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Impact of Ethics, Bias, and Culture on the Therapeutic Alliance

Introduction

In therapeutic relationships, the counselors experience ethical issues which are complex to solve, and this affects how they deal with the clients and the relationship after the sessions. Counselors serve many clients who come from different cultural backgrounds and who have different beliefs and values. These professionals must determine how they will handle these issues by educating themselves on how to perform these duties better. The most common source of ethical issues emerges when the personal values and biases of the clients clash with those of the counselor (Bolsinger et al., 2020). The case study where Derric Armstrong is the client in a therapeutic session is an excellent example of possible cultural issues and personal bias and how professionals should apply professional and ethical standards to cope with these situations.

Application of Ethical Standards and Professional Boundaries

Professional boundaries refer to the ethical, organizational, and ethical frameworks that protect employees and clients from emotional or physical harm, enabling a safe working environment. Therapeutic work sometimes experiences challenging situations, making it difficult to maintain these professional boundaries. For instance, in therapeutic roles, a client can offer professional things such as gifts or requests for an extension of their friendship which can put the professional in an ethical dilemma (Reamer, 2020). The client might also bring information irrelevant to the therapeutic sessions and objectives. Therefore, there is a need for the therapeutic professional to understand the professional and ethical boundaries, codes of conduct, and organizational goals. The professional should also be clear and assertive to the client to ensure that the clients understand only to discuss what is relevant to the therapeutic process.

The first ethical standard is to protect the client’s confidential information in a therapeutic process. In this case, the client, Derric Armstrong, has disclosed confidential information to the counselor, and it is the counselor’s responsibility to keep the information confidential. For instance, Armstrong has described the challenges in his marriage that make him stressed, which is why he is seeking counseling intervention. He further explained that he does not have good communication with his wife and is in the process of reconnecting with his wife and making good communication. Armstrong is also heterosexual, while the counselor is gay. The counselor should be ethical enough to protect such information given by the client because he came to seek help. According to the ethical standard related to this profession, every client has the right to confidentiality and privacy. The ethical standard suggests that the professional must tell the client the limit of the confidential information to disclose to prevent the client from disclosing irrelevant confidential information.

The second ethical standard related to the case study is that the professional should recognize and enhance the client’s strengths to enable him to recover from their problems. The professional should identify the client’s strengths instead of focusing on their weaknesses. The client’s strong points can be used to give them direction on overcoming their weaknesses. Its first strength of Armstrong is their strong willpower to change. For example, he has explained that he was about to separate from his wife due to communication and trust issues, but now he is willing to change his behaviors to save the marriage. Secondly, he stopped consuming alcohol too much because he noticed it contributed to his argument with his wife. In general, their strengths are that he is willing to change for the better. Since he stopped taking too much alcohol, their marriage has been relatively peaceful. The professional counselor should rely on these strengths to give Armstrong recommendations for change to improve his condition.

Personal Bias Discussion

In the therapeutic process, personal bias refers to the attitude, perception, and emotion which can affect how the professional relates to the client and offers guidelines. Personal bias might make the professional tend to marginalize the client’s experience. For instance, confirmation bias refers to the professionals’ habit of seeking specific information that demonstrates their beliefs and attitudes toward the client. The professional might be inclined towards picking specific information from the client, hindering the professional’s ability to think objectively and logically. In every psychological research, the bias always undermines the process by altering the recommendations, which is harmful to the client because they might suffer from the biased recommendation. In the case of Armstrong, two personal biases are likely to occur, and they include biasness related to religious orientation and gang membership. The case study indicated that the counselor strongly resists people who leave Catholic Church and their beliefs to join Islam and Jew religion.

In this case, the potential source of bias is that the counselor was raised as a catholic and strongly recent people who converted from catholic to Jew or Islam. On the other hand, the client’s affiliation is Jewish, which might be a source of biased consultation and therapeutic outcomes. The counselor should be free from bias and understand that a client is different and everyone has their preferences. Another bias from this case is that the client was recruited as a gang member. Being in a gang might result in biasness from the counselor since the gang members killed his sister, and the case was never solved. Since his sister was shot dead, he has lived to hate the gang members, and he terms the people who join the gangs as a desperate and stupid move.

These potential sources of bias can make the professional counselor give illogical recommendations because he already hates these people. For the professional in psychological research and human services, biasness should not be involved in the decision-making, and the professional should not relate his past experiences with gangs affects the treatment process with Armstrong. Addressing personal bias requires the professional to understand the client’s cultural background and that everyone is unique based on their orientations in social life; by understanding that every cultural background matters, I will be able to avoid individualizing the client as a professional. Stereotyping might be biased, which should be combated by individualizing clients. As a counselor, I should also understand and respect unconscious bias’ magnitude.

Analysis of Cultural Concerns

The cultural issues more likely to emerge from this case are associated with stereotypes and microaggressions. Stereotyping is a belief in which people or things with similar traits or characteristics are assumed to be the same. Usually, these beliefs are unfair because they are generalized from one person or specific things (Jongen et al., 2018). In the case study, the cultural concern related to stereotyping is sexual orientation because the counselor is gay while the client is heterosexual. The client might have specific stereotypes about gay men, such as feeling insecure around him because gay men are attracted to people of the same sex. Armstrong might have a stereotype about gay men, and this belief might be gotten from his parents, church, and mass media. Many people are unfamiliar with gay men because their sexual orientation is recognized as queer, which has been generalized by negative stereotyping. People usually rely on generalized information about gay men because they lack firsthand familiarity with the correct information. Negative stereotypes of gay people depict them as murderers and violent, especially in fictional elements. Therefore, Armstrong might be afraid of interacting with the counselor because he is gay.

The other cultural concern likely to occur in this case is related to microaggression. Microaggression refers to the small racist gestures imposed on people of different cultures and nationalities. Racism practices or attitudes might affect the professional and the client relationship because it might lead to biasness, especially when giving recommendations related to mental health in the therapeutic process. The client is an African American, while the counselor is European American. Past research has shown that differences in ethnicity affect how healthcare services are delivered to people of a specific culture. African American has a history of being discriminated against in health care services in the United States. The racial differences between the two can influence the professional’s attitude toward offering healthcare services to clients. Unconscious bias can be the reason for discrimination here, where the professional has an unconscious bias towards Armstrong.

Conclusion

Ethics, cultural backgrounds, and bias can affect the relationship between the client and the therapeutic professional. The professional-client alliance should not be negatively affected by these aspects but should be strengthened by educating the professionals on the importance of understanding ethical standards and cultural backgrounds. Ethical standards in healthcare professions are critical in guiding the actions and the relationship between the clients and the healthcare professionals. The most common issues affecting this relationship and a smooth treatment flow include biasness, cultural and sexual orientations, and religious beliefs. Stereotypical beliefs exist in healthcare but should not be allowed to prevent the efficient delivery of healthcare services to patients. Confidentiality in the counseling sessions should be maintained to protect the client’s information and privacy.

References

Bolsinger, J., Jaeger, M., Hoff, P., & Theodoridou, A. (2020). Challenges and opportunities in building and maintaining a good therapeutic relationship in acute psychiatric settings: a narrative review. Frontiers in psychiatrypp. 10, 965.

Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency interventions: a systematic scoping review. BMC health services research18(1), 1–15.

Reamer, F. G. (2020). Boundary issues and dual relationships in human services. In Boundary Issues and Dual Relationships in the Human Services. Columbia University Press.

 

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