Counselling Dilemma: An Issue of Sexuality and Boundaries
A counsellor has been working with a client over a period of 9 months assisting with inner child therapy work. During the period, the client also talks about her relationship issues, sexuality as well as a relationship with another person. The counsellor, who also happens to be in a same sex relationship and going through her own separation issues, advises the client she will help counsel her through separating from her husband if the client decides she is lesbian. When the counsellor discovers the ‘other person’ the client is seeing is a male, the counsellor immediately advises the client to stop seeing him and have her husband and herself, come for marriage counselling.
Do you think the counsellor should have referred the client or continued the extensive progress that had been made during the course of the sessions? If the counsellor decided to refer on, when would have been the most appropriate time to do that? Also please explain your position on counselling couples and each individual partner separately?
Yes, the counsellor should have definitely referred the client on as there seems to be some counter transference happening, and it seems that the counsellor cannot put her own values and beliefs aside, and work in a professional manner. I think it would also be very important for the counsellor to see a supervisor so that she doesn’t continue to keep reflecting her values onto others. I think the counsellor should have referred her client before she suggested that she would “help counsel her through separating from her husband if the client decides she is lesbian” as this is highly unethical, that is also when she should have been self-aware enough to see this as a personal trigger for her, perhaps explain this to the client and then refer her on to someone more suitable, then seek supervision.
Meeting with partners individually can pose certain difficult ethical questions, an example being the scenario above. The issue of whether to hold individual sessions with members of a couple is complex. On one hand, valuable information can be gathered regarding each individual’s history and commitment to the relationship and treatment. On the other hand, sometimes during these sessions, one individual will take the opportunity to divulge a secret to the counsellor, which can create an ethically difficult situation. I myself would choose not to hold individual sessions at all, so that I do not have to confront issues such as these.
The counsellor is acting completely inappropriately. The role of a counsellor is not to give advice and so he or she should not have advised the client to stop seeing the other person. The counsellor needs to do some self-reflective work on his or her own personal values and biases which are impacting the work they are doing with this client. It would be advisable that the counsellor seeks supervision immediately around this issue.
Maybe the work they have been doing together over such an extended period of time has led to some blurring of boundaries. In my opinion a referral will probably serve the client’s best interests. This referral needs to be made immediately and in consultation with the supervisor because the counsellor is no longer working safely with the client.
After working over a 9 month period with a client I do not believe it would be ethical or therapeutically effective for another person to join the sessions. In cases when a partner is invited in there needs to be some strong boundaries identified which ensures that the person joining does not feel like an outsider joining an already established counselling relationship.
This scenario highlights what can happen when a counsellor does not engage on their own therapeutic work. When a client brings issues that are very similar to those the counsellor is either currently experiencing or has previously experienced, it is an absolute ethical requirement that the counsellor takes this as an indicator to self-reflect.
There are a few things that may have been going on for the counsellor: grief and loss over the upcoming ending of her own relationship; empathy with regard to same sex relationship; and/or attraction to her client. There is extensive research to show that the grieving process can affect a person’s physical and mental wellbeing and could have therefore affected the counsellor’s ability to make rational choices. The counsellor’s own life-changing event therefore may very well have impacted on the way she was hearing the client’s story and could have led her to over-identify. There is also substantial research to show that feeling attracted to a client can impair objectivity and impact on the way the client’s story is being perceived.
It is ethically imperative in this situation to utilise resources such as self-reflection and supervision. If the counsellor then decides to undertake her own therapy it is at this point that a transparent conversation with the client should be held regarding the possible need to refer.
The other side to this dilemma is whether a counsellor who is seeing someone individually can go on to offer couples counselling. Again, research shows that objectivity will be affected here. Furthermore, the partner who doesn’t have a previous relationship with the counsellor is likely to feel that the counsellor’s allegiance would lie with her client. There is also the ethics around transparency and confidentiality. What if the counsellor and the client know something that the partner doesn’t but needs to know in order to ensure efficacy in relationship counselling?