The 2023 Revision to the CRCC Code of Ethics: Implications for Defining and Protecting the Counselor–Client Relationship

Foundation of Section A: The Counseling Relationship

The foundation of Section A draws from the multiple influences that help define ethical behavior for rehabilitation counselors. A challenge the rehabilitation counseling profession encounters when defining ethical behavior is determining the source of expected practices and behaviors. As noted by Tarvydas et al. (2004), the profession “. . . has struggled with the balance between two traditions and sources of knowledge, skills, and attitudes: counseling and rehabilitation” (p. 234). In the development of Section A, a question remains if defining the counseling relationship is based on a generic consideration of counseling practice or based on a rehabilitation professional who used counseling as one of many tools.

The focus of Section A of the CRCC Code of Professional Ethics has been the relationship between CRCs/CCRCs and clients. Research has shown that one of the greatest predictors of success in counseling, including rehabilitation counseling, is the relationship between counselor and client (Lustig et al., 2002). In 1979, Bordin introduced the concept of the working alliance, which has three components: goals, tasks, and bonds. Goals involve collaboration between CRCs/CCRCs and clients to set appropriate, and achievable goals to be accomplished for the rehabilitation counseling process. Tasks involve the agreement between the CRC/CCRC and the client on the tasks that must be completed by each party to accomplish the agreed-upon goals. Bonds refer to the positive working relationship between CRCs/CCRCs and clients and it is this relationship that has an impact on goals and tasks (Bordin, 1979).

Lustig et al. (2002) conducted a study looking at the working alliance within the State-Federal Vocational Rehabilitation (VR) system. They found that a stronger working alliance between CRCs/CCRCs and clients positively impacted employment outcomes. The working alliance also contributed to the client’s perception of future employment possibilities and satisfaction with their current employment position. Therefore, these research findings suggest that it is vital that CRCs\CCRCs develop a positive working counseling relationship with the clients they serve to lead to successful outcomes.

This article will review the purpose of Section A of the CRCC Code of Professional Ethics, the revisions that have been made to this Section of the new 2023 Code, and how the changes in each sub-section of Section A impacts counselors/practice. The prevention of potential violations and concerns related to Section A, and practical recommendations for practitioners and implications for practice will also be discussed.

Purpose of Section A

It is fitting that the first section (A) of the revised code pertains to the counseling relationship. Certified rehabilitation counselors and Canadian certified rehabilitation counselors regularly face a multitude of ethical dilemmas in their work, and no ethical or legal issues have caused more controversy within the counseling profession than personal/professional boundary issues related to client interactions. For example, CRCs/CCRCs often struggle with the question of whether it is permissible to accept gifts from a current client or become involved in a friendly relationship with a former client (Remley & Herlihy, 2020). The purpose of Section A of the CRCC Code of Professional Ethics (hereafter referred to as the Code) is to help CRCs/CCRCs understand their responsibilities in a counseling relationship. Section A exists to help reduce the chance of crossing the line between personal and professional relationships.

Indeed, counseling often involves a great deal of emotional intimacy. Section A of the Code provides structure to the counseling relationship, creates a safe space for the client, and protects vulnerable clients from harm (Remley & Herlihy, 2020). Many experts have discussed the importance of counseling relationships in the rehabilitation counseling process (Herlihy & Corey, 2015; Hill et al., 2022; Kocet & Herlihy, 2014; Lustig et al., 2002; Pope & Keith-Spiegel, 2008; Roberts et al., 2002). Issues around dual relationships or multiple counseling relationships are often complex and ambiguous (Remley & Herlihy, 2020). However, some requirements regarding the counselor/client relationship are very clear. For example, CRCs/CCRCs are prohibited from having a sexual relationship with clients (past and present), trainees and research participants, their partners, or their family members for at least 5 years after the counseling relationship ends.

Section A of the Code serves a key purpose in the practice of rehabilitation counseling (past, present, and future). There is a need for conceptual clarity regarding when actual violations have occurred and for language that makes enforceability of the current Code viable thereby improving the ability of CRCs to resolve ethical dilemmas promptly, efficiently, and effectively. With all of this in mind, the overall goal of the 2023 CRCC Code is to: (a) improve conceptual clarity and (b) address current ethical challenges and projected ethical issues that we envisage may arise in the future. This review explains how those goals have been addressed concerning Section A of the Code.

Changes to Section A

Both minor and major changes were made across various sub-sections in Section A of the previous 2017 CRCC Code. Common minor but important changes included changing the word, “rehabilitation counselor” to “certified rehabilitation counselor”; expanding the word “electronic” to include “virtual,” “remote,” and “online” (see A.4.a, c, and d); and infusing the word “multiculturally competent” (see A.2.a), “client centered,” and “respecting client’s informed decision making” (see A.1.b). Because the old sub-section A.4: ‘avoiding value imposition’ in the 2017 CRCC code more closely aligns with Section D of the 2023 Code, it was moved to sub-section D.2.a in the new Code.

Consequently, the old sub-section A.5: “Roles and relationships with clients” was renumbered as A.4 with the word, “prohibited” added to the title. The new A. 4 sub-section title now reads “Prohibited roles and relationships with clients (see CRCC, 2023, p. 6 for details). In sub-section, A 5 “Multiple clients,” the word, “sibling” was added to the list of examples of persons that CRCs/CCRCs can agree to provide services (see CRCC, 2023, p. 7). These minor changes seek to address issues, such as confidentiality in social media, and cultural diversity that CRCs/CCRCs wanted to be addressed in future iterations of the Code (Hill et al., 2022). The expectation is that with increased clarity and understanding provided by these changes, CRCs /CCRCs would be more effective in the delivery of rehabilitation counseling services to their clients with a possible reduction in reported violations.

Application of Revised Section A to Counselor Responsibilities

The introduction to Section A of the new Code (CRCC, 2023) states:

CRCs/CCRCs work in cooperation with their clients to promote client growth, welfare, and support them in developing and progressing toward their goals. CRCs/CCRCs understand that trust is the cornerstone of the counseling relationship, and they have the responsibility to respect and safeguard the client’s right to privacy and confidentiality. CRCs/CCRCs respect the rights of clients to make their own decisions about matters that affect their own lives. CRCs/CCRCs make reasonable efforts to ensure clients make informed choices about every aspect of the rehabilitation counseling process. CRCs/CCRCs are expected to understand the diverse cultural backgrounds and identities of the clients they serve and do not discriminate in their provision of rehabilitation counseling services based on protected identities. CRCs/CCRCs also explore their own backgrounds, cultural identities, and experiences and how these affect their values and beliefs. (p. 4)

As CRCs/CCRCs, the primary responsibility is service provision for clients with disabilities. This service provision should be done for the dignity of the client and promoting the welfare of the client, as well as their freedom of choice. Certified rehabilitation counselors and Canadian certified rehabilitation counselors should “work with clients to develop avocational, independent living, and community integration goals consistent with their abilities, interests, culture, needs, and welfare” (CRCC, 2023, p. 4). Certified rehabilitation counselors and Canadian certified rehabilitation counselors should also empower clients to make their own decisions when possible, reinforcing client autonomy and cultural identity. Rehabilitation and treatment plans should be multiculturally relevant and created collaboratively. The support of others should be used and incorporated when appropriate and/or when requested by the client.

Relationships between CRCs/CCRCs and clients should always be professional and centered on the welfare of the client. This includes the prohibition of engaging in sexual or romantic relationships with current clients and refraining from engaging in virtual relationships, such as accepting friend or connection requests on social media, with current clients. Judgment should be used when engaging in these types of relationships with former clients and should never be engaged in with vulnerable former clients or those not capable of informed decision-making. If CRCs/CCRCs engage in boundary extensions, such as attending graduation or marriage ceremonies, they should carefully consider the risks and benefits of these activities and seek supervision or consultation as needed. Any boundary extensions should be documented appropriately. In the same vein, CRC/CCRC role changes should be carefully considered and documented. They should also obtain new informed consent from the client to reflect the new role.

When terminating the professional relationship with clients, the process should be explained thoroughly to clients. Termination should occur when the client’s goals have been met and the client no longer needs assistance, the client is no longer benefiting from services, or the client is being harmed by services. Termination should not occur because of personally held values on the part of the CRC/CCRC. Making referrals or transferring a client to another provider should also not occur because of a perceived values conflict on the part of the CRC/CCRC. Certified rehabilitation counselors and Canadian certified rehabilitation counselors have an ethical obligation to respect the diversity of clients and should seek out training or professional development related to areas in which they are at risk of imposing their values or beliefs onto clients, especially when the CRCs/CCRCs values or beliefs are discriminatory or in conflict with the goals set by the client.

Certified rehabilitation counselors and Canadian certified rehabilitation counselors have an ethical obligation to ensure that they have the skills and competencies necessary to build a quality relationship with clients. They must have:

keen awareness and mastery of interpersonal communication skills that help facilitate relationship values that are fundamental to the counseling process. At the foundation of the counseling relationship are the principles of respect, warmth, understanding, genuineness, congruency, authenticity, and positive regard. (Stebnicki, 2018, p. 223)

When working with terminally ill and end-of-life clients, CRCs/CRCCs should always be aware of their competencies and make referrals to ensure clients receive appropriate assistance. Certified rehabilitation counselors and Canadian certified rehabilitation counselors should also develop skills to handle clients who may have difficult behaviors, are uncooperative, or dealing with trauma, as these skills go beyond the basic counseling skills. McCarthy (2014) found that clients had more successful outcomes when rehabilitation counselors used counseling micro skills, such as paraphrasing and confrontation, and when rehabilitation counselors used skills to handle difficult client behavior. Therefore, CRCs/CRCCs must develop, practice, and use basic counseling skills to build rapport and a positive counseling relationship with clients.

Preventing Violations and Issues Related to Section A

Certified rehabilitation counselors and Canadian certified rehabilitation counselors have a responsibility and obligation to read and understand the CRCC Code of Ethics and apply the guidance and standards in their everyday rehabilitation counseling practice, regardless of the setting in which they work. However, when it comes to working with real people in real situations, applying the Code can be difficult to navigate. Therefore, CRCC has provided resources to assist CRCs/CCRCs in navigating ethical dilemmas such as advisory opinions and grievances. For information related to ethical decision-making, please see the article in this special issue on this topic.

Cartwright and Hartley (2016) conducted a content analysis of 127 advisory opinions from 1996 to 2013. These advisory opinions referenced 470 citations to specific sections of the Code. Out of the 470 citations, 135 were references to Section A, making it the most referenced section. Within Section A, the most commonly cited standard had to do with informed consent and professional disclosure. Cartwright and Hartley (2016) stated that “these results are not surprising especially when one considers that the development of a therapeutic relationship and trust is critical to effective rehabilitation practice” (p. 90). Based on this information, CRCs/CCRCs must develop and provide clients with a thorough informed consent and professional disclosure statement and review this statement with clients to ensure understanding. This can be the first step in building rapport and establishing the working alliance between the CRC/CCRC and the client.

Serious ethical violations can occur related to Section A including inappropriate relationships with current or former clients. Regrettably, the problem of sexual violations is likely to continue. Certified rehabilitation counselors and Canadian certified rehabilitation counselors can and sometimes do have romantic feelings and fantasies toward their clients (Alpert & Steinberg, 2017). The goal is not to limit the feelings that some CRCs/CCRCs have toward their clients, but to prevent behavioral violations of ethical requirements regarding romantic and/or sexual relationships. Certified rehabilitation counselors and Canadian certified rehabilitation counselors should never engage in a romantic or sexual relationship with a current client or a vulnerable former client. If a CRC/CCRC begins developing sexual or romantic feelings toward a current client or a current client discloses sexual or romantic feelings toward a CRC, the CRC/CCRC should seek supervision and consultation as understanding and interpreting this transference/countertransference reaction can be extremely valuable. Consultation is needed to help the CRC/CCRC manage boundaries and to address the transference or countertransference within the therapeutic relationship. In a situation where the CRC/CCRC may conclude that this is not possible, the CRC/CCRC should consider transferring the client to another CRC/CCRC. For consideration of engaging in a romantic and/or sexual relationship with a former client, at least 5 years should have passed since the last professional-client contact, and careful consideration should be given to the potential for the relationship to be considered or perceived as coercive or exploitative. Regardless of the time elapsed, CRCs/CCRC should never enter a romantic or sexual relationship with a vulnerable former client, including those clients that have impaired decision-making capabilities. If CRCs/CCRCs choose to engage in this type of relationship with a vulnerable former client, this is cause for an ethical violation and the CRC’s/CCRC’s certification may be revoked if this relationship is reported to the CRCC Ethics Committee. Beyond the prohibition against working with clients determined to be vulnerable, CRCs/CCRC should always carefully consider the power dynamics and potential for ethical conflicts when engaging in a romantic and/or sexual relationship with a former client, even if the client is not considered to be compromised in their capacity to engage in such a relationship.

Recommendations/Implications for Practice

Sexual relationships with clients are undoubtedly harmful to the therapeutic counseling relationship. While the prohibition of any type of sexual intimacy with a current client is universally (Remley & Herlihy, 2020) accepted, the question of post-termination sexual relationship is still a subject of debate in the counseling profession. The CRCC Code of Ethics should be used as a resource and a source of training for counselors and trainees to engage in ethical practices, but with the understanding that the Code is limited in providing clear guidance to CRCs/CCRCs in rural settings. There is a need for education about boundaries, transference, the power differential, ethics, and self-care to be integrated into rehabilitation trainings/programs (Alpert & Steinberg, 2017). Given that previous ethical researchers have documented some benefits of dual relationships and the complex nature of dual relationships particularly in rural settings, we agree with Luse (2018) that training materials and supervision provided to counselors on how to avoid intimate relationships must be empirically validated and culturally appropriate for rural settings. A summary of specific professional and educational strategies is listed below:

Conclusion

Ethical standards related to the counseling relationship have changed and are documented in the revised CRCC (2023) Code of Ethics. Changes to Section A of the Code and related implications for practice are summarized. Virtual service delivery modalities may be considered in current and future rehabilitation counseling practice.