On this we can agree; the idea that psychotherapy is value neutral is no longer tenable. (Corey, Schneider-Corey, & Callanan, 2007, p. 78) As we strive to maintain our prospective clients’ autonomy, it is important that we be honest and open with ourselves regarding our personal values and how those values affect the client-therapist relationship. Values can impact that relationship directly and indirectly, and that impact can manifest as conscious effort on the part of the therapist or (perhaps more importantly) subconsciously.
We as therapists are trained not only to listen, but to interpret the context and sub-context of therapeutic discussion. Without consciously or implicitly doing so, it is entirely possible that we as counselors can lead clients to our predetermined conclusions (goals) and subsequently rob them of the ability to make that choice. Self-determination is a key component in goal setting, and to what degree it is possible, it should be client driven not therapist driven.
Goals are usually based on values and beliefs, and clients may adopt goals that the therapist thinks are beneficial. (Corey et al., 2007, p. 79) I think this is of particular significance when you encounter a client who is indecisive about his goals. To use couples therapy as an example, I anticipate that we will encounter situations where one party or the other insisted on counseling as a way to help resolve marital issues. The “other half” may come to the table with little more than wish to fulfill the other person’s desire for marital counseling, and subsequently not have clearly defined goals to express to the counselor. Even a well intentioned clinician is prone to suggesting possible goals for the indecisive other half, but even those gentle nudges have potential to skew the goal setting process and subsequently impair the ability of the couple to engage each other in the cooperative effort of goal setting.
I would suggest that, generally speaking, our own personal values can best be exposed in the form of a question. Unfortunately, even the process of questioning our clients leaves potential for the client-therapist relationship to be inexorably altered by the values that produced the question in the first place. For example, if we decide to proceed with a line of questioning involving religion and the role the spirituality plays in a specific clients life (on the basis that it plays a role in our lives) we may be wasting our time “drilling down” on the topic unless the client themselves shows interest or otherwise shows concern for religious or spiritual considerations. If we ignore the absence of a response and continue to drill the religious line of questioning for our own benefit, we would be doing a disservice to our clients.
Conversely, if our client is passionate about religion and spirituality, and we do not share those beliefs… we do an equally damaging injustice to the client by passively ignoring those responses in favor of lines of questioning that better fit our own personal worldview. When counselors fail to raise the issue, clients may assume that such matters are not relevant for counseling, and counselors may be guilty of excluding an important issue of diversity and experience. (Corey et al., 2007, p. 93) So our ethical concern is twofold, it is contained not only in what we do and say as it relates to sensitive subjects like religion, but also in what we choose NOT to do or say. The ethical issue lies in our ability to choose to ignore (or otherwise gloss over) considerations that play a crucial role in our clients decision making processes, simply because we do not employ them in our own structures of decision making.
We should be consideration of clients who are in a crisis situation, and acknowledge that the spiritual domain may be a source of comfort and support. Consequently, clinicians must remain open and nonjudgmental when discussions in this realm occur. (Corey et al., 2007, p. 94) This can be done without implying support for specific religious beliefs. (Corey et al., 2007, p. 95)
Religious dogma is not part of the theoretical foundation of psychotherapy. Therapists should neither impose their religions views on clients, nor should they pretend to be experts in religion any more than they are in medicine, culture, finances, or any other related area. (Corey et al., 2007, p. 99) If religion and spirituality plays a predominant role in the decision making process of a client, and we are operating outside of what we consider to be our own competency, it is imperative that we utilize a multi-disciplinary approach that utilizes religious resources when appropriate. Leveraging the expertise of our colleagues and the religious community can allow us to continue to play a positive role in conflict resolution, all while allowing the systems we lean on to address the intricacies of faith.
Corey, G., Schneider-Corey, M., & Callanan, P. (2007). Issues and ethics in the helping professions (8th ed.). Belmont, CA: Brooks/Cole.