4.4 The Nine-Stage Model

The nine-stage ethical decision-making model is one of the most widely used and accepted models in counseling. Developed by Barnett & Johnson (2015), it attempts to integrate the “best” components of previous ethical decision-making models and scholarly ethics literature (Barnett & Johnson, 2008; Cottone & Tarvydas, 2006; Forester-Miller & Davis, 1996; Kitchener, 1984) into a single cohesive model.

The nine-stage model consists of the following steps. The following is adapted from Barnett & Johnson (2015) as influenced by the work of Barnett & Johnson (2008), Cottone & Tarvydas (2006), Forester-Miller & Davis (1996), and Kitchener (1984).

Stage 1: Define the Situation

• Explain the nature of the situation.
• Gather and list as many relevant facts as possible.
• Note the primary ethical dilemma.
• Begin consideration of ethical issues and obligations.

Stage 2: Determine Who Will be Impacted

• Identify primary and secondary stakeholders.
• Identify your professional obligations to each stakeholder.
• Identify the rights of each stakeholder involved.
• Consider the possibility of harm.
• Begin exploring potential impacts on stakeholders involved.

Stage 3: Refer to Ethical Codes and Principles

• Consider how you are promoting core counseling values such as autonomy, beneficence, fidelity, non-maleficence, and veracity.
• Review ethical codes you have pledged to abide by (E.g. ACA, NAADAC) as well as other codes relevant to your profession.

Stage 4: Refer to Laws, Regulations, and Organizational Policy Relevant to the Dilemma

• Review legal statutes relevant to your profession.
• Consult organizational policies.
• Arrange consultation with a legal professional if necessary.
• Seek consultation when ethical and legal obligations conflict.

Stage 5: Reflect on Personal Feelings, Reactions, and Competencies

• Explore your thoughts and feelings regarding the situation.
• Consider the possibility of countertransference.
• Consider whether personal feelings or countertransferential reactions are impairing your ability to act objectively.
• Reflect on your past education, experience, and training. Consider whether you are appropriately equipped to deal with the situation effectively.

Stage 6: Consult with Trusted, Honest, and Competent Colleagues

• Carefully choose one or more colleagues who you trust to provide honest and competent feedback.
• Look for an individual who embodies the core tenets of the ethical codes and will respect provider and client confidentiality.
• Prepare a presentation of the key facts and ethical dilemmas to facilitate a productive consultation.

Stage 7: Determine Alternative Courses of Action

• Given everything you have learned from previous analysis and consultation, consider your full range of potential options.
• Consider both the feasibility and ethical/legal/organizational implications of your actions.

Stage 8: Consider Potential Outcomes

• Explore potential impacts on all previously identified stakeholders.
• Consider the risks and benefits associated with these outcomes.
• Consider how potential outcomes align with your ethical and legal obligations.
• Document your reasoning process.

Stage 9: Decide on a Course of Action and Monitor Outcomes.

• Based on the ethical decision making process, choose an appropriate course of action.
• Discuss your decision and rationale with affected stakeholders.
• Take full responsibility for your decision and its associated consequences.
• Monitor the outcomes of your decision and modify your course of action as needed.
• Document each stage of the decision making process and continue to document any outcomes and changes made.