Contemporary Decision-Making Models

Although the Code provides guidance for ethical practice, it is impossible to address every possible ethical dilemma that rehabilitation counselors may face. When faced with ethical dilemmas that are difficult to resolve, rehabilitation counselors are expected to engage in a carefully considered ethical decision-making process. 

Ethical decision making is a skill that rehabilitation counselors must cultivate over the course and scope of their career. No one authoritative model exists to serve as the mechanism for rehabilitation counselors to make ethical decisions. To that end, the CRCC does not advocate or advise one strategy over another. However, many sound models prescribe similar processes to weigh ethical dilemmas. Traditional models evolved from the moral-based medical ethics strategy of Beauchamp and Childress (1979) into using principle ethics as the foundation for counselor problem-solving (Kitchener, 1984). The most contemporary models integrate traditional concepts such as arbitrating and negotiating with virtue ethics ideals of self-reflection, community consideration and collaboration as a holistic decision-making framework, emphasizing advocacy and client empowerment outcomes. While there is no specific ethical decision-making model that is most effective, a modification of the steps included in Corey, Corey, Corey, & Callanan (2014) may be used as a foundation:

  • recognizing a problem;
  • collaborating with the client to define the problem;
  • developing solutions with the client;
  • choosing a solution;
  • reviewing the process with the client and re-choose;
  • implementing and evaluating with the client; and
  • continuing reflection.


Comparative Chart of Contemporary Decision-Making Models

Tarvydas
(1998)


Cottone
(2001)
Garcia, Cartwright, & Borchukowska
(2003)
Corey, Corey, Corey, & Callanan
(2014)
Herlihy & Watson
(2007)
Interpret situation Obtain information from those involved Awareness and fact finding – Enhancing sensitivity and awareness means not only being aware of a dilemma but also how that dilemma may affect the different stakeholders involved who may have different or opposing worldviews.  It is the counselor’s responsibility to know the differences. Identify the problem or dilemma Discernment
Review problem or dilemma Assess the nature of relationships - Conflicting opinions? Adversarial? Formulations of an ethical decision – review potential discriminatory laws or institutional regulations; make sure potential courses of action reflect the different worldviews involved; consider the positive and negative consequences of opposing course of action from the parties involved; consult with cultural experts, if necessary; select a course of action that best represents an agreement of the parties involved in the case. Identify the potential issues involved Respectfulness
Determine standards that apply to dilemma Consult valued colleagues and expert opinions including ethical standards Arbitration – Parties may not always agree.  In that case, the parties may seek arbitration if disagreement persists.  This is similar to negotiating where a third party can make the final decision or assist in coming to an agreement. Review the relevant ethics codes Acknowledgement of emotions in the decision-making process
Generate possible and probable courses of action Negotiate if necessary Know the applicable laws and regulations

Self-reflection
"Who shall I be?"

Consider consequences for each course of action Consensualize Obtain consultation Community consideration
Consult with supervisor or peers Interactive reflection (when consensualization fails) Consider possible and probable courses of action Consultation
Select an action by weighing competing values, given context Arbitrate if necessary Enumerate the consequences of various decisions Collaboration
Plan and execute that selected action Choose what appears to be the best course of action
Evaluate course of action

 

Representative Contemporary Decision-Making Model Citations

Corey, G., Corey, M. S., Corey, C., & Callanan, P.  (2014). Issues and ethics in the helping professions (9th ed.). Belmont, CA: Brooks/Cole.

Cottone, R. R.  (2001). A social constructivism model of ethical decision-making in counseling.  Journal of Counseling Development, 79, 39-45.

Garcia, J., Cartwright, B., Winston, S., & Borchukowska, B.  (2003). A transcultural integrative ethical decision-making model in counseling.  Journal of Counseling and Development, 81, 268-276.

Herlihy, B. & Watson, Z. E.  (2007). Social justice and counseling ethics.  In C.C. Lee (Ed.), Counseling for social justice (2nd ed., pp. 181-199). Alexandria, VA: American Counseling Association.

Tarvydas, V.M. (1998). Ethical decision-making processes.  In R.R. Cottone & V.M. Tarvydas (Eds.), Ethical and Professional Issues in Counseling (pp. 144-154). Upper Saddle River, NJ: Prentice Hall.