Theory and Practice of Couples and Family Counseling. James Robert Bitter

      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, and service. We find many of these same themes in the thoughts of Plato (380 B.C.E./1992) and most subsequent philosophers in Western societies. These Western traits were formulated for and assigned to individuals who sought to live a good life in relation to others of similar status and condition.

      As Aristotle (350 B.C.E./1985) noted, there are certain preconditions to such virtuous action, and again each of these preconditions must be held by the individual or it invalidates virtue. Included in the preconditions are free will and voluntary action, the capacity for rational decision-making, the intention of achieving rational ends, and choice (or the power to enact either good or evil). These individual conditions have, for the most part, been enshrined in each of the codes of ethics that address professional practice in the helping professions. But what does this mean for cultures and societies in which the individual is not the most important character in the determination of moral action, as is true for many Asian countries? And what does it mean for the systemic therapies that approach the work relationally rather than individually? Do systemic therapy masters have anything to add to a conversation about individual virtue or goodness and a good society (or system)?

      Systemic Perspectives

      Perhaps the most fully developed individual and systemic positions on virtue come from Adler (1927/1957, 1933/1938). Adler posited that the nature of human beings was to be connected to and in relationship with others. He called the capacity for such connectedness a community feeling (Gemeinschaftsgefühl). The enactment of a community feeling was characterized by the taking of an active social interest in the wellness of others. Not only was this the basis for virtue, but by extension it was also the basis for individual and family mental health.

Heinz Ansbacher (1992) addressed and clarified community feeling and social interest, noting that a community feeling is related to the feeling of being in harmony with the universe and with the development of life throughout time. He called social interest “the action-line of the community feeling” (p. 405): the practical implementation of an interest in the well-being of others. To Ansbacher’s description of social interest we would add the following traits found in the writings of many Adlerians: cooperation, contribution, caring, connectedness, courage, confidence, and competence (what might be called the 7 Cs).

      McGoldrick (2016) spoke to this community feeling when she suggested that

      we human beings need to appreciate that we are all connected to each other and to the earth, to the past and the future of each other and our planet. So making the best choices means aiming towards positive connectedness with family, friends, community, coworkers, and nature that surround us. (p. 2)

      Although Adler may have had the most developed perspective on what constitutes a good life, he was not the only systemic thinker to contribute to this discussion. Other family therapists have developed models that directly or indirectly suggest a diversity of values, virtues, and qualities of a good life.

      Kerr and Bowen (1988) highly valued rational thought and placed it in opposition to emotional reactivity, but the true test of a differentiated self was the ability to stay calm and observant in the midst of often emotionally charged personal family systems. It was in elevating one’s rational responsiveness that whole systems had a chance to change (Kerr, 2019).

      Satir (1964/1983) wrestled with the same concerns for the individual in relation to the system. For her, however, the answer was not in rational thought but in emotional honesty communicated congruently in the present moment. The mark of maturity could be seen in “one, who having attained his [sic] majority, is able to make choices and decisions based on accurate perceptions about self, others, and the context . . . ; who acknowledges these choices and decisions . . . ; and who accepts responsibility for their outcomes” (p. 118).

      One of the virtues that emanates from the work of both Bowen and Satir is the value of clarity of both mind and heart. Both masters knew that such clarity came from reflection and from a refusal to act based on automatic reactions. Although Whitaker (1976) appeared to value spontaneity of experience over all else, including reflection, in practice his interventions were designed to do many of the same things that Bowen and Satir valued: (a) release the family from self-imposed constrictions; (b) augment freedom of movement and expression; and (c) help family members find a balance between individuation and connectedness, dependence and