As an ADAPT Functional Health coach, you will encounter ethical issues and dilemmas in your work with clients. It’s the nature of working with people. Ethical dilemmas are often complex and not resolved with a simple solution from the ethical codes. Sometimes, no ideal solution exists. To avoid making quick, emotional, or even simplistic solutions to complicated problems, ethical decision-making models are warranted. The ADAPT Ethical Decision-Making Model is a research-based approach (Duff & Passmore, 2010; Forester-Miller & Davis, 2016; Pope & Vasquez, 2016) for ADAPT health coaches to follow when responding to and resolving ethical dilemmas.
1. Define the problem
Objectively define the problem. Separate out all of the opinions, assumptions, suspicions, and theories about the dilemma, and list only the facts.
- How does my objective intellect define the problem, minus my emotions?
- What are the actual facts?
- What are the various ways of defining the problem?
- Who is involved (which could include multiple individuals and systems)?
- Who could be affected by the problem and the decision?
- Is this an ethical, legal, professional, or clinical problem? Is it a combination?
Additional important questions to ask are:
- Is the problem related to me and what I am or am not doing?
- Am I prepared or qualified to handle the situation? What steps, if any, could I take to respond more effectively?
- In the light of all relevant factors, who else might be more qualified to handle the situation? If I do not feel within my scope of practice or expertise, what are the consequences of referring or not referring the client?
- Is the problem related to a client and/or the client’s significant others and/or what they are or are not doing?
- Is the problem related to technology in the provision of services or in storing client records?
- Is the problem related to the institution or agency for which I am employed and its policies and procedures?
Coaches are urged to avoid rushing this step. Choosing the most ethical response to the problem rests on clearly understanding the problem. In cases of a legal problem, contact legal counsel or appropriate legal resources immediately.
For example, let’s say that a client shows up intoxicated for a session. Whether the client drives under the influence and kills a pedestrian can depend on how we define the problem. A coach colleague begins to show signs of cognitive impairment or dementia. How we define the problem can affect our colleague’s safety and well-being and the clients they are serving.
2. Identify Emotions, Biases, Judgements
Clarify your emotional response to the problem, including judgments and personal biases that might affect your decision-making process. Emotional awareness is important for coaches to recognize, feel, and honor in the early stages of an ethical dilemma.
- What is my emotional reaction to the problem? How am I feeling?
- Do I feel angry, sad, or afraid?
- Do I feel the need to please someone?
- Do I feel desperate to avoid conflict?
- Am I afraid that choosing the most ethical path will get me into trouble?
- Am I afraid of making someone mad at me?
- Am I afraid of being second-guessed or challenged by colleagues?
- Will doing the right thing cost me time, money, friends, referrals, prestige, a promotion, my job, practice, or certification?
- What is my heart wanting me to do?
Pope and Vasquez (2016) emphasize that “being relentlessly honest with ourselves as we feel our way through as well as think our way through ethical challenges can help us avoid rationalizing our way off the path toward the most ethical response for this specific situation.”
3. Apply the Ethical Codes or the Law
Apply the NBHWC Ethical Codes and ADAPT SOP/COE to the problem.
- Do the codes or the law offer a possible solution to the problem?
- Are there any conflicts between the codes and the law?
- Would it be helpful to consult with a person associated with the codes?
If so, follow the course of action indicated in the codes. If a legal problem emerges, follow the legal advice provided. In many cases, resolving legal issues offers a clearer path; it’s a matter of following the laws.
Important to keep in mind when choosing a course of action supported by the codes is the emotional awareness explored in Step 2.
For example, as a coach, if you believe that you are not performing effectively or at your best because of a personal or mental health issue, the NBHWC Ethical Codes provide a possible solution to the dilemma:
Part Two: The NBHWC Standards of Ethical Conduct, Section 1 states: Professional Conduct at Large: Strive at all times to recognize any personal issues that may impair, conflict with or interfere with my coaching performance or my professional coaching relationships. I will promptly seek the relevant professional assistance and determine the action to be taken, including whether it is appropriate to suspend or terminate my coaching relationship(s) whenever the facts and circumstances necessitate.
Here the codes direct the coach to recognize possible impairment and seek appropriate professional assistance promptly.
Yet, if while contemplating seeking assistance you feel guilt or shame because of the personal or mental health issue causing impairment, you might be reluctant to follow the codes and try to resolve the issue on your own or through less effective means. Attempting to resolve a personal or mental health issue on your own without support or professional assistance could hinder your effectiveness as a coach, cause harm to your clients, and even cause you further mental and emotional distress.
This example reveals how our emotional response to a potential ethical dilemma runs the risk of preventing us from taking the necessary ethical action to resolve the dilemma appropriately and in the best interest of our clients and ourselves. In this case, seeking supervision from a mentor coach or supervisor is highly advised, professional, and ethical.
If and when a problem is not solved by applying the NBHWC Ethical Codes and ADAPT SOP/COE, coaches are advised to complete the additional steps in the ethical decision-making process.
4. Reflect, Support, Consult
If, when applying the codes to the dilemma, a more complex, complicated ethical dilemma emerges, coaches are advised to reflect on the dilemma further and involve professional support in the process. Coaches are urged to avoid rushing the reflection process and seek consultation, supervision, and/or peer support to process the ethical dilemma thoroughly and then decide collectively on the most ethical course of action to take. Consultation is an important ethical step that should not be avoided in complicated, complex ethical dilemmas.
Consult the relevant professional coaching literature, and state or national coaching associations for assistance to ensure that you are using the most current professional literature and are aware of the diversity issues involved in the dilemma (i.e., culture, race, ethnicity, religion or spirituality, sexual orientation, age, socio economic status).
When accessing support, consider a variety of options based on your personal and professional style, need, the dilemma at hand, and your stage of development as a coach.
For example, experienced coaches may have a broader network of professional support or have more confidence in resolving ethical dilemmas because of their years of experience. For new, novice coaches and/or coaches in training, supervisors play an important role in mentoring coaches through the process of resolving ethical dilemmas.
5. Brainstorm and Evaluate options
Then, in consultation with your chosen support network, collectively brainstorm any and all possible and probable solutions to the ethical dilemma. Avoid judging or resisting possible options at this point.
Next, for each option, write down and discuss all the possible benefits, risks, and consequences (positive and negative) and how each option resonates with your personal moral codes, emotional response to the issue, the professional codes, and any associated legal requirements and contracts. Examine the implications of each possible course of action.
Then, begin eliminating the options that clearly will not provide the desired outcomes or may cause additional problems, negative consequences, or ethical dilemmas or legal issues.
Review the remaining options and determine which one or combination of options responds to the situation and addresses the identified priorities best.
Next, Stadler (1986) recommends applying three tests to the chosen option to ensure that it is appropriate:
- Justice: Ask yourself: Would I treat other the same in this situation?
- Publicity: Ask yourself: Would I want my chosen course of action reported to the press or media?
- Universality: Ask yourself: Would I recommend the same course of action to another coach in the same situation?
If the chosen option passes the questions of justice, publicity, and universality, and you believe that you have selected the most appropriate, ethical course of action, then step into the shoes of each person involved in the dilemma. How might each person involved respond to the chosen course of action? Contemplating this question can broaden our perspective and decrease the risk of seeing the consequences from our perspective only.
Pope and Vasquez (2016) further emphasize, if time permits, rethinking the intended and agreed-upon course of action and walking through the decision one more time to ensure that you have decided upon the best possible solution to the problem.
6. Implement and Take Action
Move forward and implement the selected option by taking action. Realize that making ethical decisions and carrying out the most ethical solution to the problem is not always easy, and in most cases, is difficult and can cause a variety of thoughts and feelings. Thus, requesting supervision or mentor coaching support may be necessary.
Regardless of your decision, risk or consequences may emerge. Trust that you made the best, most ethical decision possible using the steps of the model, the information you had at the time, and professional consultation with your support network. As coaches, we cannot practice risk-free or without consequences; however, we can reduce risk, and negative consequences and outcomes by following an ethical decision-making model.
Once the most appropriate course of action has been selected and carried out, coaches are advised to document the steps taken in the ethical decision-making process objectively, citing the model as the framework utilized. It is also wise to follow up on the situation to see if your actions resulted in the effect, risk, or consequences you anticipated.
Likewise, coaches are encouraged to incorporate new learning gained from working through the ethical dilemma into their evolving professional practice by reflecting on the process and identifying key awareness and insight.
- What could I do differently in the future?
- How could I reduce problems like this or strengthen my response in the future?
- Are there changes in our policies, procedures, or practice that could alleviate problems like this in the future?
Furthermore, coaches may wish to share the scenario (in a confidential manner) with their own peer network so that colleagues can benefit from the learning associated with working through and solving real ethical dilemmas.
- Duff, M., & Passmore, J. (2010). Ethics in coaching: An ethical decision making framework for coaching psychologists. International Coaching Psychology Review, 5(2), 140–151.
- Forester-Miller, H., & Davis, T. E. (1995). A practitioner’s guide to ethical decision making. Alexandria, VA: American Counseling Association.
- Pope, K. S., & Vasquez, M. J. (2016). Ethics in psychotherapy and counseling: A practical guide. Hoboken, NJ: John Wiley & Sons.
- Stadler, H. A. (1986). Making hard choices: Clarifying controversial ethical issues. Counseling and Human Development, 19, 1–10.