Ethics are not just remote, detached, philosophical principles enshrined in professional codes. Ethics are all about us, intricately worked into the personal and professional values which shape our work and give it meaning. They permeate every moment of our counselling and psychotherapy practice.
‘Relational ethics’ sees ethics in terms of relationship rather than directives. In a psychotherapeutic context, what’s in the client’s interests and risks of harm depend on the meanings in the situation. A therapist who asks lots of questions could be seen as invasive or genuinely interested. If a therapist encourages a client to do more self-care, it might be viewed as caring or critically blaming. The holding of a time boundary may feel safe or harsh. A therapeutic challenge issued to a client could be in their interests and feel uncomfortable simultaneously; one client might feel stimulated by it, another threatened. It all depends.
Rather than simply respecting clients and prioritising their interests, relational ethics demands that we recognise the interconnection between therapist, client, and our wider communities (Faris & van Ooijen, 2012). Professional guidelines have practical implications; they require us to be mindful about these wider relationships, critically appraising the impact of imbalance of power and the use of unthinking or instrumental ways of relating. Therapist integrity, duty of care towards clients/colleagues, and informed consent are foundational relational-ethical principles , along with being open to collaboration and dialogue that respects other’s difference and aims to minimize oppressive power imbalances which acknowledges the broader social context.
Relational ethics are concerned with how our professional codes are applied practically within therapy and in our wider social world. In my book 'Practical Ethics in counselling and psychotherapy: a relational approach', I invite you to marry externally-derived professional standards and internally-derived personal values in thoughtful, reflexive ways which attend to the specific relationships involved. For more information about relational ethics, please see my book:
In this book, I highlight numerous ethical dilemmas. Ethical guidelines, although useful, can never prepare us sufficiently for situations arising in practice which "make our heads spin and hearts ache" (Ellis, 2007; Finlay, 2012). Ethical judgments need to be made in context and its complicated. Virtually every ethical issue and dilemma we encounter can be answered with the phrase ‘it depends’. Professional standards, personal values, legal requirements, agency policy, cultural context and relational considerations all complicate the field. We can aspire to certain standards of practice but may not always meet these. The question is how to be a good-enough, ethically-responsive, therapist.
I see ethics in the way we hold and contain our clients' processes in boundaried ways. To give an example, consider the idea that we might offer the client some 'holding'. This holding only works if we respond to the relational context. We can’t just decide to ‘hold’ the client. The client needs to be receptive; they need to accept and take in that the holding and feel held. What level of holding can the client tolerate? And, in turn, we need to be alert to when the client is accepting (or resisting) being held. How does that impact on us and how do we respond back to the client? We also need to factor in our own needs and readiness. If we are uncomfortable using touch yet still push ahead with it, this may have negative implications for the relationship. In other words, decisions as to when and how to hold involve exquisitely delicate processes of clinical reasoning and negotiation. Providing a holding environment appropriate for a particular client, and our relationship with them, requires us to think things through and engage in a process of creative negotiation. If I find myself pulled to physically hold a client, I might ask myself ‘why?’ Am I intuiting the client’s needs? Or does this feeling have something to do with my own needs? Could it be something that is emerging from the relationship? In whose interest is this holding?
These questions similarly apply to other issues such as the advisability of therapist self-disclosure: If I find myself wanting to disclose something, I would ask myself 'why?' Am I intuiting the client's needs or is this my need or, perhaps, a response to the relational pulls? In whose interests is this disclosure - might it help the client in some way?
As therapists, we strive to create safe therapeutic spaces of hospitality where the client can feel held, affirmed, supported, resourced, empathised with -- and challenged to grow. Therapist integrity, duty of care, and informed consent are key foundational relational-ethical principles, along with being open to dialogue that respects the other’s difference. But the sheer messiness, uncertainty and complexity of practice defy easy answers; there are no clear-cut ethical recipes. As practitioners we’re left with trying to exercise our professional judgment as best we can, moment-to-moment, given our knowledge, ability, and the relational/cultural context. If we do this sensitively, thoughtfully, and with caring humane intention, that – for me – is being ethical. This is the 'take home' message of my book.
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