Many countries across the world have a set of ethics or guidelines that are mandatory for therapists and counselors to follow. The code of ethics supports both the practitioner and the client by:
Clearly laying out the guidelines for the engagement
Helping both define the boundaries of the relationship
And establishing safety (physical and emotional) for both.
In India, though, there is no governing body or uniform rule of ethics that are in practice. This means that many people who begin consulting a therapist don’t know what due processes need to be followed, and what are not advisable.
White Swan Foundation spoke to some practitioners to understand what code of ethics or guidelines they follow in therapy. Here are some of them:
What to expect:
In the first session, your therapist or counselor will tell you what you can expect. They may ask you to fill in some paperwork to understand your medical or mental health history, and tell you about their approach.
In the first few sessions, your therapist may help you understand your situation and clarify your goals from therapy so that both of you are aware of what you are working towards.
Your therapist will be clear with you about their areas of specialization, and inform you if they don’t have the skills or capacity to support you fully. They may also refer you to another mental health professional.
Therapy is often non-directive. Therapy is often collaborative: you as the client have full autonomy over their decisions and the professional functions as a reflection space or someone who supports you in gaining clarity.
Your mental health professional will offer you an emotionally safe, empathetic, non-judgemental listening space.
All your conversations with your therapist are confidential, and the therapist does not share them with anyone else – including your friends and family. However, if your therapist has enough reason to think that you are in a position where you may harm yourself or others, they may share this with your family or with other mental health professionals, for your safety.
However, this is something your therapist will tell you, ideally in your first session with them.
“As a helpline, we are aware that our only interaction with the client is through technology. We do not make diagnoses, screening, or recommendations on the phone. What we will do is suggest that the person consider consulting someone else who can help. We then connect them to on-the-ground services as required - therapists, special cells, legal aid, NGOs or hospitals.
Program Associate, iCALL Psychosocial Helpline, Mumbai
What to look out for:
Any concrete solutions or timelines set by the therapist in the first couple of interactions – it takes time to get the full picture and understand what the possible outcomes can be.
Being offered advice or ready solutions, or being told what decisions to take.
Being blamed, criticized or shamed for your emotions, your identity, your experiences or your choices.
Information or details about your conversations with your therapist being shared with your friends and family without your consent.
A big no for me is this: I don't provide documentation that I can't stand behind (I have been asked for letters on the first session to provide a diagnosis or at times say that I have seen the client for ongoing sessions when I haven’t done so) so that the individual can go back to work after a medical leave. This is a strict no no in terms of protecting the therapists own ethical responsibilities: Only report what you have actually done.
Dr Divya Kannan, clinical psychologist, Bangalore
As a therapist, and someone who offers online counseling, I’m clear about what solutions I can and can’t take provide in terms of immediate care. Certain conditions such as paranoid schizophrenia have somatic and neurological aspects along with psychological ones that need responsible medication and perhaps other support systems as well. Then, I have to clearly state that online intervention by itself won’t work. I make sure to recognize my own limits and make referrals to other professionals if necessary.
Scherezade Siobhan, Psychologist, The Talking Compass
If you’re considering going into therapy, it’s important you keep this in mind and talk to your therapist if they’re doing something differently.
And, at the same time, it’s also essential to go with your own impression of whether your choice of therapist is working for you. Do you feel safe enough to share with them after a few sessions (Often, it takes a few initial sessions to build rapport)? Do you have a sense that they’re listening to you with openness?
At any point, if something feels uncomfortable, you have the right to speak up and ask your therapist to tell you why they’re doing what they’re doing. And if the discomfort persists, it may be time to evaluate whether this relationship is working for you and supports you in addressing your mental health issues.
Also read: What are the ethics of counseling?