When Doing “No Harm” Isn’t Good Enough: Bringing beneficence to your clients

Curt and Katie chat about ethics again. We look at how therapists decide what is beneficial for clients. We also contrast the concept of “beneficence” (doing good) versus “nonmaleficence” (doing no harm). We specifically explore how to identify when something is in the therapist’s interest versus the client’s interest as well as what therapists can do when clients hold harmful, untrue beliefs. This is a law and ethics continuing education podcourse.
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In this podcast episode we talk about how therapists do good, beyond “do no harm”
Therapist healthcare ethics are often taught from the perspective that the professional’s role is to “do no harm” when providing treatment to clients. Lost in the teachings is that therapists have other obligations to address when providing treatment. This workshop focuses on examples of bringing the principle healthcare ethic of beneficence to therapy to help determine “doing good” for the client’s benefit.
What is beneficence in the context of psychotherapy?
Do what is good for the client and for treatment
“For the benefit if the client”
Comparing this with the idea of non-maleficence (“do no harm”) which is don’t do bad things, but also try to prevent bad things from happening
How do therapists decide what is “good” for their client?
Assessing the risk of overtaking client autonomy and becoming paternal or parental
Balancing all of the core ethical principles and putting them in context for the unique situation for each client
Looking at whether therapist self-disclosure is in the benefit of the client
Identifying what is therapeutic and beneficial
Making sure that therapists move beyond what is comfortable (and not “harmful”) to something that may be less comfortable (and more beneficial)
Looking at who therapists choose to work with, balancing therapist self-care and self-protection with what is beneficial to the client and society
What are specific concerns to consider when deciding whether a therapist is working for the benefit of the client?
Therapy dogs (are they certified and registered, is it in the treatment plan)
Contact between sessions initiated by the therapist (who is the contact for? What does the treatment model say about this type of contact?)
Have a thought process and document that thought process when deciding what to do as a therapist
What can therapists do when clients hold distorted beliefs?
Identify: Do the distorted beliefs that the client holds cause (or could cause) harm?
Understand: What laws or ethics are relevant to whether the distorted belief should be addressed?
Get client consent (or not) to talk about the distorted belief and potentially change the course of therapy
Is it necessary to discuss the belief at this time?
What countertransference issues could impact the efficacy of the conversation with the client?
Will the conversation be helpful and potentially change the client’s view?
How will the conversation change the course of therapy?
Does the therapist have appropriate expertise and training to address the distorted belief?
Who we are:
Curt Widhalm, LMFT
www.curtwidhalm...
Katie Vernoy, LMFT
www.katievernoy...
A Quick Note:
Our opinions are our own. We are only speaking for ourselves - except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

[@TheCounselingGuild]

Great episode! I liked your practical examples. However, I think the discussion could have been enhanced by including the principle of veracity or dealing truthfully with individuals found in the ACA code of ethics. When faced with dilemmas of autonomy, beneficence, and nonmaleficence, veracity can serve as a valuable counterbalance. While we should avoid imposing our morality directly on clients, we can still strive to provide accurate information about the potential outcomes of various choices(Psychologically, behaviorally, or otherwise). This respects the client's autonomy but also allows counselors to still deal with reality.
I also like to conceptualize these ethics within the golden mean idea. It's possible to bring any of the foundational ethics to their excess and deficiencies.
Thanks for your work!