanalytic therapy: “to change the 
extreme suffering of the patient into normal misery of everyday life.” In this sense 
an individual leading an alienated, unhappy and driven existence dominated by
 excessive power needs, competitive urges and insatiable ambition, could still fall
 within the broad definition of mental health if he does not suffer from manifest 
clinical symptom.”(4)

To conclude, I willingly acknowledge that I did not highlight the more ‘obvious
’ practical ethical issues, yet I feel that the areas I have attempted to address – the more
 undercurrent forces – are crucial to psychotherapy and those who practice it.
 Therefore, those of us working in this complex, demanding field ought to maintain 
the highest degree of personal honesty and self reflection, involve ourselves deeply 
and seriously in our own ‘inner journey’ and avail of regular supervision with an 
experienced person or group if we are to encounter with any sense of competency 
and sound judgement, the intricate delicate ethical labyrinth that may become
 obvious to us as we journey with our clients.

Jimmy Judge is a psychotherapist working in the Rutland Centre

Bibliography

1. Frank Luke Tight Comers in Pastoral Counselling P56 Darton, Longman and Tod

2. Jeffrey Masson Against Therapy p. 43 Fontana l990

3. Ibid p.4

4. 
Stanislav Grof Beyond the Brain, p.396 Suny