Academic journal article Journal of Mental Health Counseling

Ensuring Ethical Practice: Guidelines for Mental Health Counselors in Private Practice

Academic journal article Journal of Mental Health Counseling

Ensuring Ethical Practice: Guidelines for Mental Health Counselors in Private Practice

Article excerpt

Since mental health counselors in private practice often work in relative isolation, it is especially important that they attend to ethical issues. This article reviews four dimensions of ethical knowledge: the foundation of ethical actions, counselors as agents of ethical action, the need to establish a decision-making process, and the importance of sustaining ethical practice by keeping current with clinical developments and attending to their own well-being.


One of the benefits of being in private practice is freedom to conduct an independent professional life. While insurance companies can affect what occurs in the consulting room, their influence is at a distance. Fears of a malpractice charge or an ethics board complaint may sometimes rise to consciousness, but they are easily put to rest by reflecting that relatively few mental health counselors (MHCs) ever face such charges (Glosoff & Freeman, 2007; Neukrug, Milliken, & Walden, 2001; Saunders, Barros-Bailey, Rudman, Dew, & Garcia, 2007). The freedom and flexibility to determine independent practice conditions, such as seeing no clients before 10:00 a.m., or a practice focusing solely on the elderly or the young, for example, are what motivate many MHCs to join or start a private practice. As with political freedom, however, this professional freedom comes with added responsibilities.

MHCs in private practice need to attend to the ethical dimensions of their practice with heightened diligence. There is often no immediate oversight or system of checks and balances to support ethical practice. Indeed, in private practice no one is looking over your shoulder. That is why private practitioners need to build their own ethical support system. This article describes the knowledge needed and the steps that must be taken to ensure ethical practice.


The standards of ethical practice are set forth in the codes of professional bodies and in the laws of each state. For licensed counselors, codes include the American Counseling Association Code of Ethics (ACA, 2005) and the American Mental Health Counselors Association Code of Ethics (AMHCA, 2010). Licensed psychologists follow the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2010). Licensed social workers adhere to the National Association of Social Workers (NASW) Code of Ethics (2008). In addition to the mandatory codes, there are also aspirational codes developed for various specialties. For example, the Association for Specialists in Group Work (Thomas & Pender, 2007) has a detailed aspirational code. While these codes are essential, private practitioners must also follow the ethical requirements of the state where they practice. If there is ever a conflict between the professional and the state code, the more stringent one is to he followed.

It is not surprising, then, that the first step toward being an ethical private practitioner is to become familiar with the codes and laws. Certain concepts that lie at the heart of the counseling process are equally important whether MHCs are in agency settings or in private practice. Terms like confidentiality, duty to warn, multiple relationships, and privacy should be familiar to all MHCs. Because these guiding principles are important in all counseling settings, they need not be reviewed here.

Far too many MHCs feel that reviewing the ethical codes and laws is all they need to do to conduct an ethical private practice. It is not. MHCs need to understand the principles that informed the creation of the ethics codes and recognize how principles and laws are translated into the kinds of actions a private practitioner must take.

Ethical Principles

The actions of MHCs working with clients should always be informed by the core ethical principles of autonomy, beneficence, fidelity, justice, and non-maleficence (Beauchamp & Childress, 2001; Kitchener & Anderson, 2010). …

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