Anorexia NervosaNovember 15th, 2007
MacLeod (1981) states people with anorexia are notoriously difficult persons who are determined to hang on to their symptoms at all costs. This is a common view throughout the medical profession and related fields, possibly due to the ego-syntonic nature of eating disorders—the person is comfortable with the disorder and views it as consistent with their goals and wishes. It is therefore important for counsellors to develop an understanding of these disorders in order to develop empathy and the ability to validate the client’s experience. This involves realising that letting go of the eating disorder may represent a significant loss for the person, and that there may be a fear that recovery will come at too high a price. Therefore the initial goal of treatment is simply for people to begin thinking about change. At this point, the enhancement of motivation is crucial. The two categories which will be looked at here are Anorexia Nervosa and Bulimia Nervosa due to the ego-syntonic nature of these disorders. This post will focus on Anorexia Nervosa.
Diagnostic Features
There are a number of essential features associated with a clinical diagnosis of Anorexia Nervosa. These include a refusal to maintain a minimal body weight considered normal for the person’s age and height, an intense fear of gaining weight, and a significant disturbance in the person’s perception of their body shape and size.
In addition, females with this disorder have a condition known as amenorrhea, resulting from abnormally low levels of estrogen, where they have either ceased menstruation or, in younger females, it has been delayed. Also when the disorder occurs in a young person during childhood or early adolescence, rather than a significant drop in weight, there may instead be a failure to make expected weight gains consistent with a continued growth in height. For a clinical diagnosis of Anorexia Nervosa to be made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the person must weigh less than 85% of the weight considered normal for his or her age and height.
An alternative guideline used by the ICD-10 Diagnostic Criteria for Research (World Health Organisation, 1993) suggests a body mass index (BMI) equal to or less than 17.5 for a diagnosis. The BMI is calculated by dividing weight in kilograms by height in squared metres. These are regarded as guidelines only as a person’s individual body build and weight history also need to be taken into account. Usually weight loss associated with Anorexia Nervosa is maintained primarily through restricted food intake. Sufferers may begin by excluding foods believed to be high in calories or specific food groups such as meat. This often leads to continued restriction resulting in a very narrow choice of foods. Further weight loss is often attempted via purging, such as self-induced vomiting or the misuse of laxatives or diuretics and excessive exercise. An intense fear of gaining weight and becoming ‘fat’ is usually not alleviated by weight loss; in fact weight concerns often increase as body weight decreases. This leads to a distorted body image wherein the experience and significance of body weight and shape are distorted, either overall or in one or two specific areas of the body, such as the abdomen, buttocks or thighs.
A person with a distorted body image will often engage in a variety of ‘checking’ techniques, including excessive weighing, obsessive measuring of body parts, and persistently using a mirror to check for perceived areas of ‘fat’. Not all Anorexia sufferers experience a distortion of body image, however even those who can acknowledge being underweight may still deny the serious medical implications arising from this. Individuals with Anorexia Nervosa frequently lack insight into the problem and may even deny the presence of the problem.
As a result, it is often necessary to obtain information from parents or other outside sources to evaluate the degree of weight loss and other aspects of the illness. Anorexia is often brought to professional attention by family members after marked weight loss has occurred.
It is rare for an individual with Anorexia Nervosa to seek help themselves, although they may do so due to the distressing nature of other features associated with the disorder, such as depression and self-loathing.
Subtypes and Associated Features
Subtypes The following subtypes are used to specify clinical features of the current episode of Anorexia Nervosa: Restricting Type: This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, or excessive exercise. During the current episode, these individuals have not regularly engaged in binge eating or purging. Binge-Eating / Purging Type: This subtype is specified when the individual has regularly engaged in binge eating or purging (or both) during the current episode. Most individuals with Anorexia Nervosa who binge eat also purge through self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
Some individuals included in this subtype do not binge eat, but do regularly purge after the consumption of small amounts of food. It appears that most individuals in the Binge-Eating/Purging Type engage in these behaviours at least weekly, but sufficient information is not available to specify a minimum frequency. Associated Features Not surprisingly the self-esteem of a person with Anorexia Nervosa is highly linked to their body shape and weight. Weight loss is generally viewed as a positive step and an indication of self-discipline, whereas weight gain is perceived as failure and a complete lack of self-control.
When seriously underweight, many individuals with Anorexia Nervosa manifest depressive symptoms such as depressed mood, social withdrawal, irritability, insomnia, and diminished interest in sex. Such individuals may have symptomatic presentations that meet criteria for Major Depressive Disorder.
Obsessive-compulsive features are often prominent. Most individuals with Anorexia Nervosa are preoccupied with thoughts of food. Some collect recipes or hoard food. Observations of behaviours associated with other forms of starvation suggest that obsessions and compulsions related to food may be caused or exacerbated by undernutrition.
Other features sometimes associated with Anorexia Nervosa include concerns about eating in public, feelings of being inept, a strong need to control the surrounding environment, inflexible thinking, limited social spontaneity, and overly restrained emotional expression (Garner and Garfinkel, 1997; APA, 2000).
In the next post we’ll look at Bulimia Nervosa. Related Posts: The Starvation Syndrome, Stages of an Eating Disorder, It’s All about Me: Blogs and Teenagers
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The Starvation SyndromeNovember 12th, 2007
One of the most important advancements in the understanding of eating disorders is the recognition that many of the symptoms once thought to be primary features of anorexia nervosa are actually symptoms of starvation.
An experimental study, conducted and published 50 years ago by Ancel Keys and his colleagues at the University of Minnesota (Keys, Brozek, Henschel, Mickelsen & Taylor, 1950) is the best example of the wide-ranging physical, cognitive, social and behavioural effects of starvation, initially thought to be the symptoms of anorexia nervosa. The subjects of the study were 36 healthy young men who volunteered as an alternative to military service. During the first three months of the study, the volunteers ate normally while their personality, behaviour and eating patterns were studied. Over the next six months, the men decreased their food intake by about half, losing on average about a quarter of their former weight. This was followed by three months of rehabilitation where gradual refeeding occurred.
Each volunteer responded differently but there were dramatic physical, psychological and social changes, many of which persisted even during the refeeding stage. The significance of this study (commonly known as the “Starvation Study”) is that the experiences displayed by the volunteers due to starvation are the same symptoms experienced by people with an eating disorder. The volunteers became overwhelmingly preoccupied with food, plagued by incessant thoughts of food and eating, resulting in poor concentration in other areas. Food became the topic of conversation, reading and daydreams. They played with their food, and there was an over consumption of salt, spices, coffee, tea, and gum. As starvation progressed, the volunteers increasingly hoarded food and food-related items, such as cookbooks and menus. This tendency to hoard is often observed in persons with anorexia nervosa. During refeeding, most of the abnormal attitudes and behaviours persisted. 40% of volunteers mentioned cooking as an interest post-experiment and some even changed occupations, three becoming chefs and one went into agriculture.
All volunteers reported increased hunger in the semi-starvation phase. Some were able to tolerate this while others were could not control themselves, partaking in episodes of binge eating followed by self-deprecation and disgust, and in some cases vomiting. No factors could be identified to distinguish reasons for these differences. After five months of refeeding, overcompensation of eating persisted, but by eight months of refeeding most had returned to normal eating habits. The previously psychologically healthy volunteers suffered significant emotional deterioration as a result of semi-starvation. These symptoms included severe depression and extreme mood swings, anxiety symptoms such as biting nails and smoking, apathy, and significant neglect of personal hygiene tasks. Two men were disturbed enough to be admitted to a psychiatric ward.
The emotional disturbances of the volunteers persisted during the refeeding period, with some men becoming more depressed, irritable, argumentative and negative than during semi-starvation. Previously outgoing and friendly, the men became withdrawn and isolated, unwilling to be involved in planning, decision-making or participating in group activities.
The men’s social interaction with women significantly declined, with those relationships that did continue becoming strained. Libido was also reported to have decreased and was slow to return. Similar to people with eating disorders during weight gain, the subjects reported that they were “feeling fat” despite body weight and body fat percentages being at pre-experimental levels after nine months of rehabilitation. Many of the symptoms outlined above are similar to those displayed by individuals with anorexia or bulimia nervosa. Therefore, it is recognised that these symptoms are due to starvation rather than being specific to these disorders. Furthermore, symptoms are not limited to food and weight but affect nearly all areas of psychological and social functioning. The study challenges the popular idea that body weight is altered with a bit of “willpower” and demonstrates that the body does not simply adjust to a lower weight during severe dieting. Related Posts: The Development of an Eating Disorder, What Are Eating Disorders?, What does bullying do to your health?
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Stages of an Eating DisorderNovember 5th, 2007
Lemberg (1992) also proposes a model of development whereby a person moves from voluntary dieting through a number of stages to reach a fully entrenched eating disorder. Stage 1: Normal, voluntary dieting behaviour. Unfortunately dieting behaviours have become the “norm”, with 47% of people in Australia having tried to lose weight in the past twelve months. 68% of fifteen year old girls are dieting at any one time, 8% of these are on a severe diet (Lemberg, 1992). While these diets are severe enough to be considered an eating disorder, they are unhealthy and result in rapid weight changes, disrupted metabolism, dehydration, low energy and lack of essential vitamins, minerals and nutrients. Stage 1B: (in Bulimia Nervosa only). The hunger associated with dieting and restriction leads to severe and constant cravings, which result in loss of control and overcompensation by bingeing on large amounts of food. Stage 2: A Diagnosable Disorder. At this stage the dieting behaviour has become a diagnosable mental illness according to the Diagnostic & Statistical Manual IV-TR (APA, 2000). At this stage there are serious consequences and a morbid fear of fatness, and the dieting is no longer under the person’s control. However the person is unable to see the negative consequences and is in denial of the eating disorder. In bulimia nervosa the bingeing behaviours, rather than being due to dietary restriction, occur more generally as a result of stress or negative emotional states. Stage 3A: Autonomous Behaviour. At this stage the person is generally able to see there is a problem, but as the behaviours are no longer under the person’s control, the disorder does not resolve even if precipitating conditions have been resolved.
Stage 3B: Illness becomes the identity. At this stage, rather than the eating disorder behaviours being a solution to a problem, the person now identifies him or herself only with the eating disorder and has difficulty separating themselves from the illness. The eating disorder behaviours are now constant rather than used as coping strategies, and the person feels they are nothing without their illness. They identify with being the illness, i.e. I am anorexic, rather than I have anorexia. The prospect of giving up the disorder can lead to existential fears of nothingness. Recovery requires not only finding alternative coping strategies, but helping the person identify themselves without the eating disorder. Related Posts: The Development of an Eating Disorder, What Are Eating Disorders?, Stages of a Relationship
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The Development of an Eating DisorderNovember 2nd, 2007
There are many environmental, cultural, psychological and biological factors which combine in different ways in the development of an eating disorder. These factors can be divided into three factors, as seen below in Figure 1.
Important factors which predispose a person to developing an eating disorder include being female, living in Western society, being an adolescent, having low self-esteem, perfectionism, and/or depression, and having a family history of any type of eating disorder, obesity, depression, or substance abuse.
Significant precipitating factors which may trigger the disorder include dieting to lose weight, occupational or recreational pressures to be slim, critical comments about weight and shape, and sexual abuse. Key factors which maintain the disorder once it has developed primarily involve the psychological, emotional, and physical effects of starvation.
Related Posts: Stages of an Eating Disorder, What Are Eating Disorders?, Anorexia Nervosa
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What Are Eating Disorders?November 1st, 2007
Eating disorders are complex, multifaceted physical and mental health problems. Their development usually involves a number of different contributing and perpetuating factors. The exact processes are unclear and is it uncertain how they interact to develop or maintain an eating disorder (Fairburn & Harrison, 2003).
Contributing factors could include one or a combination of physical, emotional or sexual trauma; cultural emphasis on body image ideals; peer influences; loss and grief; brain chemistry; physiological effects of dieting, starvation or purging behaviours; relationship issues; stress; and maladaptive coping skills. The complexity of eating disorders means there are no simple solutions.
In this new ‘Special Reports’ series, we’ll explore the theory behind eating disorders and find out what they really are.
Editor’s Note: The content in this series is derived from Counselling Academy’s “Eating Disorders” online professional development course. All content is copyrighted and it was re-published with the Academy’s permission. Related Posts: The Starvation Syndrome, The Development of an Eating Disorder, Stages of an Eating Disorder
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Blog URL: http://www.counsellingconnection.com/
Thursday, November 15, 2007
Bullying
According to Rigby (2006), bullying is the intentional act of causing harm and unhappiness to others through harassment, physical assault, cyber assault, or other more subtle methods of coercion such as manipulation. Further, the harassment can be verbal, physical and/or emotional.
Bullying is a general term applied to a pattern of behaviour whereby one person (the bully) who has uncontrolled anger, resentment and/or aggression (and lacks interpersonal/social skills) chooses to displace their aggression, social dominance and power onto another (the victim). Bullies use tactics, such as criticism, manipulation, ridicule, exclusion, isolation and teasing to ridicule or incite the victim (Masheder, 1998).
Bullying can occur in any setting where individuals interact together (such as school, home and workplace). It can also extend to affect social groups, social classes and between countries, this is known as military bullying (Connor, 1990).
Within the school environment, bullying usually occurs in areas with minimal or no adult, teacher supervision. It can occur in or around the school buildings, though it more often occurs in outside classes like sports, at lunch breaks, in toilets, the playground, in and waiting for buses, and/or during after-school activities (Elliott, 1991).
Victims of childhood bullying who have had no treatment or intervention often remain passive, detached and lacking social competence and skills needed to have healthy, functional interactions with others as an adult. As a counsellor, are you aware of the strategies children can use to cope with bullying? How about as a parent, friend or carer? In this article, we will explore some of these strategies.
Strategies Against Bullying
There is a range of counselling skills and strategies which can enhance a victim of bullying's ability to cope and stop the cycle of bullying. They include teaching a child how to build a healthy self esteem, teaching a victim who generally has a passive communication style how to become more assertive and stand up for their own rights without violating others.
Conflict resolution skills are one of the more effective counselling techniques and interventions a counsellor can apply in an effort to reduce victimisation.
Conflict resolution aims to create a win-win situation for everyone involved. By shifting attention away from those involved and onto the problem, creative problem solving can happen (Morrison, 2002).
Teaching a child early on the skills of conflict resolution will empower, prepare and support students to deal successfully with conflict situations at school, at home and in later life. The range of conflict resolution skills also includes effective listening, negotiation skills, assertiveness skills training, problem solving and reflecting skills.
Conflict resolution skills are adaptable as they can be taught on an individual or group basis. More effectively they can be introduced, developed and reinforced as ongoing components of the all-curriculum areas (Morrision, 2002).
Anti-bullying programs or a critically focused curriculum, which is informed by understandings of the role of power in relationships, can expand opportunities for all groups to explore their personal and social needs within a climate of respect and valuing of difference (Morrison, 2002).
How to Teach a Child Conflict Resolution Skills
- Discuss and assess their communication style (i.e. passive, assertive or aggressive). Pitch your language according to the child's age and developmental stage.
- Explain the importance to them of being able to stand up for themselves and that conflict resolution skills will assist them in reducing the incidence and effect of the bullying.
- Discuss, role-play and teach assertive communication techniques. Below are the skills relevant to assertive communication.
Stating - When you do ......., When I see you......... I feel.
Checking - Can you tell me what you think I said?
Insisting - Yes, I understand that you are angry at me.
Compromise - Can't we just be friends?
Goal setting - What if we decided to play with other kids and not together?
Goal inviting - What do you think we can do to make this situation better?
Reflecting - Do you feel ....... when I......? I can see that you are angry.
Accepting - Now I understand why you think that..
Inquiring - Were you upset by......................?
- It is important that to assist a child's understanding by utilising other therapy techniques such as play therapy, sand tray, role play and drawing to facilitate self-expression.
- The use of I statements can be positive and powerful. Teaching a child to be able to say "I don't like it when.." can be useful.
- Check the level of a child's self esteem by asking them questions about "how they see themselves", what's good and not so good about themselves?"
- It is important that children have a positive self-concept and self-worth in order to confidently apply conflict resolution skills. Confidence building strategies may, therefore, form part of the intervention package for developing conflict resolution skills in children.
- Encourage children to speak about their feelings openly and not to withdraw or retreat as this may exacerbate feelings of sadness and isolation. Below are a series of questions you can use to teach a child how to effectively manage their feelings:
Questions to Ask When You Are Angry, Hurt, or Frightened
- Why am I feeling this way?
- What do I want to change?
- What do I need to do to let go of this feeling?
- Whose problem is this really? How much is mine? How much is theirs?
- What is the unspoken "message" I interpret from this situation? E.g. they don't like me, they don't respect me.
Goals in Communicating Emotions
- To communicate your feelings of anger, hurt, or fear.
- To change the situation
- To prevent the recurrence of the same anger, hurt, or fear.
- To improve the relationship and increase communication
More Strategies to Reduce the Effect of Bullying
Researchers, (Ross, 1998 & Morrison, 2002) provide several strategies which address ways in which counsellors could further assist their clients to reduce the impact of bullying behaviours, these include:
- Encourage children to make adults aware of the situation and involve them. This could be a parent, friend or teacher.
- Make it clear that bullying is never acceptable or deserved.
- Liaise and interact with the children's school- case conference with them.
- Speak to the school about getting more monitoring in the playground, toilets etc.
- Emphasise caring, respect and safety.
- Emphasise the consequences of being hurt and of hurting others.
- Check with the school to see what process is in place for ensuring consistent and immediate follow up and consequences for aggressive, bullying behaviours.
- Teach your client positive behaviours and encourage them to seek out people they can trust.
- Teach co-operative learning activities.
- Help and teach bully children to control their anger through anger management training and the development of empathy skills.
- Encourage positive peer relations.
by
http://www.aipc.net.au/
www.aipc.net.au/video.
According to Rigby (2006), bullying is the intentional act of causing harm and unhappiness to others through harassment, physical assault, cyber assault, or other more subtle methods of coercion such as manipulation. Further, the harassment can be verbal, physical and/or emotional.
Bullying is a general term applied to a pattern of behaviour whereby one person (the bully) who has uncontrolled anger, resentment and/or aggression (and lacks interpersonal/social skills) chooses to displace their aggression, social dominance and power onto another (the victim). Bullies use tactics, such as criticism, manipulation, ridicule, exclusion, isolation and teasing to ridicule or incite the victim (Masheder, 1998).
Bullying can occur in any setting where individuals interact together (such as school, home and workplace). It can also extend to affect social groups, social classes and between countries, this is known as military bullying (Connor, 1990).
Within the school environment, bullying usually occurs in areas with minimal or no adult, teacher supervision. It can occur in or around the school buildings, though it more often occurs in outside classes like sports, at lunch breaks, in toilets, the playground, in and waiting for buses, and/or during after-school activities (Elliott, 1991).
Victims of childhood bullying who have had no treatment or intervention often remain passive, detached and lacking social competence and skills needed to have healthy, functional interactions with others as an adult. As a counsellor, are you aware of the strategies children can use to cope with bullying? How about as a parent, friend or carer? In this article, we will explore some of these strategies.
Strategies Against Bullying
There is a range of counselling skills and strategies which can enhance a victim of bullying's ability to cope and stop the cycle of bullying. They include teaching a child how to build a healthy self esteem, teaching a victim who generally has a passive communication style how to become more assertive and stand up for their own rights without violating others.
Conflict resolution skills are one of the more effective counselling techniques and interventions a counsellor can apply in an effort to reduce victimisation.
Conflict resolution aims to create a win-win situation for everyone involved. By shifting attention away from those involved and onto the problem, creative problem solving can happen (Morrison, 2002).
Teaching a child early on the skills of conflict resolution will empower, prepare and support students to deal successfully with conflict situations at school, at home and in later life. The range of conflict resolution skills also includes effective listening, negotiation skills, assertiveness skills training, problem solving and reflecting skills.
Conflict resolution skills are adaptable as they can be taught on an individual or group basis. More effectively they can be introduced, developed and reinforced as ongoing components of the all-curriculum areas (Morrision, 2002).
Anti-bullying programs or a critically focused curriculum, which is informed by understandings of the role of power in relationships, can expand opportunities for all groups to explore their personal and social needs within a climate of respect and valuing of difference (Morrison, 2002).
How to Teach a Child Conflict Resolution Skills
- Discuss and assess their communication style (i.e. passive, assertive or aggressive). Pitch your language according to the child's age and developmental stage.
- Explain the importance to them of being able to stand up for themselves and that conflict resolution skills will assist them in reducing the incidence and effect of the bullying.
- Discuss, role-play and teach assertive communication techniques. Below are the skills relevant to assertive communication.
Stating - When you do ......., When I see you......... I feel.
Checking - Can you tell me what you think I said?
Insisting - Yes, I understand that you are angry at me.
Compromise - Can't we just be friends?
Goal setting - What if we decided to play with other kids and not together?
Goal inviting - What do you think we can do to make this situation better?
Reflecting - Do you feel ....... when I......? I can see that you are angry.
Accepting - Now I understand why you think that..
Inquiring - Were you upset by......................?
- It is important that to assist a child's understanding by utilising other therapy techniques such as play therapy, sand tray, role play and drawing to facilitate self-expression.
- The use of I statements can be positive and powerful. Teaching a child to be able to say "I don't like it when.." can be useful.
- Check the level of a child's self esteem by asking them questions about "how they see themselves", what's good and not so good about themselves?"
- It is important that children have a positive self-concept and self-worth in order to confidently apply conflict resolution skills. Confidence building strategies may, therefore, form part of the intervention package for developing conflict resolution skills in children.
- Encourage children to speak about their feelings openly and not to withdraw or retreat as this may exacerbate feelings of sadness and isolation. Below are a series of questions you can use to teach a child how to effectively manage their feelings:
Questions to Ask When You Are Angry, Hurt, or Frightened
- Why am I feeling this way?
- What do I want to change?
- What do I need to do to let go of this feeling?
- Whose problem is this really? How much is mine? How much is theirs?
- What is the unspoken "message" I interpret from this situation? E.g. they don't like me, they don't respect me.
Goals in Communicating Emotions
- To communicate your feelings of anger, hurt, or fear.
- To change the situation
- To prevent the recurrence of the same anger, hurt, or fear.
- To improve the relationship and increase communication
More Strategies to Reduce the Effect of Bullying
Researchers, (Ross, 1998 & Morrison, 2002) provide several strategies which address ways in which counsellors could further assist their clients to reduce the impact of bullying behaviours, these include:
- Encourage children to make adults aware of the situation and involve them. This could be a parent, friend or teacher.
- Make it clear that bullying is never acceptable or deserved.
- Liaise and interact with the children's school- case conference with them.
- Speak to the school about getting more monitoring in the playground, toilets etc.
- Emphasise caring, respect and safety.
- Emphasise the consequences of being hurt and of hurting others.
- Check with the school to see what process is in place for ensuring consistent and immediate follow up and consequences for aggressive, bullying behaviours.
- Teach your client positive behaviours and encourage them to seek out people they can trust.
- Teach co-operative learning activities.
- Help and teach bully children to control their anger through anger management training and the development of empathy skills.
- Encourage positive peer relations.
by
http://www.aipc.net.au/
www.aipc.net.au/video.
Thursday, November 8, 2007
Psychology and Astrology (Fang Sui etc)
by Alina
Email: essentialitem@yahoo.com
Personality is a term commonly used in everyday language. But how does psychologist define personality? Personality is closely related to other human cognitive and emotional systems; it is not an independent mechanism. Psychologists defined personality as reasonably stable patterns of emotions, motives, and behavior that distinguished one person from another. Within this general definition, a number of different theoretical approaches exist.
According to psychodynamic theory of personality by Jung, Adler, etc, each of which owes its origin to thinking of Sigmund Freud (1905), these theories have a number of features in common. Each teaches that personality is characterized by conflict, a dynamic struggle (Freud, Sigmund 1905). At first, the conflict is external: Sexual drives, aggression, and the need for superiority (Maslow’s Hierarchy of needs) (Maslow, A.H. 1943) came into conflict with the laws, social rules, and moral codes. However, at some point laws and social rules are brought inward. After that, conflict is between opposing inner forces. At any given moment our behavior, thought, and emotions represent the outcome of these inner contests.
According to Freud, personality has a definable structure with three basic components Id, Ego, and Superego (The Ego and The Id 1923). The most primitive part of the personality, present in the infant is the id. Id is a Latin word that means “it”. The Id is unconscious, irrational and immoral part of the personality that exists at birth (biological), containing all the basic biological drives: hunger, thirst, self-protection, and sex. As of component of personality, the id seeks immediate satisfaction of nature urges through primary process, without concern for the morals and norms of society. Ego and Superego dealt with how the mind worked: conscientiously and unconsciously (Freud, The Interpretation of Dreams, 1899). It also described the behavior of the human body and why we do the things we do. Freud identified man’s weaknesses in saying that man is a biological creature with biological drives. He reflected these ideas from Darwin’s original ideas (Freud, Civilization).
Freudian theories (Freud, Sigmund 1905) scientifically predicted the future of an individual with the five-stage change in growth and the three components, id, ego and superego (Freud, Civilization). Hans J. Eysenck (1916-1997), the most influential psychologists giving attention to parapsychology and astrology (1975-1985). Indeed, he believed that empirical evidence supported the existence of paranormal abilities. Astrology is as much of a science as psychology. It is definitely better than the 'pseudo psychology' but psychologist named this belief pseudo psychology, a systems of explaining human behavior that are not based on the notion that the positions of the sun, the moon, and the stars affect human temperament and human affairs (Eysenck HJ 1975). For example, people borne under the sign of Jupiter are believed to be playful, good humor and jovial. One supposedly can also foretell the future by studying the positions of these bodies. With scientific evidence, astrologers maintained that the positions of the heavenly bodies at the time of our birth determined our personality and destiny totally disregard Freudians’ psychoanalytic theories and the psychosexual theory. The prepared forecasts called horoscopes that are based on our birthdates, indicate what it is safe for us to do. Astrologers claimed that your sign which reflected the month during which you were born (Eysenck & Nias 1982), indicates whom you will be compatible with doing away with the ‘MBTI’ test or the ‘Big Five’ test. Thus, a breakdown of marriages or a crash in personality has nothing to do with genes or Erik Erikson’s psychosocial theories.
Although psychologists and other scientists considered astrology to be pseudoscience, but it is being widely practiced in the Western world. The National Science Foundation (2002) found that astrology is rejected by 60% of Americans, but 43% still check their horoscopes from time to time.
In Chinese astrology, the entire birth charts are organized in order to determine which signs will hold their influence over an individual in the coming year. Here, elemental theory is employed to do the same. In the Greek zodiac, birth charts are used as well, but the continued influence of the stars does not change throughout one's life: it is determined by their arrangement at the date and time of one's birth.
If personality were determined solely by environmental factors, then it makes sense to think of personalities are only coming in a specified number and applying to more than one person. However, upon closer examination of people it is found that personalities are not the same, even for people borne on the same day (example: twins as in research) in the same circumstances, thus disproving the blanket theory that environment is the sole determinant of personality. Whereas personality psychologist engaged in research-based on science and mental processes including nervous system, sensation and perception, learning and memory, intelligence, language, thought, growth and development, stress, etc. The goal of psychologists is to seek, to describe, to explain, to predict (base on science), and to control behavior and mental processes.
Unlike astrologers who believed in the movement of the universal; palms (hands), and stars matches the birth date of the person in question.
It is a scientific fact that the gravitation during full moon causes high tides as well as influences mental patients who become more hyperactive. But Gravity is a "Cause" which cannot actually be seen, touched, tasted, smelled or heard; it is only "real" in the sense that its effects can be observed (Research, Freiburg and Naples in 1986, 1987 and 1988).
It is a scientific fact that the gravitation during full moon causes high tides as well as influences mental patients who become more hyperactive. But Gravity is a "Cause" which cannot actually be seen, touched, tasted, smelled or heard; it is only "real" in the sense that its effects can be observed (Research, Freiburg and Naples in 1986, 1987 and 1988).
Thus, the effect of other planets on human personality cannot be questioned. What does that say about the power of astrology? Do this magnetic force change the id (genetic trait)? Does it cause the aggression gene to be triggered easily when basic needs are not met (Maslow’s Need of Hierarchy)?
Lastly, Astronomy, not astrology, is a science. The latter, like religion, is purely a matter of faith. Astrology is a pseudo psychology, not testable; nor based on observation. And because of the alleged complexity of natal horoscopes, any missed prediction can be excused, and its terms are too vague to yield definite predictions. Astrology, whatever the school or faction, can in no case claimed to be scientific!
Reference:
1. National Science Foundation (2002). Cited in Associated Press. (2002, April 30)
2. Erikson E.H. (1963). Childhood and society. New York: W.W. Norton.
3. Freud, S. (1927). A religious experience. In Standard edition of the complete psychological work of Sigmund Freud, Vol. 21. London: Hogarth Press, 1964.
4. Crowe, R.A. (1990). Astrology and the scientific method. Psychological Report, 67, 163-191.
5. Eysenck HJ (1975). Planets, stars and personality. New Behaviour, 29 May, 246-249.
6. Eysenck, Hans and Nias, David, Astrology: Science or Superstition? , London: Pelican 1982.
7. Maslow, A.H. (1943). A theory of human motivation. Psychological Review 50, 370-396
Lastly, Astronomy, not astrology, is a science. The latter, like religion, is purely a matter of faith. Astrology is a pseudo psychology, not testable; nor based on observation. And because of the alleged complexity of natal horoscopes, any missed prediction can be excused, and its terms are too vague to yield definite predictions. Astrology, whatever the school or faction, can in no case claimed to be scientific!
Reference:
1. National Science Foundation (2002). Cited in Associated Press. (2002, April 30)
2. Erikson E.H. (1963). Childhood and society. New York: W.W. Norton.
3. Freud, S. (1927). A religious experience. In Standard edition of the complete psychological work of Sigmund Freud, Vol. 21. London: Hogarth Press, 1964.
4. Crowe, R.A. (1990). Astrology and the scientific method. Psychological Report, 67, 163-191.
5. Eysenck HJ (1975). Planets, stars and personality. New Behaviour, 29 May, 246-249.
6. Eysenck, Hans and Nias, David, Astrology: Science or Superstition? , London: Pelican 1982.
7. Maslow, A.H. (1943). A theory of human motivation. Psychological Review 50, 370-396
Monday, November 5, 2007
Guide to Ethical Decision Making
A Practitioner's Guide to Ethical Decision Making
Holly Forester-Miller, Ph.D.
Thomas Davis, Ph.D.
Copyright © 1996, American Counseling Association. A free publication of the
American Counseling Association promoting ethical counseling practice in service to the
public. -- Printed and bound copies may be purchased in quantity for a nominal fee from
the Online Resource Catalog or by calling the ACA Distribution Center at 800.422.2648.
ACA grants reproduction rights to libraries, researchers and teachers who wish to copy
all or part of the contents of this document for scholarly purposes provided that no fee for
the use or possession of such copies is charged to the ultimate consumer of the copies.
Proper citation to ACA must be given.
Introduction
Counselors are often faced with situations which require sound ethical decision making
ability. Determining the appropriate course to take when faced with a difficult ethical
dilemma can be a challenge. To assist ACA members in meeting this challenge, the ACA
Ethics Committee has developed A Practitioner's Guide to Ethical Decision Making. The
intent of this document is to offer professional counselors a framework for sound ethical
decision making. The following will address both guiding principles that are globally
valuable in ethical decision making, and a model that professionals can utilize as they
address ethical questions in their work.
Moral Principles
Kitchener (1984) has identified five moral principles that are viewed as the cornerstone
of our ethical guidelines. Ethical guidelines can not address all situations that a counselor
is forced to confront. Reviewing these ethical principles which are at the foundation of
the guidelines often helps to clarify the issues involved in a given situation. The five
principles, autonomy, justice, beneficence, nonmaleficence, and fidelity are each absolute
truths in and of themselves. By exploring the dilemma in regards to these principles one
may come to a better understanding of the conflicting issues.
1. Autonomy is the principle that addresses the concept of independence. The
essence of this principle is allowing an individual the freedom of choice and
action. It addresses the responsibility of the counselor to encourage clients, when
appropriate, to make their own decisions and to act on their own values. There are
two important considerations in encouraging clients to be autonomous. First,
helping the client to understand how their decisions and their values may or may
not be received within the context of the society in which they live, and how they
may impinge on the rights of others. The second consideration is related to the
client's ability to make sound and rational decisions. Persons not capable of
making competent choices, such as children, and some individuals with mental
handicaps, should not be allowed to act on decisions that could harm themselves
or others.
2. Nonmaleficence is the concept of not causing harm to others. Often explained as
"above all do no harm", this principle is considered by some to be the most
critical of all the principles, even though theoretically they are all of equal weight
(Kitchener, 1984; Rosenbaum, 1982; Stadler, 1986). This principle reflects both
the idea of not inflicting intentional harm, and not engaging in actions that risk
harming others (Forester-Miller & Rubenstein, 1992).
3. Beneficence reflects the counselor's responsibility to contribute to the welfare of
the client. Simply stated it means to do good, to be proactive and also to prevent
harm when possible (Forester-Miller & Rubenstein, 1992).
4. Justice does not mean treating all individuals the same. Kitchener (1984) points
out that the formal meaning of justice is "treating equals equally and unequals
unequally but in proportion to their relevant differences" (p.49). If an individual is
to be treated differently, the counselor needs to be able to offer a rationale that
explains the necessity and appropriateness of treating this individual differently.
5. Fidelity involves the notions of loyalty, faithfulness, and honoring commitments.
Clients must be able to trust the counselor and have faith in the therapeutic
relationship if growth is to occur. Therefore, the counselor must take care not to
threaten the therapeutic relationship nor to leave obligations unfulfilled.
When exploring an ethical dilemma, you need to examine the situation and see how each
of the above principles may relate to that particular case. At times this alone will clarify
the issues enough that the means for resolving the dilemma will become obvious to you.
In more complicated cases it is helpful to be able to work through the steps of an ethical
decision making model, and to assess which of these moral principles may be in conflict.
Ethical Decision Making Model
We have incorporated the work of Van Hoose and Paradise (1979), Kitchener (1984),
Stadler (1986), Haas and Malouf (1989), Forester-Miller and Rubenstein (1992), and
Sileo and Kopala (1993) into a practical, sequential, seven step, ethical decision making
model. A description and discussion of the steps follows.
1. Identify the Problem.
Gather as much information as you can that will illuminate the situation. In doing
so, it is important to be as specific and objective as possible. Writing ideas on
paper may help you gain clarity. Outline the facts, separating out innuendos,
assumptions, hypotheses, or suspicions. There are several questions you can ask
yourself: Is it an ethical, legal, professional, or clinical problem? Is it a
combination of more than one of these? If a legal question exists, seek legal
advice.
Other questions that it may be useful to ask yourself are: Is the issue related to me
and what I am or am not doing? Is it related to a client and/or the client's
significant others and what they are or are not doing? Is it related to the institution
or agency and their policies and procedures? If the problem can be resolved by
implementing a policy of an institution or agency, you can look to the agency's
guidelines. It is good to remember that dilemmas you face are often complex, so a
useful guideline is to examine the problem from several perspectives and avoid
searching for a simplistic solution.
2. Apply the ACA Code of Ethics.
After you have clarified the problem, refer to the Code of Ethics (ACA, 2005) to
see if the issue is addressed there. If there is an applicable standard or several
standards and they are specific and clear, following the course of action indicated
should lead to a resolution of the problem. To be able to apply the ethical
standards, it is essential that you have read them carefully and that you understand
their implications.
If the problem is more complex and a resolution does not seem apparent, then you
probably have a true ethical dilemma and need to proceed with further steps in the
ethical decision making process.
3. Determine the nature and dimensions of the dilemma.
There are several avenues to follow in order to ensure that you have examined the
problem in all its various dimensions.
o Consider the moral principles of autonomy, nonmaleficence, beneficence,
justice, and fidelity. Decide which principles apply to the specific
situation, and determine which principle takes priority for you in this case.
In theory, each principle is of equal value, which means that it is your
challenge to determine the priorities when two or more of them are in
conflict.
o Review the relevant professional literature to ensure that you are using the
most current professional thinking in reaching a decision.
o Consult with experienced professional colleagues and/or supervisors. As
they review with you the information you have gathered, they may see
other issues that are relevant or provide a perspective you have not
considered. They may also be able to identify aspects of the dilemma that
you are not viewing objectively.
o Consult your state or national professional associations to see if they can
provide help with the dilemma.
4. Generate potential courses of action.
Brainstorm as many possible courses of action as possible. Be creative and
consider all options. If possible, enlist the assistance of at least one colleague to
help you generate options.
5. Consider the potential consequences of all options and determine a course of
action.
Considering the information you have gathered and the priorities you have set,
evaluate each option and assess the potential consequences for all the parties
involved. Ponder the implications of each course of action for the client, for
others who will be effected, and for yourself as a counselor. Eliminate the options
that clearly do not give the desired results or cause even more problematic
consequences. Review the remaining options to determine which option or
combination of options best fits the situation and addresses the priorities you have
identified.
6. Evaluate the selected course of action.
Review the selected course of action to see if it presents any new ethical
considerations. Stadler (1986) suggests applying three simple tests to the selected
course of action to ensure that it is appropriate. In applying the test of justice,
assess your own sense of fairness by determining whether you would treat others
the same in this situation. For the test of publicity, ask yourself whether you
would want your behavior reported in the press. The test of universality asks you
to assess whether you could recommend the same course of action to another
counselor in the same situation.
If the course of action you have selected seems to present new ethical issues, then
you'll need to go back to the beginning and reevaluate each step of the process.
Perhaps you have chosen the wrong option or you might have identified the
problem incorrectly.
If you can answer in the affirmative to each of the questions suggested by Stadler
(thus passing the tests of justice, publicity, and universality) and you are satisfied
that you have selected an appropriate course of action, then you are ready to move
on to implementation.
7. Implement the course of action.
Taking the appropriate action in an ethical dilemma is often difficult. The final
step involves strengthening your ego to allow you to carry out your plan. After
implementing your course of action, it is good practice to follow up on the
situation to assess whether your actions had the anticipated effect and
consequences.
The Ethical Decision Making Model at a Glance
1. Identify the problem.
2. Apply the ACA Code of Ethics.
3. Determine the nature and dimensions of the dilemma.
4. Generate potential courses of action.
5. Consider the potential consequences of all options, choose a course of action.
6. Evaluate the selected course of action.
7. Implement the course of action.
It is important to realize that different professionals may implement different courses of
action in the same situation. There is rarely one right answer to a complex ethical
dilemma. However, if you follow a systematic model, you can be assured that you will be
able to give a professional explanation for the course of action you chose. Van Hoose and
Paradise (1979) suggest that a counselor "is probably acting in an ethically responsible
way concerning a client if (1) he or she has maintained personal and professional
honesty, coupled with (2) the best interests of the client, (3) without malice or personal
gain, and (4) can justify his or her actions as the best judgment of what should be done
based upon the current state of the profession" (p.58). Following this model will help to
ensure that all four of these conditions have been met.
References
American Counseling Association (2005). Code of Ethics. Alexandria, VA: Author.
Forester-Miller, H. & Rubenstein, R.L. (1992). Group Counseling: Ethics and
Professional Issues. In D. Capuzzi & D. R. Gross (Eds.) Introduction to Group
Counseling (307-323). Denver, CO: Love Publishing Co.
Haas, L.J. & Malouf, J.L. (1989). Keeping up the good work: A practitioner's guide to
mental health ethics. Sarasota, FL: Professional Resource Exchange, Inc.
Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The
foundation for ethical decisions in counseling psychology. Counseling Psychologist,
12(3), 43-55.
Rosenbaum, M. (1982). Ethical problems of Group Psychotherapy. In M. Rosenbaum
(Ed.), Ethics and values in psychotherapy: A guidebook (237-257). New York: Free
Press.
Sileo, F. & Kopala, M. (1993). An A-B-C-D-E worksheet for promoting beneficence
when considering ethical issues. Counseling and Values, 37, 89-95.
Stadler, H. A. (1986). Making hard choices: Clarifying controversial ethical issues.
Counseling & Human Development, 19, 1-10.
Van Hoose, W.H. (1980). Ethics and counseling. Counseling & Human Development,
13(1), 1-12.
Van Hoose, W.H. & Paradise, L.V. (1979). Ethics in counseling and psychotherapy:
Perspectives in issues and decision-making. Cranston, RI: Carroll Press.
Holly Forester-Miller, Ph.D.
Thomas Davis, Ph.D.
Copyright © 1996, American Counseling Association. A free publication of the
American Counseling Association promoting ethical counseling practice in service to the
public. -- Printed and bound copies may be purchased in quantity for a nominal fee from
the Online Resource Catalog or by calling the ACA Distribution Center at 800.422.2648.
ACA grants reproduction rights to libraries, researchers and teachers who wish to copy
all or part of the contents of this document for scholarly purposes provided that no fee for
the use or possession of such copies is charged to the ultimate consumer of the copies.
Proper citation to ACA must be given.
Introduction
Counselors are often faced with situations which require sound ethical decision making
ability. Determining the appropriate course to take when faced with a difficult ethical
dilemma can be a challenge. To assist ACA members in meeting this challenge, the ACA
Ethics Committee has developed A Practitioner's Guide to Ethical Decision Making. The
intent of this document is to offer professional counselors a framework for sound ethical
decision making. The following will address both guiding principles that are globally
valuable in ethical decision making, and a model that professionals can utilize as they
address ethical questions in their work.
Moral Principles
Kitchener (1984) has identified five moral principles that are viewed as the cornerstone
of our ethical guidelines. Ethical guidelines can not address all situations that a counselor
is forced to confront. Reviewing these ethical principles which are at the foundation of
the guidelines often helps to clarify the issues involved in a given situation. The five
principles, autonomy, justice, beneficence, nonmaleficence, and fidelity are each absolute
truths in and of themselves. By exploring the dilemma in regards to these principles one
may come to a better understanding of the conflicting issues.
1. Autonomy is the principle that addresses the concept of independence. The
essence of this principle is allowing an individual the freedom of choice and
action. It addresses the responsibility of the counselor to encourage clients, when
appropriate, to make their own decisions and to act on their own values. There are
two important considerations in encouraging clients to be autonomous. First,
helping the client to understand how their decisions and their values may or may
not be received within the context of the society in which they live, and how they
may impinge on the rights of others. The second consideration is related to the
client's ability to make sound and rational decisions. Persons not capable of
making competent choices, such as children, and some individuals with mental
handicaps, should not be allowed to act on decisions that could harm themselves
or others.
2. Nonmaleficence is the concept of not causing harm to others. Often explained as
"above all do no harm", this principle is considered by some to be the most
critical of all the principles, even though theoretically they are all of equal weight
(Kitchener, 1984; Rosenbaum, 1982; Stadler, 1986). This principle reflects both
the idea of not inflicting intentional harm, and not engaging in actions that risk
harming others (Forester-Miller & Rubenstein, 1992).
3. Beneficence reflects the counselor's responsibility to contribute to the welfare of
the client. Simply stated it means to do good, to be proactive and also to prevent
harm when possible (Forester-Miller & Rubenstein, 1992).
4. Justice does not mean treating all individuals the same. Kitchener (1984) points
out that the formal meaning of justice is "treating equals equally and unequals
unequally but in proportion to their relevant differences" (p.49). If an individual is
to be treated differently, the counselor needs to be able to offer a rationale that
explains the necessity and appropriateness of treating this individual differently.
5. Fidelity involves the notions of loyalty, faithfulness, and honoring commitments.
Clients must be able to trust the counselor and have faith in the therapeutic
relationship if growth is to occur. Therefore, the counselor must take care not to
threaten the therapeutic relationship nor to leave obligations unfulfilled.
When exploring an ethical dilemma, you need to examine the situation and see how each
of the above principles may relate to that particular case. At times this alone will clarify
the issues enough that the means for resolving the dilemma will become obvious to you.
In more complicated cases it is helpful to be able to work through the steps of an ethical
decision making model, and to assess which of these moral principles may be in conflict.
Ethical Decision Making Model
We have incorporated the work of Van Hoose and Paradise (1979), Kitchener (1984),
Stadler (1986), Haas and Malouf (1989), Forester-Miller and Rubenstein (1992), and
Sileo and Kopala (1993) into a practical, sequential, seven step, ethical decision making
model. A description and discussion of the steps follows.
1. Identify the Problem.
Gather as much information as you can that will illuminate the situation. In doing
so, it is important to be as specific and objective as possible. Writing ideas on
paper may help you gain clarity. Outline the facts, separating out innuendos,
assumptions, hypotheses, or suspicions. There are several questions you can ask
yourself: Is it an ethical, legal, professional, or clinical problem? Is it a
combination of more than one of these? If a legal question exists, seek legal
advice.
Other questions that it may be useful to ask yourself are: Is the issue related to me
and what I am or am not doing? Is it related to a client and/or the client's
significant others and what they are or are not doing? Is it related to the institution
or agency and their policies and procedures? If the problem can be resolved by
implementing a policy of an institution or agency, you can look to the agency's
guidelines. It is good to remember that dilemmas you face are often complex, so a
useful guideline is to examine the problem from several perspectives and avoid
searching for a simplistic solution.
2. Apply the ACA Code of Ethics.
After you have clarified the problem, refer to the Code of Ethics (ACA, 2005) to
see if the issue is addressed there. If there is an applicable standard or several
standards and they are specific and clear, following the course of action indicated
should lead to a resolution of the problem. To be able to apply the ethical
standards, it is essential that you have read them carefully and that you understand
their implications.
If the problem is more complex and a resolution does not seem apparent, then you
probably have a true ethical dilemma and need to proceed with further steps in the
ethical decision making process.
3. Determine the nature and dimensions of the dilemma.
There are several avenues to follow in order to ensure that you have examined the
problem in all its various dimensions.
o Consider the moral principles of autonomy, nonmaleficence, beneficence,
justice, and fidelity. Decide which principles apply to the specific
situation, and determine which principle takes priority for you in this case.
In theory, each principle is of equal value, which means that it is your
challenge to determine the priorities when two or more of them are in
conflict.
o Review the relevant professional literature to ensure that you are using the
most current professional thinking in reaching a decision.
o Consult with experienced professional colleagues and/or supervisors. As
they review with you the information you have gathered, they may see
other issues that are relevant or provide a perspective you have not
considered. They may also be able to identify aspects of the dilemma that
you are not viewing objectively.
o Consult your state or national professional associations to see if they can
provide help with the dilemma.
4. Generate potential courses of action.
Brainstorm as many possible courses of action as possible. Be creative and
consider all options. If possible, enlist the assistance of at least one colleague to
help you generate options.
5. Consider the potential consequences of all options and determine a course of
action.
Considering the information you have gathered and the priorities you have set,
evaluate each option and assess the potential consequences for all the parties
involved. Ponder the implications of each course of action for the client, for
others who will be effected, and for yourself as a counselor. Eliminate the options
that clearly do not give the desired results or cause even more problematic
consequences. Review the remaining options to determine which option or
combination of options best fits the situation and addresses the priorities you have
identified.
6. Evaluate the selected course of action.
Review the selected course of action to see if it presents any new ethical
considerations. Stadler (1986) suggests applying three simple tests to the selected
course of action to ensure that it is appropriate. In applying the test of justice,
assess your own sense of fairness by determining whether you would treat others
the same in this situation. For the test of publicity, ask yourself whether you
would want your behavior reported in the press. The test of universality asks you
to assess whether you could recommend the same course of action to another
counselor in the same situation.
If the course of action you have selected seems to present new ethical issues, then
you'll need to go back to the beginning and reevaluate each step of the process.
Perhaps you have chosen the wrong option or you might have identified the
problem incorrectly.
If you can answer in the affirmative to each of the questions suggested by Stadler
(thus passing the tests of justice, publicity, and universality) and you are satisfied
that you have selected an appropriate course of action, then you are ready to move
on to implementation.
7. Implement the course of action.
Taking the appropriate action in an ethical dilemma is often difficult. The final
step involves strengthening your ego to allow you to carry out your plan. After
implementing your course of action, it is good practice to follow up on the
situation to assess whether your actions had the anticipated effect and
consequences.
The Ethical Decision Making Model at a Glance
1. Identify the problem.
2. Apply the ACA Code of Ethics.
3. Determine the nature and dimensions of the dilemma.
4. Generate potential courses of action.
5. Consider the potential consequences of all options, choose a course of action.
6. Evaluate the selected course of action.
7. Implement the course of action.
It is important to realize that different professionals may implement different courses of
action in the same situation. There is rarely one right answer to a complex ethical
dilemma. However, if you follow a systematic model, you can be assured that you will be
able to give a professional explanation for the course of action you chose. Van Hoose and
Paradise (1979) suggest that a counselor "is probably acting in an ethically responsible
way concerning a client if (1) he or she has maintained personal and professional
honesty, coupled with (2) the best interests of the client, (3) without malice or personal
gain, and (4) can justify his or her actions as the best judgment of what should be done
based upon the current state of the profession" (p.58). Following this model will help to
ensure that all four of these conditions have been met.
References
American Counseling Association (2005). Code of Ethics. Alexandria, VA: Author.
Forester-Miller, H. & Rubenstein, R.L. (1992). Group Counseling: Ethics and
Professional Issues. In D. Capuzzi & D. R. Gross (Eds.) Introduction to Group
Counseling (307-323). Denver, CO: Love Publishing Co.
Haas, L.J. & Malouf, J.L. (1989). Keeping up the good work: A practitioner's guide to
mental health ethics. Sarasota, FL: Professional Resource Exchange, Inc.
Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The
foundation for ethical decisions in counseling psychology. Counseling Psychologist,
12(3), 43-55.
Rosenbaum, M. (1982). Ethical problems of Group Psychotherapy. In M. Rosenbaum
(Ed.), Ethics and values in psychotherapy: A guidebook (237-257). New York: Free
Press.
Sileo, F. & Kopala, M. (1993). An A-B-C-D-E worksheet for promoting beneficence
when considering ethical issues. Counseling and Values, 37, 89-95.
Stadler, H. A. (1986). Making hard choices: Clarifying controversial ethical issues.
Counseling & Human Development, 19, 1-10.
Van Hoose, W.H. (1980). Ethics and counseling. Counseling & Human Development,
13(1), 1-12.
Van Hoose, W.H. & Paradise, L.V. (1979). Ethics in counseling and psychotherapy:
Perspectives in issues and decision-making. Cranston, RI: Carroll Press.
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