Counselling Dilemma: A Complex Family Situation
You have been counselling a married couple for several weeks. The couple came to you because of problems they were having in their relationship. During the process you have seen the pair separately at which time you learnt that the husband is only staying with his wife because of their two children. The wife meanwhile has confided to you that her husband is not the biological father of one of the children.
If you were confronted with this dilemma how would you deal with this couple?
There are several issues for consideration in this scenario. Firstly, the wife has confided that she is hiding the true paternity of one of the children from her husband and secondly, the husband has disclosed that he is only staying in the relationship for the sake of the children.
As a counsellor I am bound by confidentiality, however, I would find it somewhat compromising to counsel the husband and wife, either separately or together, for any length of time whilst this information was being withheld.
Regardless of the ethical obligations I have as a counsellor to maintain confidentiality, should the husband become aware of the true paternity of one of the children, he may feel betrayed by me as I have withheld this information from him. Although this would only be one of the consequences for the husband on being informed, it may directly affect the counselling relationship thus further complicating his own situation.
My approach would be to talk with the wife individually, emphasising her responsibility for the information she holds and how she wishes to deal with it. I would encourage her to explore the pros and cons of either:
? Informing her husband of the true paternity of one of the children.
? Withholding the true paternity of one of the children from her husband either temporarily or permanently.
I would also see the husband individually in order to work through the relational issues he has and examine the alternative courses of action available to him.
I would then assess how the sessions to date may have affected the current situation and make a decision whether I could continue to work with the couple objectively whilst withholding critical information.
The nature of this situation highlights the importance of providing clients with clear information regarding ethical boundaries and confidentiality early in the counselling relationship so as to minimise difficulties and misunderstandings.
Can you put this in a REBT format and a treatment plan
Ethical decisions inherently involve issues concerning our definition of what is ?acceptable? human behaviour. However, the definition of what constitutes ?acceptable? is neither universal nor static, but is ever-changing and evolving in a melting pot of diversity, culture, gender and nationality.
Without doubt, our sense of what is right or wrong has been influenced by our environmental and social context and our inherited traits – the unique combination of our individual identity.
There are two major theoretical perspectives we might consider – Teleology and Deontology. The main teleological theory, Utilitarianism, judges actions as good or bad, right or wrong, on the basis of the consequences they produce. Deontology, on the other hand, is concerned with ?duty? and the fact that some acts are obligatory regardless of their consequences.
Ethics, unlike legislation that requires an act to have occurred, is concerned with the prevention of damage or prescribing a course of action. Fortunately, there are signposts in the ?minefield? of ethical dilemmas, one of these signposts ?Professional Codes of Ethics? serves to guide us through decisions in our professional lives involving issues of honesty, fairness and justice (www.theaca.net.au).
Background
In the scenario above, all three people, wife (W), husband (H), and the counsellor (C) are presented with an ethical dilemma.
In his decision to stay ?for the sake of the children? H has taken a utilitarian ethical stance on this issue, that is, H is making his decision to stay based on his desire for a particular outcome i.e. ?for the sake of the children?.
In aligning himself this way H is using the relationship with his wife as a means to get his desired end. His goals for the relationship have changed from being in a marriage with W to fulfilling his parental responsibilities until such time as his sons are able to look after themselves.
W?s contribution to child raising is the utility upon which he can fulfil his parental obligations. H?s ethical dilemma is whether it is fair and just to stay in the relationship with W without revealing to her what his new goals are and how he honestly feels about their relationship.
W too, has been setting future goals alongside H in joint counselling sessions to improve her relationship with her partner. Her reluctance to tell H that he is not the biological father of one of the children may also be based on a utilitarian ethical stance – perhaps fear of the emotional trauma that would most likely follow disclosure, and the possibility of H deciding to end their marriage, is holding W back from disclosure.
Like H, W is using her husband to maintain a secure family environment for herself and her children. Alternatively, if both H & W decided to adopt a deontological ethical stance in this dilemma, both would feel ?duty bound? to disclose their information to each other irrespective of the effects on their relationship.
The fact that H and W have decided to disclose their information to C indicates that as counselling sessions have progressed it has become increasingly difficult for them to withhold this information from each other. Thus, the ethical dilemma presented to W and H is about whether to be totally honest with each other and face the consequences, or to continue their deception irrespective of the potential negative effect this may have on the future of their relationship.
And what of C?s ethical considerations in this case?
C?s dilemma is primarily concerned with professional accountability to self and to W & H. In accordance with the ACA Code of Ethics counsellors must at all times:
? Establish the helping relationship in order to maintain the integrity and empowerment of the client without offering advice.
? Offer a promise of confidentiality and explain the limits of duty of care.
Thus, it is neither C?s role to advise the clients to reveal this information to each other nor to breach confidentiality and disclose to either client. The primary role of a counsellor is to facilitate the exploration of issues by encouraging clients to determine their own outcomes.
To unduly influence or direct either H or W into prematurely making their revelations to each other would be a misuse of C?s position, an imposition of C?s values onto the clients and a breach of the Professional Code of Ethics.
On the other hand, C can use feedback and influencing skills to highlight some discrepancies in W & H thoughts, actions and feelings. For example, with regard to their stated desire to improve their relationship through counselling, C can explore individually with H & W, the potential impact of non-disclosure on the future stability of the relationship.
Certainly, C is now in the unenviable (and powerful) position of being the only one in this triangle (H, W & C) who is privy to information from both partners that could significantly affect the course of this couple?s relationship. Having acknowledged this, C needs to evaluate the effectiveness of continuing to counsel this couple either on an individual or joint basis.
For example, how will C encourage this couple to explore issues and set joint goals for the future knowing that H is not committed to the relationship? And that W is withholding information from H that he may deem crucial to his ongoing commitment? Who came to counselling first? Was it H or W, or did they come together? If W came first, then should she be retained as a client if C decides against counselling the couple together?
In all aspects of working with people, it is imperative that C is aware of any legal implications that may result from a particular course of action, in this instance the rights of the child to know his biological parents. Apart from the more obvious emotional and psychological needs, the child?s future medical requirements may require immediate knowledge of his blood and tissue types.
Does C?s duty of care extend to protecting the rights of this child, who, while not in immediate danger, may become so in a medical emergency?
The very fact that W & H have requested to see C on an individual basis and that each has voluntarily made a significant disclosure directly relevant to their relationship, must surely indicate more commitment to, and potential for, the relationship that might at first have been apparent. Does this new information, handled in a sensitive, responsible and constructive manner, have the potential to resurrect this relationship rather than bury it? C would need to consider whether to continue counselling the couple under supervision, or refer either (or both) to a more experienced relationship counsellor.
Liz – Beautifully considered. Professionally astute with enough care and warmth for all. As a student counsellor, ‘coming up through the ranks’ – I found your response to the article very helpful and insightful. Thank you for sharing your knowledge, skills and personal views on the topic. Marika :o)
Thanks Liz for a really in depth view from all sides of the dilema. My initial thoughts were as you said if W and H have shared this information with the counsellor it may mean they are now putting all their cards on the table in the hope that there be a resolution to their relationship either way.
A point i had to think about was ,is it my role to counsel in a way that aims brings them back together or to seperate ( is that my agenda?) or to counsel in a way that allows each of them to make that decision and how could that be done with this information being under the table.
I think I would find it very difficult to hold this information and not let it influence the way I couselled these two . My position would to now to work with both of them on the impact of disclosing or not disclosing to each other
Any feedback on my thoughts and ideas would be much appreciated.
I would look at the process not the content.
I think that both has been open regarding where they are standing and I will be working from there.
It is in their hands to decide if they will disclose to each other and when and as parents they will decide when and if they will disclose to the child.
Our role is to support and facilitate the process no to idealised in rights and wrongs, with time and patiente they will explore and find a way.
Very interested to read the opinion of people with knowledge and experience.
Gracie
Liz – thank you for such insight shared. I am also a student counsellor and found your article helpful and thought provoking.
Tracy
Hi, I am still in my early years of studying to be in the profession, all the views here have greatly enhanced my worldview about the expectation of the profession.
In my opinion, I feel that what the husband and wife want at this point is crucial, be it a choice of duty and responsibility or ethical reason or truly wanting to save the marriage.
The fact that both are seeking counseling is an action of good faith and should be encouraged if there are no other harmful issues to consider. The whole systemic perspectives need to be considered if it matters to them like society or culture impact that may stress the couple whatever their decision may be.
Openness in relationship is always critical but is their choice, depending very much on influence by their upbringing and expectations. Ultimately, I think the couple needs to be true to themselves and be responsible for whatever their decisions considering the impact it may have on themselves and their children.
Probably, this opinion may change as I develop but hopefully with complete awareness.
Thanks to all!
Kindest regards, Vina
Thanks for all the thoughtful posts. Not all that unusual a situation. Only the strength or depth of the deceptions are different. Moving from couples to seeing the couple individually, there is a high likelihood of one or other piece of important data being shared. For instance one is having an affair, one is gay, one is depressed, on is losing their job, one hates the others and various other disclosures all of which may put the counsellor in a bind.
The earlier comments all carry. So I will take this tack and try and set up some structure prior to seeing them individually. When a couple wants to see a counsellor individually that is one thing.When a counsellor wants to see the clients individually that is another. Such as: will they agree to voluntarily bring back the gist of what is worked with individually or; is the counsellor given permission to do so. Bother of these obviously raise the stakes for disclosure and hences disclosure may not happen. However it can be put in simpler terms such as: Is it OK if I encourage you to disclose it in your relationship the things you raise individually, is that what you are seeking? This one is in line with the earlier suggestion of building on their initial desire to even have counselling. There would be a variety of structure you could talk through with a couple that allows you to place the individual work in the context of the couple.
Presuming they started counselling, together then your client is in effect their relationship. This attitude can assist a counsellor to keep clear while being buffeted by the various revelations from individual clients. It can also help frame a structure for seeing people singly.
On the other hand I, being the devious person I am, would also make sure I asked questions such as: How do you know? (That he is not the father). A lot of people claim to know a lot of things for which they have little proof. The number of people who claim to have had Ross River Virus because a natural healer looked into their eyes and told them so, is phenomenal. It might be a myth that she believes becasue one day her Mum told her their child looked like and earlier boyfriend.
As well, I would be suspicious about the husbands disclosure. I don’t know many parents who would not welcome a break from a relationship during difficult periods. Mnay people feel like leaving and feel like staying at the same time. So firstly I would treat this as serious venting of frustration and disappointment. There may be also many other reasons why he stays such as: good sex or sex; a nice house; simplicity; not a good time to leave; financial costs; fear of lonliness and others. I would examine either with the client or in my reflections, why this clients feels a need to let me know this. If I take the point of view that because he wants to leave he should leave I may well be following either a temporary response to stress in the father or only one response in a complex of responses.
I would also need to examine my relationship with ‘conflict’ as it could be that they tell me these things privately because they suspect I cannot handle conflict well. If they cannot handle conflict well and I cannot handle conflict well then:a) I need further development and good supervision and; b) It is unlikely to come out in the couples work beause there wont be adequate safety.
Great topic and great responses. I hope mine adds to the mix.
until they say otherwise, they are a couple both committed to their children. A father without biological paternity is still a father. There are levels of knowing, maybe he picks it up at some level. He expresses his disatisfaction in the marriage by saying ‘I’m just staying for the sake of the children’. he uses this as an excuse, for not having the courage to face the deeper dillemma he intuits. Somewhere a barrier is put up, because of the deeper issue, that its based on a fantasy and there in front of them is the evidence of it. The fantasy can be skillfully dismantled, but be careful to supply a splint at the same time. I know a couple who have been able to move through forgiveness, and retain the family structure, through understanding the context and circumstances that led there, but that is rare. assuming of course everyone is telling the truth here. give her the options as stated, but only pursue the supported disclosure if she is making a fully informed choice and is prepared for the worst case scenario. I have heard of this occuring where one person has been unable to conceive, and that can cause a problem too. Because then you might also the situation wherby to face up to the truth, is also to face up to an absent sperm count and a changed identity. In that case, the dad may want to deny it, and if the relationship came back on track without the disclosure, it would not be for me to say, you need to know the truth. They might want to convert it into their truth and much also depends on the biological father and his ideas which could be explored with the wife. These are very interesting dillemma’s I must say
Sorry to return but this one intrigues me. I have since learnt that men are more genetically primed to only want to raise their genetic offspring. but that the social construct is strong too, esp with age of the child. I also have been thinking through the burden of knowing vs the privelidge of not knowing and how this could be explored with the wife. there is also the issue of how much risk, she is prepared to take. But the crux of this for me is having a set of guidelines, which set out what can and cannot be regarded as a decision by the person who is not in the know, as to whether he wants to know. For instance as you explore his below conscious level suspicions, if he begins to be angry/defensive, could you take that as him not wanting to know right now? and at what point do you credit him with having made conscious his suspicion, then how do you handle it from there? as she and the child may be at risk. It seems like a minefield to me, but if he is anywhere near the truth of his paternity, then i would want some kind of contract of no harm before he left me. Its the subtlety of this that is hard, are there any guidelines out there?
In my connection with this family I have been given information by both the adults that may have grave consequences on the whole of the family. I would need to go over my sessions with a supervisor before going any further into their lives. The children are the main characters in this and need to be protected. Just because there is a contract does not mean that there would be safety for the children either psychologically or physically. Whatever either of the parents have told me in confidence should remain that way until they themselves learn how to work it out.