Ethics Coverage at This Year's Annual AASECT Conference

In less than a month, AASECT members will gather in Monterey, California for the organization's 46th annual conference. In addition to the many opportunities to mingle with fellow industry luminaries, the conference schedule is rife with sessions on everything from sex education tools to classroom-based slut-shaming to the latest research on female kink. 

In giving you a glimpse at what you have to look forward to, however, we at Contemporary Sexuality would like to hone in on the diverse range of ethics workshops on the program. Especially considering that issues of ethics are an essential part of the foundation of the work AASECT members do, whether educator, counselor, or therapist.

Why You Should Add Ethics Workshops To Your Conference To-Do List

As presenter Chris Fariello, PhD, MA, LMFT, CST, CSE, CSSP, says, "Ethical considerations are an important underpinning to my work, especially sex therapy." 

When asked how, in particular, ethics play a part in his work, he adds, "Clients  — and even therapists — are not typically aware of what a dual relationship is and may not be skilled enough to manage personal boundaries. As a teacher and a supervisor, I address a variety of ethical concerns, including issues of sexual feelings in clinical practice. Students are often appreciative of learning these skills as part of their training."

Sara Oswalt, MPH, PhD, CSE, whose focus is on education, finds that attention to ethics helps guide her work in a different way. "I use ethical principles as a way to understand differences of opinion," she says. "Understanding ethical principles and how they guide individuals' perspectives becomes the foundation when we discuss issues that may be controversial, or if differing opinions arise in classroom discussions."

One of Oswalt's fellow presenters, Heather Eastman-Mueller, MS, PhD, CHES, CSE, who educates future educators, adds to this. "Every day, I teach students about ethics. I am in charge of 20 undergraduate peer educators and we are constantly talking about our spheres of influence and what it means to represent ourselves, our health center, and our institution. It is a difficult concept for undergraduate students to grasp as often they have not been given the opportunity to think through what their actions are and how that will affect others."

In giving her students a grounding in ethics, Eastman-Mueller prepares them for the challenges that can often arise in the classroom environment among those who come to the topic of sexuality from varying backgrounds, and with differing biases and viewpoints.

The Difficulties Inherent in Incorporating Differing Codes of Ethics

Of course, every industry has its own code of ethics and, as AASECT members tend to have their hands in many different pots, these codes can overlap and, sometimes, contradict each other. This is just one more reason it's important to continue educating oneself on the evolution of various laws and codes as things shift over time. 

In interviewing workshop presenters for this piece, I found that — as industry professionals grapple with these multiple codes — they each find their own way of achieving a sort of balance.

Karen Engebretsen-Stopczynski, PsyD, DABPS, DNBAE, DAPA, FACAPP, FAAIM, DAC, CHT, CST, DABS, says, "Where there becomes a dilemma is where ethics is dissonant with the law. It might be ethical for me to do something but, on the other hand, it might be illegal for me to do what's ethical." 

She expands upon this, mentioning, for one, Tarasoff vs. Regents of the University of California. In this case, the Supreme Court of California held that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient, superseding their patient's right to confidentiality. The original 1974 decision mandated warning the threatened individual, but a 1976 rehearing of the case by the California Supreme Court called for a "duty to protect" the intended victim.

This is only one example in which the courts have overruled a typical, therapeutic ethical code. 

"Ethical codes do typically overlap," admits Fariello. "However, if there appears to be any conflict, I encourage that the therapist defer to the more stringent ethical code." 

Eastman-Mueller adds, "Every day, we as sexuality educators are faced with meeting the needs of the masses and still being held accountable to our administration. Oftentimes, they are not good bedfellows. It comes down, for me, to: what does my gut tell me to do? Can I sleep at night? Would what I am doing or the messaging I am sending out be okay with our top administrators? I call it the belly button radar. If something does not sit well with me, more than likely it is something I need to reconsider."

Varying Issues of Ethics in the Field of Sexuality

What are other ethics issues that commonly come up today? Stephanie Buehler, PsyD, MA, MPW, CST, CSSP, another conference presenter, says, "I would say that ethics trails behind in some ways. It is strange to me that so little training is required in human sexuality, for example. If psychotherapists aren't trained to treat these problems, then who is supposed to?" 

She also brings up a newer dilemma. "The issue of being able to treat people across state lines is very blurry," says Buehler. "Telemental health is becoming more accepted, but therapists are still required to practice only in the state in which they are licensed, which limits consumer choice."

Fariello echoes the point Buehler makes about training and certification requirements. "I tend to be a stickler for consistency in qualifying/licensing people in their specialty areas," he says. "I supervise students from different schools and different states. Each program has unique clinical requirements, yet the licensure they eventually obtain is the same. I would like to see greater consistency in training standards for clinical professionals as well as certification requirements. I believe AASECT has been aware of this issue and has recently begun to make efforts to create a more consistent certification process. The next step will be to identify the states that have LCSW and see them differently from LSW in those states."

And then there are the issues they're addressing at this year's conference, yet another example of how questions of ethics can directly touch upon so many different aspects of a sexologist's career.

Fariello's presentation, for example, is titled "Pros & Cons of Keeping Secrets in Couples Sex Therapy: Ethical Considerations." "During my training experience," he says, "I was taught to let clients know that I would not keep secrets. It was even suggested that I should only meet with the couple so as to not put myself in a boundary conflict." 

While Fariello hewed to his training, over time, he began to notice the limitations inherent in the rules he was following. "I learned that I missed out on a great deal of therapeutic opportunity," he says. "Clients would often lie to keep the secret or terminate therapy." 

He continues. "As a sex therapist, I deal with many issues that feel so private for people. I have been asked by clients not to reveal many issues from their past, such as drug abuse, abortions, affairs, and sexual behaviors. It seems that almost on a weekly basis I am asked to keep in confidence some important pain that needs to be worked through but is only shared in confidence." These are all issues he plans to explore in his workshop on Friday, June 6 from 9 a.m. - 10 a.m.

Oswalt, Eastman-Mueller, and  Joleen Nevers, MAEd, CHES, CSE  are giving a workshop titled "How Do I Answer That? Answering Difficult Questions Through an Ethical Framework." Taking place Saturday, June 7, from 9 a.m. - 10 a.m., their presentation brings attendees into the classroom and explores the ways in which personal, professional, and institutional principles affect ethics.

Engebretsen-Stopczynski is giving a workshop on the "Therapist as Victim of Emotional Terrorism: Ethical and Supervision Issues" on Friday, June 6, from 10:30 a.m. - 12:30 p.m. "As someone who has been psychoanalytically trained," she says, "I'm probably much more in tune with transference and counter-transference." During Hurricane Wilma, she suffered $20,000 worth of damage. "I was very aware of the things I had lost," she says. "A therapist can get distracted by what's going on in their own thoughts and feelings instead of paying attention to the patient."

More recently, because of another personal struggle, she made a decision that it was not right for her to work with sex offenders. "In my particular presentation," she says, "I'll give case examples of how I'm hearing my patients differently. I need to make a living but, at the same time, I want to make sure I don't hurt patients. We have a Hippocratic oath to do no harm. I don't want personal issues from my own life to spill over and cause me to make a mistake."

Similarly to Fariello, Buehler is also tackling ethics within the context of couples therapy. Her workshop, taking place on Friday, June 6 from 2 p.m. - 3 p.m., is called "Ethics in the Therapist-Couple Tap Dance." "As a supervisor," she says, "the issue of who the client is comes up quite a bit. Therapists really do want to help and mean well, but sometimes I will hear a situation that raises some ethical questions, such as when a therapist is doing couples therapy and individual work. This can constitute a dual relationship, which is prohibited in ethics guidelines."

Considering the variety of educational opportunities on offer at the conference, all of these presenters hold out hope that they'll have the time to check out other things on the schedule.

"There are so many interesting presentations," says Fariello. "I think because I am doing a workshop on keeping secrets, I am interested in Stephanie Buehler's presentation on Ethics in the Therapist-Couple Tap Dance. It seems as if she will be talking about what happens when a secret is disclosed. We will not be spending time on this in my workshop, but it is an important consideration when keeping secrets."

Oswalt says, "I tend to look for sessions that will enhance my expertise as an instructor... so either pedagogical techniques or content that I should include/expand in my courses. The following three would fit that goal:

• Slut-Shaming & Stud-Baiting: The Courageous Bystander Model in the Classroom, Presenter: Catherine Dukes, PhD
• Teaching Pleasure: Best Practices, Presenters: Laura Rademacher, MA, LAMFT, Lindsey Hoskins
• Positive Notions of Childhood and Adolescent Sexual Development, Presenters: Stephen Duclos, MS/MSW, CST, CRC, Jessica Price, MSW"

Buehler also has her eye on a number of different workshops. "I see a workshop on lesbian couples facing infertility," she says, "which is a unique topic, and I do treat couples who have infertility and sexual problems. I also see a workshop on developing competency in offering a SAR, which I know my associate Liz Dube, MFT and I will need to attend because we are offering a SAR this fall." 

There's no question that AASECT's 2014 annual conference has something for everyone. Still, the sheer number of ethics-related presentations alone at this year's conference is a testament to the fact that ethics in particular continues to be an important topic area, rich for further exploration.

Clinicians can choose to learn more about the ethics behind keeping secrets in couples and sex therapy, or they can investigate issues of transference and counter-transference. Educators can learn techniques about discussing controversial topics in the classroom.

And even outside the bounds of the conference schedule, there are an endless array of ethics-related issues ripe for discussion: dual relationships, overlapping codes of ethics, issues of licensing, telemental health and interstate therapy...

The beauty of the annual conference is that educational opportunities exist inside and outside the realm of formal presentations. With the chance to finally interact with fellow sexuality professionals face to face, there's no limit to the things you might learn.