Code of Ethics for Psychological Counseling

The core essence of the psychological counseling ethics code has never been an "industry tightrope" that binds counselors' hands and feet, but a two-way protective net that simultaneously supports the well-being of clients and the occupational safety of counselors. It does not have an absolutely standardized execution template, and the ultimate criterion for all clauses is "client interests first."

To tell the truth, I took on my first long-distance case the year I just got my practicing certificate. At the end of the day, the client gave me a small can of cranberry cookies baked by me. There was also a sticky note with a little sun on the iron box, and said, "Teacher, it's quite troublesome for you to listen to me vomiting my bitterness for two hours at a time. You can use this as a snack." I was stunned for three minutes holding the iron box, then turned around and asked the supervisor for help. Unexpectedly, the two supervisors gave completely opposite opinions - the senior who did psychoanalysis had a tense face and said that he must not accept the gift. Once the door is opened to accept the gift, subsequent visitors can easily use the sense of contribution to hijack the consultation relationship. It is essentially the externalization of empathy, and must be resolutely refused and clarified. ； The supervisor, who is a humane person, laughed and said that it was only a few dozen yuan of handmade snacks, and they were holding them in hand. If you forcefully push them back, it would really hurt their hearts and break the trust that had been built so hard.

In the end, I accepted the request. During the second consultation, I spent ten minutes talking to her about the process of making cookies. I confirmed that she was simply expressing her gratitude and had no other requests. I also told her clearly, "I really don't need to bring her with you next time. You are willing to tell me what you have been hiding for several years, which is the greatest affirmation of my work." I worked on that case for 8 months. When she finally came out of her depression, she brought me a watercolor painting she painted. I still have it posted on the locker in the consulting room.

You see, this is the most interesting thing about the code of ethics - what it writes on paper is always principles, such as "avoid multiple relationships" and "not accept expensive gifts from visitors", but when it comes to specific scenarios, there is never a black and white standard answer. I have seen a novice counselor who is obsessed with rules. A visitor asked him, "Can I add you on WeChat? Sometimes I suddenly get emotional and want to send you a message." He directly quoted the rules and said, "We can't have any contact outside of consultation." This made the little girl blush on the spot, thinking that he had made some particularly excessive demands. ； I have also seen counselors who have no boundaries. After taking a case of a high school student, I added the mother's WeChat account. Every day, I received more than a dozen voice messages from the other party asking, "What did my child say to you today?" In the end, the client found that everything he said was relayed to the parents by the counselor, and he immediately fell out.

Many people think that the code of ethics is full of "forbidden" and "not allowed." In fact, if you look through the Chinese Psychological Society's Code of Ethics for Clinical and Counseling Psychology, you will find that the most core articles are centered around the client: Informed consent simply means that you have to keep things separate from the client. How long will it take to send, how long will it take, how much will it cost each time, and what circumstances will break confidentiality (for example, if the visitor has a tendency to harm himself or others, or if a minor is abused, etc.), don’t start by reading the informed consent form like a car insurance contract. People will sign it in confusion after hearing it, and it will be troublesome if anything goes wrong later.； The principle of confidentiality is not dead. Last year, I took a girl who was a sophomore in high school. During the third consultation, she suddenly told me, "I saved half a bottle of sleeping pills last week and I want to take them after the exam." I comforted her and contacted her parents on the same day.

Of course, there are still ongoing disputes over many ethical boundaries in the industry. For example, most counselors who do classic psychoanalysis strictly adhere to the "blank screen" principle. Not to mention accepting gifts and WeChat messages, they will not even reveal even half of their private lives to the visitors, for fear of affecting the presentation of empathy. ； However, counselors who do postmodern and narrative therapy sometimes take the initiative to reveal some of their own relevant experiences to the client. For example, if the client says that his mother was very depressed when she got cancer, the counselor may say, "I was so panicked that I couldn't sleep when my mother had surgery two years ago. I know how you feel." In the eyes of the former, this is a serious boundary violation, and in the eyes of the latter, this is a necessary way to establish an alliance. For another example, counselors who do family therapy often have to conduct interviews at home and directly enter the client's private space. Most counselors who switch to individual counseling will feel that this is a multiple relationship scenario that must be avoided - who do you think is right and who is wrong? In fact, there is no standard answer. As long as the starting point of all choices is "benefit to the visitor" and sufficient information is given in advance, it will not be considered a violation of ethics.

There is another point that many people misunderstand: they think that the code of ethics is used to regulate consultants, but in fact it is also a protective umbrella for consultants. Two years ago, a colleague received a case of severe depression. Each consultation was conducted with detailed risk assessment records, and the informed consent form and confidentiality exception were signed by the client. Later, the client committed suicide during the consultation period, and the family went to the agency to claim compensation. In the end, relying on the complete records of the ethical process, neither the consultant nor the agency took responsibility. To be honest, in this industry, we are exposed to other people’s negative emotions every day, and the probability of encountering extreme situations is really not low. By adhering to ethics, we are actually leaving a way out for ourselves.

This is my 7th year in this profession, but the more I do it, the more I feel that the code of ethics is not a rule written on paper at all, but a string that hangs in my heart every time I sit in the consulting room and face the visitors. Every time before you make a choice, ask yourself: Am I doing this for the benefit of the visitor, or to save myself trouble?

After thinking about this, most of the ambiguous questions actually have answers already.