2006 Ethics Survey

EXECUTIVE SUMMARY

CRCC Certificants’ Perceptions of Ethical Dilemmas and
Implications for Code of Ethics Revisions


by Vilia Tarvydas, Ph.D., LMHC, CRC

In 2006, the Commission on Rehabilitation Counselor Certification (CRCC) conducted a web-based survey of a random, stratified sample of its 7,660 certificants for whom they had e-mail addresses. The survey queried responding CRCs concerning both ethically challenging, troubling incidents or dilemmas that they or a colleague have faced in the past year or two. In addition, they were asked about what ethically troubling issues or dilemmas they project may arise for rehabilitation counseling professionals in the near future. Beyond these two core questions, additional responses were solicited about whether the Code of Professional Ethics for Rehabilitation Counselors (the Code) addressed the ethical issues they have faced in the past; if they were able to resolve the issue; and how these issues were resolved. If the respondents were not able to resolve the issue, they were asked what additional resources they would find helpful, or that would clarify the situation, or assist in reaching a resolution.

Content analysis of the responses to the question regarding past ethical incidents and dilemmas yielded nine general themes for the ethical incidents or dilemmas described by the respondents. These responses involved issues of the following types, reported in descending order of frequency:
  • conflicts with organizations and payers, or employer pressures;
  • confidentiality and exceptions to confidentiality;
  • autonomy and client choice;
  • client relationship;
  • violations by colleagues;
  • miscellaneous;
  • discrimination or advocacy;
  • legal concerns regarding clients’ illegal or dishonest conduct; and
  • conflicts of interest.
The three Code Sections that were most frequently relevant to these issues (in descending order of citation) were:
  • Counseling Relationships,
  • Confidentiality, and
  • Professional Responsibility.
Respondents also were asked an open-ended question that asked them to project what may become an ethically troubling issue or dilemma that would be faced by rehabilitation counseling professionals in the near future. While some new issues were raised, there appeared to be a tendency for the respondents to continue discussion of many of the same issues they had raised in their earlier reports of issues and dilemmas encountered recently.

The analysis resulted in 14 general content themes that describe the concerns related by the respondents about future ethical issues:
  • confidentiality;
  • conflicts of interest;
  • employer or payer pressures;
  • technology;
  • client boundary issues;
  • scarce resources and allocation;
  • changing client populations;
  • diversity or discrimination;
  • client choice and autonomy;
  • profession’s problems;
  • family role or issues;
  • training;
  • education and competence; and
  • ethical knowledge and skills.
The respondents of the survey provided some richly detailed perspectives on the ethical challenges present in the field at present and those that are predicted to occur in the future. There were clear indicators that some specific topics in the Code should be reviewed. There also were indications that additional standards may be necessary on several concerns. However, the primary improvements appear to involve the practitioner’s need to understand and employ robust ethical decision-making competencies. Additional challenges appear related to systemic and organizational ethical issues that can only be partially addressed within a Code that is focused on individual practitioner obligations.