Ethics of Online Counseling

by Kathryn DonevWe live in a fast-paced society where virtually everything is just a click away. With the click of a button, you can pay your bills or even have merchandise shipped to your front door without ever leaving the comforts of home. The Internet has made this and much more a reality. The number of Internet users today is reported at 972,828,001, which is 15.2% of the world’s population and the percentage of population usage growth during 2000-2005 was reported at 169.5% (Internet World Stats, 2005). As the number of Internet users across the globe continues to soar, more and more resources are becoming accessible online. The possibilities of services that can be offered on the Internet are endless. Today, one can even receive online professional services such as counseling.

Online counseling is a relatively new service. Therefore, there currently exists limited research to support or disconfirm its effectiveness. The long-term ramifications of such an experience are yet unknown. There are many concerned with the ethical dilemmas associated with online counseling. Below I will briefly explore the ethical issues centered around online counseling, beginning with a definition of a traditional counseling relationship:

A traditional counseling relationship is an interpersonal relationship between a client and counselor in which the counselor provides the client a reflection of the client’s self in a safe atmosphere in which the client feels comfortable enough to completely relay information to the counselor in order to gain order over personal conflicts.

Confidentiality:
The first and most obvious ethical dilemma with rendering mental health services over the Internet is one of confidentiality and privacy. The Internet is an open network and therefore is not secure. Consequently, when communicating through an insecure source one cannot be completely guaranteed that what is being revealed in a counseling relationship remains only in that relationship.

Because the Internet is not secure, there are numerous opportunities for an invasion of privacy. Such could occur if one were receiving counseling while at the work place where his or her email is subject to being read because it is considered company property. Other possibilities include, but are not limited to, that another could access confidential emails intentionally by eavesdropping or unintentionally if information was misdirected and intercepted.

Identification:
Another ethical issue associated with online counseling involves client and counselor identification. Without being able to confirm the identity of a client during each interaction, one cannot be certain of who is being counseled. The danger in this circumstance is that one could easily misrepresent him or herself and the counselor could be mislead to believe that he or she is counseling a particular individual when in fact this may not be the case. If this were to happen, confidential information could be unintentionally divulged to a third party.

Additionally, if the client were to misrepresent his or her own identity, for instance their sex or ethnicity, this could be just as damaging and could hinder the counseling process. If a counselor does not fully know with whom he or she is working, then the story which is being revealed by the client cannot appropriately be put into context, thus resulting in misinterpretation of what the client is communicating.

Virtual Relationship:
One of the most common negative results of interacting online is the phenomenon of being in a virtual relationship. Both the counselor as well as the client are in a sense unreal, they are simply “cyber-beings” as the author likes to describe them. Being in a virtual relationship causes an individual to have no sense of commitment to the counseling process. The client is simply writing another email via a keyboard and has minimum personal connection to the counselor.

Due to the lack of a personal relationship with the counselor, a client may be more easily offended by the advice that is given in an online counseling session. A client may feel that a cyber-being has no right to become so personal. If this is the case, then a client may also be more apt to end the relationship either temporarily or permanently by simply clicking a button.

The first and foremost responsibility of a counselor is to protect the welfare of his or her client. Yet, if one is counseling a virtual person then it is nearly impossible to be able to ensure the client’s safety. A counselor does not even truly know whom they are counseling or the location of the client’s residence. With this being the case, a counselor cannot intervene if a client is a danger to him or herself or others. A counselor’s hands are tied when it comes to his or her “Duty to Warn.”

Dishonesty:
As a result of communicating over an insecure source to a cyber-being, a client receiving online services may not be willing to be straightforward about all information. Additionally, when information is shared with a lack of commitment to the counseling process this could lead the client to actually falsify information. Not only is there a danger that a client might be misleading or may even lie, but there is also the risk that a client could intentionally leave out parts of his or her story. A client may feel the need to be deceitful due to the fact that he or she may fear a breach of confidentiality or simply feel no responsibility to be honest because no personal relationship exists between counselor and client. If this is the case, then the counselor cannot work at full capacity because of a lack of all the pieces of the client’s history.

Dishonesty leads to confusion which makes the counseling process difficult if not impossible. If a client were able to be assured that what is said would stay only between counselor and client, then there would be more freedom to be completely honest. Also, if a client were in a face-to-face relationship, they may perhaps feel more of an obligation to be upfront.

Lack of Nonverbals:
Nearly 94 percent of all communication is nonverbal. We communicate with our facial expressions, posture, eye contact and so forth. Needless to say, reading nonverbals is an essential element of counseling. If one is being counseled online, these nonverbals are unobservable and such is detrimental to the counseling process. Nonverbals which cannot be observed during an online session are nervous behaviors, whether eye contact is maintained, angle and distance of body in relationship to the counselor, etc. Also, a client may be typing content which appears to be uplifting, but at the same time may be crying. Conversely, a client may be typing distraught messages but may be laughing while doing so. Such is evident of inappropriate affect and is a good indicator of possible mental diagnoses.

Abandonment Issues:
Another responsibility of the counselor is to not abandon a client. Yet, abandonment may be impossible to avoid when counseling occurs online due to the instability of the Internet. Communication could be hindered because of technology failures or glitches or as a result of a poor Internet connection.

If a relationship is suddenly ended for any reason, it would be almost, if not, impossible for a counselor to get back in touch with his or her client due to the fact that in an online counseling relationship the client is anonymous in most of the cases; thus making abandonment impossible to avoid. Furthermore, if a client were to abruptly leave a counseling session after threatening to harm him or herself or others, then not having the ability to protect your client would be the ultimate case of abandonment.

Conclusion:
There appears to be many “ifs” in the ethical dilemma of online counseling and not enough certainty. “If” we as counselors could guarantee the privacy of our clients, “if” we could make certain of who we are counseling, “if” our client is completely truthful and “if” we were guaranteed they would not terminate before a session is over, then there would be little debate over whether online counseling should be attempted. Nevertheless, as of now, the “ifs” do exist.

Counseling, whether online or in person, involves much responsibility. When counseling an individual, you are placed in a position where you are a major influence in that person’s life. A counselor holds much control over the mental health of another. If Internet counseling is attempted, it should only be done by a competent professional who is well-educated in the field and should only be done via secure websites or with an encryption technological e-mail communication application.Counseling online is a great responsibility as is counseling an individual face to face. As well, such a relationship should be treated with the highest ethical professionalism. Regardless of that an online client is communicating in a virtual world, his or her problems are still very much real.

Reference:
Internet World Stats (2005). Usage and Population Statistics, downloaded from http://www.Internetworldstats.com/stats.htm on 12/2/05. 10 a.m.

Working Strategies

During our time of ministry in Bulgaria, we use several strategies for ministry, but that of Market Place Ministry proved to be best suited for the setting. Theoretically, this approach to ministry is not new for the Christian church. It simply implements taking the Gospel to the people, instead of expecting the people to come to the Gospel.Fundamentally, Market Place Ministry is a Biblical method, which has also found its place in a number of modern day management paradigms. John Maxwell finds it implemented in the business paradigm called “Management by Walking Around” (MBWA).

Being rather an Oriental approach, it is often seen in the ministry of Jesus and the apostles, it is normal that in a Western context it remains difficult to implement. However, for Bulgaria where the economy, social life, and the community are built around the market places, it fits perfectly.

We are combining the Market Place Ministry with media ministry into a dynamic paradigm which takes the Gospel to the people and transformed their lives in their own social context. The downside of such paradigm is that a ministry team cannot be confined to a certain location like a church building or an office, but must be constantly on the go. This however, turns to be the very effectiveness of the paradigm as it brings the church out of its comfort zone to a place of real life-changing ministry in the market place.

Christmas for Evangelicals

Christmas for Evangelicals

Communism changed a lot in the Bulgarian mentality. For 45 years Christian holidays like Christmas and Easter were strictly forbidden. Christmas symbols and words were changed in an anti-Christian propaganda. For example, the traditional Bulgarian Christmas greeting Tchestito Rozdestvo Hristovo (Happy Birth of Christ) was replaced with Vesela Koleda (Joyfull Koleda – the word koleda derives from the Bulgarian word “kolia” which means to kill, to slay, and symbolizes the Bulgarian custom of slaying a pig in the preparation of the Christmas dinner). The name of Santa Claus was replaced with Grandpa Frost – again an old man with red clothing, long white beard and bag with presents; however, completely separated from the Christian meaning of the holiday. Even the traditional Orthodox Church was limited in their practice of Christmas.

Nevertheless, regardless of the persecution, secretly or openly, Christmas has always been present among the Bulgarian Protestants. Usually the church congregation would gather for a special Christmas service on Christmas Eve. In the Underground Church this event was one of the few occasions where the local congregation would come together and remain unnoticed by the secret police because of the celebration going on. Using the rare opportunity the church would not only use the time for fellowship but also for Communion and Baptism services. Since the churches did not own buildings, the baptismal would usually be performed in a river after the ice had been broken.

With the Fall of the Berlin Wall the situation changed dramatically. Through the largest spiritual revival Eastern Europe has ever known, in 10 years millions came to Christ. In the midst of the severe national economic crises, for protestants Christmas became not only a time of celebration, but also a time to reach to the ones in need. Thus the renewed Christmas became more powerful as it not only reflected on the Christian tradition but a real-life inspired practice of Christianity.

The Bulgarian Church of God is no stranger to these events. Every Christmas is seen as a ministry opportunity, as several activities take place. There are Christmas dinners for the needy which take place in the churches that sponsor social centers across the country. There is also a Christmas gift service for children from homes for children.

Christmas is a time when the church congregation comes together for reconciliation and recognition of the Birth of Christ. As the Christmas message is preached and Silent Night is sung, this holiday also becomes a celebration of the liberation of spirit and soul, provided by God through His Son. Thus for the church in a post-Communist context Christmas is the gift of liberty to come together and to worship. Remembering the Son of God who came to liberate us from sin and death we also wish you a Marry Christmas and a Happy New Year.

Traffic Jam on The Road to Recovery

by Kathryn Donev

The doctors offer you hope that your treatment is going as planned, continuously saying that you are on the road to recovery. Yet lingering in the back of your mind are doubts about the progress. If you are on the road to recovery, should you not be feeling better? In the midst of uncertainty, this query causes you to question your ability to assess your own condition and you wonder if the pain is simply imagined, and all in your head. Eventually, you come to the conclusion that indeed the pain is unbearably real. Meanwhile you begin to question why this is happening to you. So, you review your past and contemplate if you have done something to deserve such discomfort. Perhaps God is allowing you to suffer because of past actions. Then you consider whether the pain is a consequence of the sins of your father or forefathers. If this is a likely explanation, you begin to wonder how such could even be just. Justice, what is justice anyways? Is it fair to suffer for someone else’s wrongdoings? The results of your deliberations only lead to confusion that you realize will not be resolved this side of Heaven. After much pondering and searching for answers you begin to understand how pain has a way of drawing us closer to our Heavenly Creator. Discomfort causes you to long for and appreciate the promised comfort that will abide in Heaven. With this new perspective you become thankful for the traffic jam on the road to recovery. You become more hopeful of that day when there will be as the song says, “no more sorrow, no more pain” and the traffic jam will have long become a distant image in life’s rearview mirror.

Ministry Not for Sale

My son, if sinners entice thee, consent thou not (Proverbs 1:10)

Several years ago, while employed with a certain organization, we faced the dilemma to choose between what was morally right and what was financially secure. Regardless of the jeopardy of this predicament, we were able to make the right decision, preserving our integrity and disallowing financial pressure to dictate our moral choices. Soon thereafter, we initiated a healing process which dealt with the internal wounds, restored the lost trust and attempted to recover the invested time and resources. Years past, we forgot the pain, but never forgot the lesson we learned …

Recently, while involved in a global ministry campaign, we were faced with a similar situation. This time, however, it did not involve business partners, but a multitude of Pentecostal ministers. The larger size of the context did not change the problem at hand, but rather intensified and multiplied its harmful effects. We regretfully witnessed how hundreds of men and women involved in ministry were manipulatively forced to face the same dilemma. They had to make a mandatory choice between the financial security of their families and their own moral integrity. The results were accordingly. Read more

Purpose in the Midst of Chaos

by Kathryn Donev

The manner in which God works is unexplainable and incomprehensible to the human mind. His ways are not our ways. Yet, ultimately in the midst of what appears to be chaos or random acts, His ways are always immaculately planned and in perfect order such that design by man would be impossible. Read more

Cultural Diversities

by Kathryn Donev

Upon arriving in a foreign country there are many things to which one will have to adjust. The first and most obvious is the language barrier. Yet, there are many other nonverbal forms of communication as well as common customs associated with everyday living that may seem peculiar when first encountered. The shock for some may be great, but take comfort in the existence of many universal elements that transcend cultures. In many ways, people are very much the same in the midst of their differences. It is possible for such divergences to be overcome one at a time, one day at a time. The following are some of the observations that I, from an American perspective, have experienced during my first ten days of being back in Bulgaria.

1. Even though automobile speedometers appear in kilometers, you should get worried when it surpasses 200.
2. When heading to a specific location you may end up stopping at up to five others before arriving at your final destination. So be prepared to enjoy the journey.
3. It is customary to let a woman with a child cut you in line.
4. Be advised that just because there is a pedestrian crosswalk you should not expect cars to stop for you when entering or much less to slow down if you are already in the crosswalk.
5. The person that is speaking that “funny” language and who is labeled “the foreigner” is now you.
6. You will no longer get ice in your beverage without asking and asking for ice is a sure give-away of your nationality.
7. If you do not manually open the door to the elevator once reaching your designated floor, it will start going back down. The doors are not automatic.
8. When visiting a restaurant, if ketchup is not already present on your table this is a good hint that you will likely have to pay for it.
9. When a cab driver says he will take a “short cut” you probably will end up paying a bit more than if you were to go the “long way.”
10. Energy usage charges vary according to the time of day. Therefore night energy is cheaper than energy used during peak daytime hours.
11. When the expiration date on your food appears as 02/08/05 and it is already July, don’t worry; dates are written with the day first and the month second.
12. Don’t get too excited when the price for diesel reads: 1.67. The price is per liter and if you multiple this number by about 4 you will get the price per gallon. Ouch!
13. When asking for an item at the market and the salesperson nods left to right, don’t leave. They do have what you are asking for. Bulgarians nod opposite than Americans.
14. If the price on a pack of batteries is marked one lev, you should not get carried away and stock up, the price is per battery.
15. When speaking in the native language, people will laugh, but not to worry they are simply surprised and delighted that you have done so.

To Be Continued …

When Two Cultures Collide

By Kathryn Donev

In general it is believed that when any two individuals come together, in the midst there will be some sort of tension. The coming together or collision consequences in tension that is the result of differing opinions and viewpoints. One major origin of such strain or confusion is due to misinterpretation. What is said is viewed erroneously and internalized or personalized in error. Furthermore, when this phenomenon occurs with two individuals from differing cultures, there is greater opportunity for misapprehension. It has been said that whatever is perceived by an individual is the true reality for that particular person. Meaning, how ever one views an event, even if falsely done, is what actually took place in that individual’s personalized world. It is such concept that must be taken to heart in order to genuinely be culturally sensitive. When two cultures collide there must be open-mindedness and understanding of another’s world view. Yet, the straightforward part is to understand this concept and the difficult part is to place such concept into actuality.

Group Work

by Kathryn Donev

Group work is an interesting phenomenon in and of itself. It even reflects scripture in that the Bible commands us to not forsake social gatherings. We are a being that will not function properly if left alone. Thus, simply being in a group setting provides for a reconstructive and supportive experience, which is needed for healthy development.

Some common themes of group work which appear to be most instrumental in producing change is of course being in relationship with others and then there is the concept of universality. Support groups provide to each member the feeling that he or she is not alone. Members in a group setting realize that their feelings which were once thought of as unique, are the same feelings that other members are experiencing. In knowing that one is not alone, he or she is able to take place in a reconstructive cognitive experience in which he or she is able to think more clearly on a particular issues. Being in fellowship with others, allows for us to become less self-centered and become more altruistic.

In being aware of the need for social support and in understanding that leading a group can be physically and emotionally consuming, a group leader must also realize the need to find support for him or her self. It is important to not take on the burdens of others if one is not able or ready to do so.

Notes on a 30-day fast

Day 1: Read Haggai 1-2. The fast has begun. I am waiting on the Lord. Fasting must be a great tool for God, if he calls us to do days and weeks of denial not only from food, but from the boundaries of economical and political systems, of human laws which demand food and of personal desires which starve and die when subjected under His command to fast.

Day 3: I am not hungry at all. I feel a bit lighter and can actually feel my body cleansing itself. My resting while sleeping is even better than before and my mind is much clearer and focused. Read Song of Solomon 5:8.

Day 4: Still not hungry at all. Now, I understand how Jesus fasted for 40 days and hungered only after that.

Day 5: Read Matthew 27:3 and realized that the ones who betray do come back repenting.

Day 6: Read Matthew 27:7 and noticed the word “strangers.” I am a little bit hungry.

Day 8: God spoke to me face to face.

Day 9: God confirmed His word from yesterday. It has been awhile since I have been able in such a way to feel the heavens open with every second spent in the presence of God. I am not hungry at all.

Day 11: It is quite true that the flesh dies during fasting. But the dying of the flesh goes much further than the weakness of the body. Along with the flesh, die the desires of the flesh, and all human desires, along with the desire to hurt others when we are hurt and even the desire to be ourselves, until only the desire to be like Him remains in us.

Day 15: Not hungry. Read Isaiah 58 about fasting:
1. Is. 58:2 These were people who wanted to find God, but did not want to be found by Him, for when a person is found by God all human plans must be left behind in order for the will of God to be done.
2. Is. 58:3 Require all your things from God, may mean that they fasted with the intention to receive something from God, while God sees fasting as a way to bring His plans to realization.
3. Is. 58:4 Not the many words from v. 3, but their fasting was heard before God.
4. Is. 58:5 Definition of humbleness in fasting, which is clearly not passive but it is an action. This action is clearly defined by God with 8 verbs directed outward producing results around the person (v. 6-7), and 4 verbs directed inward producing results within the person (v. 13).
5. Contrary to all human understating not the proper foods, but the absence of food brings health (v. 8) and strength (v. 11).

Day 17: Woke up extremely hungry. Read Psalm 25. God spoke to me through Isaiah 43:5; I now understand what it means that a man shall live not by bread alone, but with every word of the Lord.

Days 26: A series of radical changes and answers to prayer occurred in unexpected ways – unexpected because they were not natural ways that one may anticipate or understand naturally, but rather supernatural and miraculous. Walls which had been built for decades fell and situation which had been developed for generations and centuries came together in a divinely inspired plan which changed the past, the present and will change the future. These were accompanied by heavy anointing during prayer which cannot be described except as an open channel of communication with God.

Day 27: As the end of the fasting approaches, the body feels more and more hungry. Brief blackouts and lack of balance become more frequent. However, prayer time has advanced into an absolutely clear line of communication. While attempting to pray with a certain list of needs, the Spirit audibly and visibly shows places, people, situations and plans for the future which carry meaning so higher that the prepared list of prayer needs seems inadequate in the presence of God. His plan becomes real and its reality is so strong that every other thought, feeling and even physical and emotion sensations looses meaning as one realizes their triviality and temporality in comparison with the supremacy and allness of God.

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