The Oates Journal (ISSN: 1098-1446) is a publication of the Wayne E. Oates Institute addressing issues related to spirituality, ethics, and healing from the perspective of pastoral care and counseling.

Recently I attended an Ethics Conference called “Ethics Law and Practice Reality: Bridging The Gap Between What The Law Says and What Practitioners Actually Do.” The very title of the conference intrigued me as it suggests that what we as practitioners know, may be in conflict with what we actually practice. And, the reality is that most decisions we make daily as practitioners have an ethical component --- boundaries, documentation, forms, fees, self-care, receiving gifts, dual relationships, communication, and the list goes on.

Several years ago the Kentucky Association for Marriage and Family Therapy implemented the requirement that out of 15 continuing education contact hours for annual licensure renewal, 3 hours must be in the area of ethics. I applaud the work of the Board in making this an annual requirement. This is certainly an acknowledgement that our conduct not only affects us and the clients we serve, but it affects the whole profession.

Adherence to the American Association for Marriage and Family Therapists (AAMFT) Code of Ethics is essential for client care. For me, the Code of Ethics is so integrated with my faith and theological commitments that these elements cannot be separated. One of the issues we must continually consider as practitioners is the ethics of power in the client-therapist relationship.

In the practice of marriage and family therapy, the issue of power is critical to a discussion of how we as practitioners see ourselves and how we see ourselves as persons in relation – relation to ourselves, relation to one another, and relation to God. Oftentimes, questions about power are not even raised until there is an abuse of power, and harm has been committed. Because of the serious implications, effects, and consequences of power abuses in therapeutic relationships, a thorough and thoughtful discussion is essential to the evolving approaches to understanding power.

As therapists we must acknowledge that we cannot not participate in the recursive action of therapy, and that in doing so we have power. We cannot be a therapist and be a distant, objective observer. We participate fully. In fact, the therapist-client relationship may be the most powerful agent of change, secondary to theories or modalities of treatment.

So when can power in the client-therapist relationship lead to healing and when can it lead to harm? The concept of power is central when we fail to recognize differences and when we pay attention to differences in gender, ethnicity, race, socio-economic status and other defining categories that punctuate the way people view themselves, each other and God. Power is the capacity to influence and be influenced by the world. We must recognize these issues as ethical issues. We must recognize that pretending that differences don’t exist is a pretense that leads to abuses of power. We must be accountable to the therapeutic context and to those persons we seek to help by being honest about the differences and by having a plan for keeping ourselves in check.

How do we this? By attending training programs which address race, ethnicity, gender, transference and counter transference issues; by being open to peer consultation and choosing not to be a “lone ranger” therapist; by committing to the self-exploration of our own biases and challenging ourselves to engage in activities that challenge our assumptions; by being knowledgeable of the Code of Ethics; by knowing what our theological commitments are and how we appropriately use those commitments in the therapeutic context.

The issue of power in the client-therapist relationship is a discussion which must never end. Power in the client-therapist relationship is an ethical issue. These issues are so vital in the practice of marriage and family therapy because they dictate how we view clients and the way in which that viewpoint will affect the client and the therapeutic outcome. Recognizing power as an ethical issue is central to practicing with integrity.

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