a content analysis of The Family Journal, Southern (2005) listed the main themes addressed as “techniques, training, & supervision, assessment & diagnosis, children at risk, multicultural issues, family issues, ethics, sexual issues, marital & couple issues, addiction, and healthy relationships” (p. 8), with an increase in articles dealing with ethics, addiction, and work and socioeconomic issues. Southern also noted a trend toward increased coverage of sexual issues, training and supervision, marital and couples issues, family issues, and health.
In spite of their openness to qualitative design, such articles still make up a relatively small amount of the total number of articles. Still, I believe that qualitative investigations and action research methods hold the greatest promise for integrating scholarship and clinical practice (see Sprenkle & Piercy, 2005).
Qualitative research embeds the knower (all of us as practitioner-scholars) within the experiences of the known (the family) and asks us to consider what effects our presence and observations have on the people and systems we are investigating. Is this not what all of us have to do in clinical practice anyway? Is it not important to regularly reflect on who we are, what we are experiencing, and what kinds of recursive effects we are having with the families we serve? Qualitative research engages us in a search for patterns and themes, and the more formal processes of continual categorization, sorting and resorting, and coding and recoding have the potential to orient and train the practitioner’s mind for receiving and making meaning out of the stories and experiences in therapy (Echevarria-Doan & Tubbs, 2005). Qualitative research can be phenomenological and supports efforts to study families in natural contexts (Dahl & Boss, 2005). It reminds us that meaning can be different for various members of families and systems, that there are multiple ways of knowing, and that the language and meanings of everyday life are socially constructed and significant. Most important, qualitative research emphasizes that we are not separate from the people and families we study and serve: The knowledge we have is shared and held by practitioners and families alike. These assumptions provide a significant bond between clinical practice and clinical research with the strengths of each informing and enhancing the other.
Action research offers practitioners still another model for assessing and evaluating their effectiveness in therapy (Mendenhall & Doherty, 2005). Again, action research is a methodology that can train and orient the minds of family practitioners in useful ways. It emphasizes democratic partnership (or collaboration); problem-solving in context; cyclical processes of interventions and evaluations; and adjustments, humility, and adaptability. In action research, participants engage in corrective and evaluative processes that guide changes in approach and intervention, the very same guidance that the early masters of family therapy sought in their developmental work.
For too many years, the very word “research” has led to resistance in those who are training for the helping professions. Required courses in statistics, empirical and experimental design, and controlled studies seem to be disconnected from the rest of professional training in family practice. With the emergence of qualitative and action research methods, it is possible for scholarship to be reconnected and indeed fully integrated with clinical practice.
Summary
In this chapter, we have looked at the personhood of the family counselor—both as a practitioner and as a scholar. One of the most important issues in family practice is the attention that must be given to personal growth and development. Working with families is both complicated and exciting: It appeals to those who like challenges, who look forward to engaging with others, who see life in relational terms, and who want to make a difference in human systems. The work is personal; it happens up close. It is the kind of work that touches our own life experiences and all too easily reminds us of our own family concerns and issues. Sorting through our life experiences, personal concerns, and family issues is essential to meeting families in an open and grounded manner.
You will learn many things throughout your training as a family counselor. Asking families to see themselves in a new way requires us to be able to see our own families in a new way. Helping families through the change process is more easily facilitated when we have engaged in purposeful changes ourselves. Developing our professional processes in a therapeutic relationship is just part of the larger experience of paying attention to the relationships we have in the rest of our lives.
To be an effective family counselor, you must also engage in self-care (see Corey et al., 2018). Family practitioners who are on the front line of offering services will often see as many as 30 couples or families a week. They are constantly in the mode of caring for others. This is the nature of the work we do. Still, it is important for us as family counselors to put ourselves on the list of those who need care; that is, the care we give others is directly impacted by our ability to engage in self-care.
CHAPTER 4
Virtue, Ethics, and Legality in Couples and Family Practice
Mark Young, David Kleist, and James Robert Bitter 1
In this chapter, we consider three aspects of professional work that should be related but often are not even complementary to one another: virtue or goodness, professional ethics codes, and legal conduct.
We want you to think about what constitutes personal and relational virtue—a good life—and the morality that supports these two. In recent years, virtue has become almost exclusively the domain of religion, but once it was a matter of public discourse (see Aristotle, 350 B.C.E./1985; Cicero, 44 B.C.E./1991; Plato, 380 B.C.E./1992; and more recently, Bellah et al., 1991, 1996)—and it needs to be again. We also look at the masters of family counseling who might contribute to this discussion.
Although professional ethics can serve as guidelines for appropriate conduct with clients as well as provide opportunities for the personal learning and growth of the professional helper (Corey et al., 2019; Sperry, 2007), practicing ethically has too often been addressed simply as a means of avoiding malpractice lawsuits (Austin et al., 1990). Real ethical questions in family practice are almost never easy to answer, and even the principles that underlie our professional codes often need adjusting for application across cultures, across locations, and with multiple genders (Wilcoxon et al., 2013).
The legal requirements of each state also define practitioners’ responsibilities in relation to professional practice. This is especially true in the areas of confidentiality; child and elder abuse; harm to self, others, and sometimes property; informed consent; dual relationships; professional identity and competence; and education and training. In addition, there are federal requirements to consider, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA)2 and Jaffee v. Redmond (1996), which deal with federal validation and limitations on confidentiality in psychotherapy. Although personal virtue and professional ethics ought to be foremost in our relationships with clients, it is the laws of each state and the federal government that ultimately dictate these standards in our work.
A Consideration of Virtue
Within Western cultures, most discussions of virtue have yielded relatively common themes. Although Aristotle (350 B.C.E./1985) chose happiness as the highest good, it was never to be achieved in isolation. Indeed, happiness was the result of virtuous actions that were conducted with moderation: bravery (or courage); temperance; generosity; mildness and friendliness; truthfulness; wit; justice and fairness; consideration and considerateness; and rational thought, intelligence, and even wisdom. To this list, Cicero (44 B.C.E./1991) added orderliness, goodwill, honor, faithfulness,
